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Ketoconazole and itraconazole pharmacokinetic interactions are due to their inhibition power on liver and intestinal cytochromes P450 3A4 and on intestinal P-glycoprotein. Cytochromes inhibition leads to a reduced extent in metabolism which in turn responsible for a reduced hepatic first pass effect and a reduction of the elimination rate. PGP inhibition alters drugs efflux from the intestine cells to the intestinal lumen and therefore increases absorption. These mechanisms lead to increased drug concentrations, possibly toxic with severe or sometimes lethal consequences.  相似文献   

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