Fig. 3
From: Drug–drug–gene interactions and adverse drug reactions
Different scenarios of phenoconversion interactions where genetic effects may be reversed or shifted in the opposite direction. a Represents the normal scenario with no interacting drug or genetic variant. In b the effect of loss-of-function variant (LOF) or gain-of-function variant (GOF) is reversed with the presence of a moderate inducer drug or a moderate inhibitor drug respectively and results in a clinical outcome similar to the normal situation (a). In c the presence of a strong inducer drug has temporarily shifted a poor metabolism status into a rapid metabolism status and results in decreased active drug in the systemic circulation. In d the presence of a strong inhibitor drug has temporarily shifted a rapid metabolism status into a poor metabolism status and results in increased active drug in the systemic circulation
