transplant rejection
2 interactions related to transplant rejection
cyclosporine + st. john's wort
St. John's wort is a potent inducer of CYP3A4 and P-glycoprotein, which dramatically accelerates cyclosporine metabolism and efflux. Co-administration reduces cyclosporine blood AUC by roughly 40-50%, producing subtherapeutic levels that have caused documented acute organ rejection in heart, kidney, and liver transplant recipients.
cyclosporinest johns worthypericumtransplant rejectioncyp3a4immunosuppressantherb drug interactionp-glycoprotein
tacrolimus + st. john's wort
St. John's wort induces CYP3A4 and P-glycoprotein, slashing tacrolimus blood concentrations and risking acute graft rejection. Conversely, abrupt discontinuation of the herb can unmask tacrolimus nephrotoxicity as levels rebound.
tacrolimusst johns worthypericumtransplant rejectioncyp3a4nephrotoxicityp-glycoproteinimmunosuppressant