Abstract
The calcineurin-inhibiting drugs cyclosporine and tacrolimus are very commonly used in patients after organ transplantation, as well as in some patients with severe autoimmune diseases. However, these drugs can cause severe adverse effects, including kidney damage (particularly problematic in people who have undergone kidney transplantation), diabetes, dyslipidemia, hypertension, and many other problems.
Some herbal medicines, particularly Cordyceps sinensis = Ophiocordyceps sinensis (cordyceps) mycelium, have been shown to enhance the efficacy—while decreasing the toxicity—of cyclosporine. Other herbs that may be helpful for patients who are taking cyclosporine include Glycyrrhiza uralensis (Chinese licorice), Astragalus membranaceus (astragalus), and Allium sativum (garlic). Fish oil may also be beneficial for people who are taking cyclosporine. Dose-sparing agents for potential use with cyclosporine include Citrus x paradise (grapefruit) and Geum chiloense = G. quellyon (scarlet avens).
Hypericum perforatum
(St. John’s wort) can interfere with cyclosporine and tacrolimus and should not be taken simultaneously with these drugs. Herbs that can be beneficial in combination with tacrolimus include Camellia sinensis (green tea), Isatis tinctoria (woad), Schisandra sphenanthera (southern schisandra), grapefruit, and Citrus grandis (pomelo) — provided the tacrolimus dose is reduced—as well as Paeonia lactiflora (white peony) and Tripterygium wilfordii (thunder duke vine*). The details of these and other interactions are reviewed in this article
Get full access to this article
View all access options for this article.