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Cassia angustifolia and tacrolimus interaction in a liver transplant patient, a case report
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  • Iván Beltrá-Picó,
  • Marcos Díaz-Gonzalez,
  • Ricardo nalda-molina,
  • Amelia Ramón-López,
  • Sonia Pascual-Bartolomé,
  • Cayetano Miralles-Macià,
  • Patricio Más-Serrano
Iván Beltrá-Picó
Alicante General University Hospital Pharmacy

Corresponding Author:[email protected]

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Marcos Díaz-Gonzalez
Alicante General University Hospital Pharmacy
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Ricardo nalda-molina
Miguel Hernandez University of Elche
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Amelia Ramón-López
Miguel Hernandez University of Elche
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Sonia Pascual-Bartolomé
Hospital General Universitario de Alicante
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Cayetano Miralles-Macià
Hospital General Universitario de Alicante
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Patricio Más-Serrano
Alicante General University Hospital Pharmacy
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Abstract

Cassia angustifolia is a species of a plant from the Senna family that has traditionally been used as a laxative in different herbal products and commercial medicines. There are few described interactions between Senna and drugs, most of them related to electrolyte disturbances due to concomitant use with other laxatives or due to increased intestinal transit that may limit the absorption of drugs with low bioavailability. We present a case with supratherapeutic trough concentration of tacrolimus in a liver transplant patient after concomitant intake of tacrolimus and a herbal product based on Cassia angustifolia, suggesting a possible drug-plant interaction by means of P-glycoprotein. We observe an increase in their plasma concentration 2.8-fold and the AUC 2.1-fold.
05 Sep 2023Submitted to British Journal of Clinical Pharmacology
06 Sep 2023Assigned to Editor
06 Sep 2023Submission Checks Completed
06 Sep 2023Review(s) Completed, Editorial Evaluation Pending
27 Oct 2023Reviewer(s) Assigned