“…The reason for the altered pharmacokinetics of Hf when co-administered with kolanut is currently unknown. Hf is known to be extensively metabolized by presystemic cytochrome P450 enzymes and, thus, increased plasma concentrations have been observed when the drug is taken with grapefruit juice [15], tetracycline [14] or after pretreatment with ketoconazole [18]. In contrast, decreased plasma concentra- tions were observed when Hf was co-administered with antacid drugs due to adsorptive effects [19].…”