The nuclear receptors CAR and PXR activate hepatic genes in response to therapeutic drugs and xenobiotics, leading to the induction of drug-metabolizing enzymes, such as cytochrome P450. Insulin inhibits the ability of FOXO1 to express genes encoding gluconeogenic enzymes. Induction by drugs is known to be decreased by insulin, whereas gluconeogenic activity is often repressed by treatment with certain drugs, such as phenobarbital (PB). Performing cell-based transfection assays with drug-responsive and insulin-responsive enhancers, glutathione S-transferase pull down, RNA interference (RNAi), and mouse primary hepatocytes, we examined the molecular mechanism by which nuclear receptors and FOXO1 could coordinately regulate both enzyme pathways. FOXO1 was found to be a coactivator to CAR-and PXR-mediated transcription. In contrast, CAR and PXR, acting as corepressors, downregulated FOXO1-mediated transcription in the presence of their activators, such as 1,4-bis[2-(3,5-dichloropyridyloxy)]benzene (TCPOBOP) and pregnenolone 16␣-carbonitrile, respectively. A constitutively active mutant of the insulin-responsive protein kinase Akt, but not the kinase-negative mutant, effectively blocked FOXO1 activity in cell-based assays. Thus, insulin could repress the receptors by activating the Akt-FOXO1 signal, whereas drugs could interfere with FOXO1-mediated transcription by activating CAR and/or PXR. Treatment with TCPOBOP or PB decreased the levels of phosphoenolpyruvate carboxykinase 1 mRNA in mice but not in Car ؊/؊ mice. We conclude that FOXO1 and the nuclear receptors reciprocally coregulate their target genes, modulating both drug metabolism and gluconeogenesis.Liver plays a major role in the metabolism of therapeutic drugs and environmental contaminants. It is endowed with a mechanism to induce hepatic enzymes, leading to increased detoxification and elimination of those xenobiotics. Drug induction is generally regulated by transcriptional activation of hepatic genes encoding drug-metabolizing enzymes, such as cytochrome P450s (CYPs) and specific transferases. Acting as the principal transcription factors which also form complexes with RXR, the nuclear receptors CAR and PXR play a central role in induction by binding to the phenobarbital (PB)-and xenobiotic-responsive enhancer modules PBREM and XREM (5,6,11,12,18,46,53), respectively, and activating transcription of their target genes, such as CYP genes, in response to a distinct but overlapping group of xenobiotics (23, 36, 50). However, induction is heavily influenced by endocrine conditions; glucocorticoid hormone, for example, augments CYP induction by PB (31). In contrast, insulin is known to repress the induction of drug-metabolizing activity by certain drugs and in diabetic livers (44,49,56). Insulin treatment either eliminated or significantly reduced PB induction of CYP2B in rat primary hepatocytes (17,42,58). Hepatic CYP2B, CYP3A, and CYP4A were increased in experimentally generated diabetic rats and mice and were reduced to normal levels by insulin treatmen...