Drug‐drug interactions can involve induction of cell membrane transporters. Deinduction refers to the time course for enzymes or drug transporters to return to normal activity and can be delayed beyond the time required for clearance of the inducing agent. Clinicians should consider deinduction when starting and stopping medications involving strong inducers.
Abstract
What is known and objective
Drug‐drug interactions can involve inhibition or induction of cell membrane transporters. Deinduction occurs after an inducing agent is stopped.
Case summary
This case describes suspected P‐glycoprotein (P‐gp) deinduction by carbamazepine resulting in a slow viral response during treatment of chronic hepatitis C virus (HCV) infection. Evidence of deinduction occurred beyond clearance of carbamazepine and resulted in extension of HCV treatment.
What is new
The understanding of the role P‐gp transport plays in drug elimination is relatively new and evidence of P‐gp deinduction is variable.
Conclusion
Clinicians should consider deinduction when starting and stopping medications involving strong inducers of P‐gp transport proteins.
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