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Serotonin can then be converted into melatonin with the help of a SAM-dependent methylation reaction this again shows an interconnection to the methionine cycle

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Adverse Reactions/Side Effects The following serious adverse reactions are described below or elsewhere in the prescribing information: Risk of Thyroid C-cell Tumors [see Warnings and Precautions (5.1)] Severe Gastrointestinal Adverse Reactions [see Warnings and Precautions (5.2)] Acute Kidney Injury Due to Volume Depletion [see Warnings and Precautions (5.3)] Acute Gallbladder Disease [see Warnings and Precautions (5.4)] Acute Pancreatitis [see Warnings and Precautions (5.5)] Hypersensitivity Reactions [see Warnings and Precautions (5.6)] Hypoglycemia [see Warnings and Precautions (5.7)] Diabetic Retinopathy Complications in Patients with Type 2 Diabetes Mellitus [see Warnings and Precautions (5.8)] Pulmonary Aspiration During General Anesthesia or Deep Sedation [see Warnings and Precautions (5.9)] 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice