An oral supplement has to travel through your digestive tract, survive stomach acid, bind to a protein called intrinsic factor, and be absorbed in the small intestine
News reports state that everyone from shadowy online vendors to physicians and nurses is illegally promoting the drug before it receives the FDA approval

Abbreviations 5-HIAA: 5-Hydroxyindoleacetic acid 5-HT: Serotonin (5-hydroxytryptamine) BBB: Bloodbrain barrier BDNF: Brain-derived neurotrophic factor cAMP: Cyclic adenosine monophosphate CRH: Corticotropin-releasing hormone CRP: C-reactive protein DPP-4: Dipeptidyl peptidase-4 GABA: Gamma aminobutyric acid GLP-1: Glucagon-like peptide-1 GLP-1R: Glucagon-like-1 peptide receptor GLP-1RA: Glucagon-like-1 peptide receptor agonist HPA: Hypothalamicpituitaryadrenal axis Icv : Intracerebroventricular Ip : Intraperitoneal IL-1: Interleukin-1 beta IL-6: Interleukin-6 NF-B: Nuclear factor kappa-light-chain-enhancer of activated B cells NTS: Nucleus tractus solitarius PKA: Protein kinase A PPG: Preproglucagon PVN: Paraventricular nucleus SCFA: Short chain fatty acid T2DM: Type 2 diabetes mellitus TNF-: Tumor necrosis factor alpha VTA: Ventral tegmental area References Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, et al
Lee E et al
It was also concluded that the use of an antiseptic mouthwash, or anything else that disrupts the oral microbiome, will disrupt the conversion of beetroot nitrates into nitrites to reduce the effectiveness of beetroot production with potential negative impacts on cardiovascular health and exercise performance
G-Protein Coupled Receptors (GPCRs): Signaling Pathways, Characterization, and Functions in Insect Physiology and Toxicology