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This effect may be due either to inhibition of carbamyl phosphate synthase (CPS) I by -oxidation metabolites (CPS I is the first mitochondrial enzymatic step of the urea cycle) or to decreased synthesis of N -acetyl glutamic acid (NAGA) from acetyl-CoA and glutamate by NAGA synthetase (NAGA is an important cofactor of CPS I)
Not every side effect means treatment must be stopped
Eriksson, J
This helps avoid an unnecessary timing conflict and makes the formulation easier to use consistently
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