Upon entering the cell, inorganic sulfate is activated/adenylated using ATP to form adenosine phosphosulfate (APS) by ATP sulfurylase and then phosphorylated to form PAPS by the magnesium-dependent APS kinase activity [13,14]
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Once this dose is tolerated, the dose increases to 7mg for 30 more days
Warning signs that require immediate medical attention include severe, persistent abdominal pain that radiates to the back, nausea and vomiting that do not improve with usual anti-nausea strategies, and abdominal tenderness that worsens over hours rather than improving