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CDCA is an endogenous ligand for FXR, and its activation can reduce lipid absorption in intestinal cells and control lipid synthesis in liver cells ( in vitro studies have shown that simvastatin undergoes bioaccumulation in gut bacteria and is biotransformed by bacterial enzymes (e.g., from Lactobacillus and Bifidobacterium ), leading to delayed absorption and reduced concentration of simvastatin (71), ultimately weakening the lipid-lowering efficacy of simvastatin

Stephens FB et al