CYP3A4 and osteomalacia: • CYP3A4 like CYP24A1 metabolizes 25OHD and 1,25(OH)2D in both the 23 and 24 positions and may play a major role in vitamin D catabolism in the liver and intestines. Drugs like rifampin that induce CYP3A4 can lead to osteomalacia.