Answer
Answer
Pharmacokinetic interactions that affect hepatic metabolism occur via the following mechanisms:
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Via the cytochrome P450 enzyme system (most drugs)
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CYP3A4 is the most common enzyme responsible for drug metabolism
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Via the uridine diphosphate (UDP)-glucuronosyltransferase (UGT) 1A1 enzyme: Metabolism of INSTIs dolutegravir (DTG) and raltegravir (RAL)
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The INSTIs bictegravir and dolutegravir have mixed metabolic pathways, including both CYP3A4 and UGT1A1
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