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The enhanced bioavailability of tamoxifen by curcumin may be mainly due to inhibition of the CYP3A4 mediated metabolism of tamoxifen in the small intestine and or in the liver and to inhibition of the P gp efflux transporter in the small intestine rather than to reduction of renal elimination of tamoxifen, suggesting that curcumin may reduce the first pass metabolism of tamoxifen in the small intestine and or in the liver by inhibition of P gp or CYP3A4 subfamily is furosemide same as lasix