Interaction of Hypericum perforatum (St. John's wort) with cyclosporin A metabolism in a patient after liver transplantation
Interaction of Hypericum perforatum (St. John's wort) with cyclosporin A metabolism in a patient after liver transplantation
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DOI：
10.1016/s0168-8278(00)80321-9
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发表时间：
2000-11-01
影响因子：
25.7
通讯作者：
Broelsch, CE
中科院分区：
文献类型：
--
作者：
Karliova, M;Treichel, U;Broelsch, CE
Fiver移植后患者的免疫抑制治疗需要仔细监测免疫抑制剂如环孢菌素A的血液水平。多种药物能够干扰环孢菌素A的代谢。我们观察了一位63岁的患者，他在1998年接受了肝移植治疗隐源性肝硬化。这位患者在移植后14个月发生了严重的急性排斥反应，这与环孢素A水平的突然下降有关。两周前，他开始服用草药贯叶连翘（2x 900 mg/天），以增加抑郁症的发作。环孢菌素A的剂量后来不得不加倍，这引起了一些副作用。最后，口服环孢菌素A再吸收的评估表明环孢菌素A代谢增强。停用贯叶连翘，环孢素A用量及血药浓度立即恢复正常，肝功能完全恢复。总之，这一观察结果是一种广泛使用的草药（贯叶连翘，即圣约翰草）在肝移植后患者中先前未描述的药物相互作用。
Immunosuppressive therapy in patients after Fiver transplantation requires careful monitoring of blood levels for immunosuppressive agents such as cyclosporin A, A variety of drugs are capable of interfering with the metabolism of cyclosporin A. We observed a 63-year-old patient who received a liver allograft for cryptogenic liver cirrhosis in 1998, This patient developed severe acute rejection 14 months after transplantation which was associated with a sudden drop in cyclosporin A levels, Two weeks previously, he had started taking the herbal drug Hypericum perforatum (2x900 mg/day) for increasing episodes of depression. The cyclosporin A dosage later had to be doubled, which caused some side effects. Finally, an assessment of oral cyclosporin A resorption suggested an enhanced cyclosporin A metabolism. Hypericum perforatum was stopped, Both cyclosporin A dosage and blood levels immediately returned to normal, The liver function recovered completely. In conclusion, this observation is a previously undescribed drug interaction of a widely used herbal drug (Hypericum perforatum, i,e, St, John's wort) in a patient after liver transplantation.