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Metabolism: Drugs are usually eliminated from the body as either the unchanged (parent) drug or as a metabolite that has been changed in some way. Enzymes in the liver, usually the CYP450 enzymes, are often responsible for breaking down drugs for elimination from the body. However, enzyme levels may go up or down and affect how drugs are broken down. For example, using diltiazem (a blood pressure medication) with simvastatin (a medicine to lower cholesterol) may elevate the blood levels and side effects of simvastatin.

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