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, the enzyme and transporter that clear cyclosporine. Taking the two together markedly lowers cyclosporine blood levels, which can render the drug subtherapeutic. This has caused documented acute organ rejection in transplant recipients, making the combination a contraindication.
cyclosporinest johns worthypericumtransplant rejectioncyp3a4immunosuppressantherb drug interactionp-glycoprotein
tacrolimus + st. john's wort
St. John's wort induces the CYP3A4 enzyme and the P-glycoprotein transporter, which speeds up clearance of tacrolimus and lowers its blood levels, raising the risk of transplant rejection. Stopping the herb after the body has adjusted can let tacrolimus levels rebound, which has been linked to kidney toxicity.
tacrolimusst johns worthypericumtransplant rejectioncyp3a4nephrotoxicityp-glycoproteinimmunosuppressant