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Drug Interactions between green tea and Prograf

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

tacrolimus green tea

Applies to: Prograf (tacrolimus) and green tea

MONITOR: Limited data suggest that coadministration with green tea may increase the plasma concentrations of tacrolimus. The mechanism of interaction has not been established. Although tacrolimus is primarily metabolized by CYP450 3A4, clinical studies have not found significant effects of green tea catechins on CYP450 isoenzymes. The interaction was suspected in a 58-year-old male kidney transplant recipient whose tacrolimus levels approximately doubled from previous levels during routine therapeutic monitoring a couple days after he started consuming green tea. Tacrolimus levels gradually returned to normal within a few weeks after discontinuing green tea consumption. The patient was genotyped and found to be a poor metabolizer of CYP450 3A4. No information was provided on the type or quantity of green tea consumed by the patient.

MANAGEMENT: Caution may be advisable when tacrolimus is taken concomitantly with green tea or green tea extracts. Dosing reduction of tacrolimus and/or limiting consumption of green tea and green tea products may be required if an interaction is suspected.

References (3)
  1. Vischini G, Niscola P, Stefoni A, Farneti F (2011) "Increased plasma levels of tacrolimus after ingestion of green tea." Am J Kidney Dis, 58, p. 329
  2. Chow HH, Hakim IA, Vining DR, et al. (2006) "Effects of repeated green tea catechin administration on human cytochrome P450 activity." Cancer Epidemiol Biomarkers Prev, 15, p. 2473-6
  3. Donovan JL, Chavin KD, Devane CL, et al. (2004) "Green tea (Camellia sinensis) extract does not alter cytochrome p450 3A4 or 2D6 activity in healthy volunteers." Drug Metab Dispos, 32, p. 906-8

Drug and food interactions

Moderate

tacrolimus food

Applies to: Prograf (tacrolimus)

ADJUST DOSING INTERVAL: Consumption of food has led to a 27% decrease in the bioavailability of orally administered tacrolimus.

MANAGEMENT: Tacrolimus should be administered at least one hour before or two hours after meals.

GENERALLY AVOID: Grapefruit juice has been reported to increase tacrolimus trough concentrations. Data are limited, but inhibition of the CYP450 enzyme system appears to be involved.

MANAGEMENT: The clinician may want to recommend that the patient avoid ingesting large amounts of grapefruit juice while taking tacrolimus.

References (2)
  1. (2001) "Product Information. Prograf (tacrolimus)." Fujisawa
  2. Hooks MA (1994) "Tacrolimus, a new immunosuppressant--a review of the literature." Ann Pharmacother, 28, p. 501-11

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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