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The De Novo Pathway begins with the condensation of L-serine and a fatty-acyl CoA such as palmitoyl-CoA, myristoyl CoA, or stearoyl CoA at the endoplasmic reticulum catalyzed by the enzyme serine palmitoyltransferase (SPT) to form 3-ketosphinganine, which is then reduced to dihydrosphingosine by the NADH-dependent 3-ketosphinganine reductase (KDSR)

and step 3: stirring to dissolve and clarify the prepared solution, adding water for injection to full amount, and adjusting the pH value to 6.0-7.0 by using a 10% sodium hydroxide solution

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Lipo B12 is generally well-tolerated