Digoxin is a P-glycoprotein substrate

Digoxin is a P-glycoprotein substrate. A patient begins taking a supplement that induces intestinal P-glycoprotein. What pharmacokinetic change is most likely? a) Digoxin exposure increases because intestinal efflux decreases. b) Digoxin becomes extensively metabolized by intestinal CYP3A4. c) Digoxin absorption is unchanged because P-glycoprotein does not affect intestinal transport. d) Oral digoxin exposure decreases because more drug is transported back toward the intestinal lumen.