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NDT Advance Access originally published online on July 26, 2005
Nephrology Dialysis Transplantation 2005 20(11):2554-2556; doi:10.1093/ndt/gfi003
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

Herbal teas interfere with cyclosporin levels in renal transplant patients

Rainer Nowack1 and Barbara Nowak2

Dialysis-Centers 1 Lindau/Bodensee and 2 Immenstadt i.Allgäu, Germany

Correspondence and offprint requests to: Dr R. Nowack, Dialysezentrum Lindau, Friedrichshafener Str. 82, D-88131 Lindau, Germany. Email: info@dialyse-lindau.de

Keywords: cyclosporin; cytochrome P450 enzymes; herbal teas; herb–drug interaction; pharmacokinetics

The first 10% of the full text of this article appears below.



   Introduction
 
After a successful renal transplantation, a high fluid intake of 2–3 l daily is generally advised to achieve a steady urine flow. To reach that goal, dieticians recommend herbal teas, since they regard them as biologically inert; in contrast to black tea, coffee, alcoholics or commercial fruit juices, which are either psychotropic or rich in calories.

However, herbal teas contain plant constituents of biological relevance for the consumer, and especially for transplanted patients treated with immunosuppressive medication.

We present here three renal transplant patients who drank herbal teas with a marked influence on cyclosporin metabolism.



   Cases
 
The first patient was a 48-year-old woman (weight 56 kg, height 165 cm) who received a cadaveric renal allograft in September 2000. After two severe rejection episodes, graft function had stabilized at a serum creatinine of 1.2–1.4 mg/dl and she received maintenance immunosuppression with cyclosporin, mycophenolate mofetil (MMF) and tapered steroids which . . . [Full Text of this Article]



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