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Although the trans isomer is the most common form of presentation (since it is the most stable), it can also be found in the cis isomer (Rivire et al., 2012)

In particular, its overexpression increased cell proliferation, survival and motility in vitro and tumor formation in vivo

Am J Geriatr Pharmacother 7:3459

The mechanistic difference translates directly to side-effect profiles: cagrilintide causes nausea and vomiting in 3040% of subjects during dose titration (similar to GLP-1 agonists), while tesofensine produces insomnia, dry mouth, and increased heart rate in 2035% due to its sympathomimetic effects

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[2] Hydroxocobalamin is administered via intramuscular or intravenous injection to treat and prevent vitamin B deficiency, particularly in conditions like pernicious anemia where oral B absorption is impaired