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• PK causing decreased drug effects
• Drug binding in the gut: kaloin-pectin suspensions, aluminum-contaning antacids, bile acid sequestrants.
• alter gastric pH decreased the soluability and hense absorption of weak base such as ketoconazole
• expression of some genes resiponsible for drug elimination notable CYP3A4, ABCB1, can be markly incresed by inducing drugs
• inducing drugs: glutethimide, nevirapine
• smoking, chronic alcohol ingestion, exposure to chlorinated insectiside
• Interaction with drug delivery to intracellular cell site of action
• tricyclic antidepressants can blunt of clonidine by decreasing its uptake into adrenergic
• reduced CNS penetration of multiple HIV protease inhibitors appear attributable from P-glycoprotein-mediated exclusion from CNS, indeed inhibition of  P-glycoprotein has been purpose as a therapeutic appraoch to enhance drug entry into CNS