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1. CYP3A4 inhibitors: Gemtesa is primarily metabolized by the CYP3A4 enzyme. Concomitant use of strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, clarithromycin, or ritonavir, may increase Gemtesa exposure, leading to an increased risk of side effects. Monitoring for adverse reactions and dose adjustment may be necessary.