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Indeed, the first pass effect, or the extent to which a drug is metabolized by intestinal, hepatic, and microbial enzymes, is ultimately what determines the bioavailability of a drug (how much reaches circulation) and is subject to considerable variability depending on the presence or absence of certain microbes and enzymes

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Moreover, mistakes were mainly in the names of active pharmaceutical ingredients (APIs), such as exemastene instead of exemestane, anastrazole instead of anastrozole, and others

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However, ensuring the continuity, efficacy and safety of the treatment strategy remains a formidable challenge