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Breakouts become frequent

While the passive technique focuses on drug and vehicle interaction and optimization to affect the stratum corneum structure, the active approach utilizes external energy to facilitate the transportation of drugs through the skin or by physically disrupting the outermost layer of the skin, known as the stratum corneum [230, 231]

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DO NOT use strong CYP3A4 and P-glycoprotein inhibitors or inducers with DOACs and DO periodically assess for such DDIs