mean responses (usually of AUC and the maximum concentration, Cmax) of its product to that of the "brand name drug" is within the limits of 80% to 125%. Where AUC refers to the concentration of the drug in the blood over time t = 0 to t = ∞, Cmax refers to the maximum concentration of the drug in the blood. When Tmax is given, it refers to the time it takes for a drug to reach Cmax. While the mechanisms by which a formulation affects bioavailability and bioequivalence have been extensively studied in drugs, formulation factors that influence bioavailability and bioequivalence in nutritional supplements are largely unknown. As a result, in nutritional sciences, relative bioavailability or bioequivalence is the most common measure of bioavailability, comparing the bioavailability of one formulation of the same dietary ingredient to another. Factors influencing bioavailability The absolute bioavailability of a drug, when administered by an extravascular route, is usually less than one (i.e., F< 100%). Various physiological factors reduce the availability of drugs prior to their entry into the systemic circulation. Whether a drug is taken with or without food will also affect absorption, other drugs taken concurrently may alter absorption and first-pass metabolism, intestinal motility alters the dissolution of the drug and may affect the degree of chemical degradation of the drug by intestinal microflora. Disease states affecting liver metabolism or gastrointestinal function will also have an effect. Other factors may include, but are not limited to: Physical properties of the drug (hydrophobicity, pKa, solubility) The drug formulation (immediate release, excipients used, manufacturing methods, modified release – delayed release, extended release, sustained release, etc.) Whether the formulation is administered in a fed or fasted state Gastric emptying rate Circadian differences Interactions with other drugs/foods: Interactions with other drugs (e.g., antacids, alcohol, nicotine) Interactions with other foods (e.g., grapefruit juice, pomello, cranberry juice, brassica vegetables) Transporters: Substrate of efflux transporters (e.g. P-glycoprotein) Health of the gastrointestinal tract Enzyme induction/inhibition by other drugs/foods: Enzyme induction (increased rate of metabolism), e.g., Phenytoin induces CYP1A2, CYP2C9, CYP2C19, and CYP3A4 Enzyme inhibition (decreased rate of metabolism), e.g., grapefruit juice inhibits CYP3A → higher nifedipine concentrations Individual variation in metabolic differences Age: In general, drugs are metabolized more slowly in fetal, neonatal, and geriatric populations Phenotypic differences, enterohepatic circulation, diet, gender Disease state E.g., hepatic insufficiency, poor renal function Each of these factors may vary from patient to patient