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Updated: May 13, 2025

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Published on: March 28, 2017
Phase IV Metabolism: Gut Microbial Metabolism of Common Gastrointestinal Drugs
Deniz Coskuner1, Aadra Prashant Bhatt2
1Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, CB #7555, 130 Mason Farm Road, Chapel Hill, NC 27599-7555, USA.
Abstract:
Intestinal microbiota possess a plethora of biotransformation capabilities, which can modify medications, including their Phase I or II metabolites in a process termed "Phase IV" metabolism. Phase IV metabolism is emerging as a significant contributor to interindividual variability in drug responses. Here we present examples of gastrointestinal-relevant medications that are known to be subject to bacterial Phase IV metabolism and propose avenues to improve precision medicine by modulating these bacterial functions.
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