68.有關repaglinide藥品交互作用之敘述，下列何者錯誤？
(A)與clopidogrel併用，會造成repaglinide血中濃度上升
(B)與cyclosporine併用，會造成repaglinide血中濃度上升
(C)與digoxin併用，會造成digoxin血中濃度上升
(D)與gemfibrozil併用，會造成低血糖風險增加

Clopidogrel Metabolism

1.Hepatic: Extensive

2.Thiol derivative (major): Active; metabolism differs based on CYP2C19 genotype, affecting the degree of antiplatelet effect.(以前藥理藥化考這裡) A poor metabolizer has 2 nonfunctional alleles. The approximate frequencies of poor CYP2C19 metabolizer genotypes are 2% in white patients, 4% in Black patients, and 14% in Chinese patients 

3.Clopidogrel: Substrate of CYP2C19, CYP1A2, CYP2B6, and CYP3A (現在臨藥考這裡)

4.Acyl-beta-glucuronide metabolite: Inhibitor of CYP2C8 (現在臨藥考這裡)

主要由UGT2B7代謝， It undergoes oxidation of the ring methyl group in the liver to form an hydroxymethyl and a carboxyl metabolite.

Inhibitor of CYP2C8，In vitro, gemfibrozil is only a weak inhibitor of CYP2C8, but glucuronidation converts gemfibrozil to a strong, irreversible, and selective CYP2C8 inhibitor.