Neoral
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied Health
• Avoid grapefruit juice with this medication, it increases plasma concentrations of the drug.1
• Avoid potassium and other salt substitutes with this drug.2
• To prepare cyclosporine solution, mix with orange or other suitable juices. Avoid milk with the medication.3
• Fish oils may be helpful in preventing some of the side effects associated with the use of this medication.4
• Avoid St. John's Wort with this medication. The herb may lower concentrations of the drug leading to transplant rejection.5
• Avoid ginkgo with this medication because the herb has been shown to inhibit the cytochrome P-450 pathway. This may increase drug levels.6
References1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
1 Ioannides-Demos, LL, et al. Dosing implications of a clinical interaction between grapefruit juice and cyclosporine and metabolite concentrations in patients with autoimmune diseases. J Rheumatol 1997;24:49-54.
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Badalamenti S, Salerno F, Lorenzano E, Paone G, Como G, Finazzi S, Sacchetta AC, Rimola A, Graziani G, Galmarini D, et al. Renal effects of dietary supplementation with fish oil in cyclosporine-treated liver transplant recipients. Hepatology 1995 Dec;22(6):1695-71
4 Andreassen AK, Hartmann A, Offstad J, Geiran O, Kvernebo K, Simonsen S. Hypertension prophylaxis with omega-3 fatty acids in heart transplant recipients. J Am Coll Cardiol 1997 May;29(6):1324-31
5 Ruschitzka F, Meier PJ, Turina M, et al. Acute heart transplant rejection due to Saint John's wort. Lancet 355: 548-549, 2000.
5 Barone GW, Gurley BJ, Ketel BL, et al. Drug interaction between St. John's wort and cyclosporin. Ann Pharmacother 2000;34:1013-6.
6 Budzinski JW, Foster BC, Vandenhoek S, et al. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82.
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Disclaimers
The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.
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