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While no single unifying mechanism has been established, the published literature identifies several distinct but potentially interconnected pathways through which BPC-157 exerts its observed effects

Concomitant use of hydrocodone bitartrate and acetaminophen tablets with a CYP3A4 inhibitor, such as macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), and protease inhibitors (e.g., ritonavir), may increase plasma concentrations of hydrocodone bitartrate and acetaminophen tablets and prolong opioid adverse reactions, and which may cause potentially fatal respiratory depression (see WARNINGS), particularly when an inhibitor is added after a stable dose of hydrocodone bitartrate and acetaminophen tablets is achieved

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Mackus et al., 2020)