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It is reported that after administrated with metronidazole (500 mg twice daily) plus ciprofloxacin (500 mg once daily) for 1 week, near-complete suppression of detectable TMAO and d9-TMAO are observed under the challenge of phosphatidylcholine in both plasma and urine ( Application of TMA Formation Inhibitors In bacteria, there are several different enzyme systems involved in the conversion of TMA precursors to TMA that have been identified, including choline-TMA lyase (cutC/D), carnitine monooxygenase (cntA/B), yeaW/X TMA lyase, betaine reductase and TMAO reductase (Figure 3)
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