Figure 2.

The influence of gut microbiome on the metabolism of antihypertensive drugs. (A) Oxidation of amlodipine. Amlodipine is converted into dehydroamlodipine through the oxidation reaction of gut microbiome. (B) Oxidation of nifedipine. Biotransformation of nifedipine produces dehydronifedipine through gut microbiome. (C) Deacetylation of diltiazem. Diltiazem is converted into desacetyldiltiazem through the action of gut microbiome. (D) Deglucuronidation of losartan. Losartan is converted into losartan N2-glucuronide through the action of gut microbiome. (E) De-esterification of enalapril. Enalapril is converted into enalaprilat through the de-esterification reaction of gut microbiome.