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Commonly used classes of drugs in patients with CKD that may act as substrates, inhibitors or inducers of CYP3A4 and CYP2D6 and therefore may affect opioid metabolism and effect. CYP2D6, cytochrome P450 2D6 enzyme; CYP3A4, cytochrome P450 3A4 enzyme; SNRIs, serotonin-norepinephrine reuptake inhibitors; TCAs, tricyclic antidepressants.
