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This is due to the inhibition of DNA synthesis (specifically purines and thymidine)

If you have additional risk factors, such as a vegetarian or vegan diet (which may be lower in B12-containing foods), a history of gastrointestinal surgery, or certain medical conditions like pernicious anemia, your healthcare provider may recommend monitoring your B12 levels and considering supplementation, including B12 shots if necessary

P., Bloch, A

Four proline residues, including an unusual triple-proline sequence, confer resistance to enzymatic degradation

Serious adverse events have not been widely reported, but this may reflect the relatively small number of people who have used the compound and the limited reporting mechanisms available