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The metabolism of many chemotherapeutic and endocrine medications is facilitated by cytochrome P450 (CYP) enzymes such CYP3A4, CYP2D6, and CYP2C9, which provide a significant obstacle due to drug-drug interactions (202)

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47 Despite these effects it remains possible that the use of a longer duration of creatine or usage of alternative approaches to inhibit conversion of L-arginine to GAA might have allowed for the testing of our hypothesis