▁with ▁the ▁strong ▁C Y P 3 A 4 ▁indu cer ▁rif amp ic in . ▁The ▁C max ▁was ▁reduced ▁by ▁ 5 4 % ▁and ▁the ▁area ▁under ▁the ▁curve ▁by ▁ 7 4 % ▁in ▁this ▁study . ▁ ▁Ph arm ac ology ▁ ▁Mechan ism ▁of ▁action ▁At ▁th era pe ut ic ▁concentr ations , ▁i x az om ib ▁select ively ▁and ▁revers ibly ▁in hib its ▁the ▁protein ▁prote as ome ▁sub unit ▁beta ▁type - 5 ▁( PS MB 5 ) ▁with ▁a ▁dis soci ation ▁half - life ▁of ▁ 1 8 ▁minutes . ▁This ▁mechanism ▁is ▁the ▁same ▁as ▁of ▁bor te z om ib , ▁which ▁has ▁a ▁much ▁longer ▁dis soci ation ▁half - life ▁of ▁ 1 1 0 ▁minutes ; ▁the ▁related ▁drug ▁car fil z om ib , ▁by ▁contrast , ▁blocks ▁PS MB 5 ▁irre vers ibly . ▁Prote as ome ▁sub un its ▁beta ▁type - 1 ▁and ▁type - 2 ▁are ▁only ▁in hib ited ▁at ▁high ▁concentr ations ▁reached ▁in ▁cell ▁culture ▁models . ▁ ▁PS MB 5 ▁is ▁part ▁of ▁the ▁ 2 0 S ▁prote as ome ▁complex ▁and ▁has ▁en zym atic ▁activity ▁similar ▁to ▁ch ym ot ry ps in . ▁It ▁indu ces ▁apo pt osis , ▁a ▁type ▁of ▁program med ▁cell ▁death , ▁in ▁various ▁cancer ▁cell ▁lines . ▁A ▁syn erg istic ▁effect ▁of ▁i x az om ib ▁and ▁len al id om ide ▁has