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Drugs that interact with grapefruit have all of the following characteristics: they are administered orally, they have very low to intermediate absolute bioavailability, and they are metabolized by the cytochrome P450 3A4 enzyme (CYP3A4)

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Evidence levels range from FDA-approved (for narrow indications) to purely preclinical

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There is a strong association between NAFLD and the metabolic syndrome with higher risk of NASH in those with underlying diabetes or obesity