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Cigarette smoking increases the risk of GD and complicates its extra thyroidal manifestations through direct cell damage, downregulation of the innate immune system, and induction of epigenetic changes (27-31)

Nature 224 , 117120 (1969)

However, verapamils dual effects on drug metabolism, particularly its inhibition of CYP3A activity, raise concerns about potential interactions with essential TB drugs like rifampin, which is known to induce CYP3A enzymes [87]