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Genetic Factors Alteration of the Transsulfuration Pathway One of the classic alterations of the homocysteine metabolism is represented by the homozygous deficiency of CBS (Mudd et al, 1995)

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Correcting for fu would then be reasonable, certainly for drugs with a volume of distribution greater than 0.5 L/kg ( V V TW fu/fu T ) and for predominantly metabolized drugs of low clearance ( CL = fu CL int )