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Important drug metabolizing phase I enzymes such as cytochrome P450 enzymes (CYP2C9, CYP2C19, CYP2D6 and CYP3A4) and phase II enzymes n-acetyltransferase 2 (NAT2), UDP-glucuronosyltransferase (UGT), thiopurine S-methyltransferase (TPMT) are located in the liver. These enzymes are encoded by specific genes and polymorphism of such genes may inhibit or increase enzyme activity. Besides genetic polymorphism, environmental factors and concomitant drug intake can modulate the activity of drug metabolizing enzymes. In this context, drug interactions can occur indirectly mediated through genes. This covert gene-drug interaction is an area of great clinical importance and needs to be investigated in detail.
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Subathra Adithan (2016) studied this question.
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