Kurtaran Melek, Koc Neriman Sila, Aksun Melek Seren, Yildirim Tolga, Yilmaz Şeref Rahmi, Erdem Yunus
Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Altindag, Ankara, 06100, Turkey.
Department of Nephrology, Hacettepe University Faculty of Medicine, Altindag, Ankara, Turkey.
Ther Adv Drug Saf. 2021 Apr 19;12:20420986211009358. doi: 10.1177/20420986211009358. eCollection 2021.
Sirolimus is an immunosuppressive drug used to prevent graft rejection. Therapeutic drug monitoring is required as with other immunosuppressive drugs. Previous studies have shown the interactions between sirolimus and drugs that affect the activity of cytochrome P450 3A4 and P-glycoprotein. There is an increasing tendency for the use of herbal remedies in many countries. Medicinal herbs are rich sources of natural bioactive compounds that could interact with drugs. Parsley, , is a food, spice, and also a medicinal herb. We report a case of a renal transplant recipient who had a supratherapeutic blood level of sirolimus due to consuming excessive parsley to highlight a possible herb-drug interaction. This is the first case report describing sirolimus-parsley interaction. Herb-drug interactions are especially important for drugs with a narrow therapeutic window. For this reason, healthcare professionals should question all patients, especially transplant patients, about the use of herbs or herbal products and report interactions.
Sirolimus is a drug that suppresses the immune response used to prevent organ rejection in people who have had kidney transplants. In order to reach the optimum balance between therapeutic efficacy and adverse effects, sirolimus blood levels should be closely monitored. Previous studies have shown the interactions between sirolimus and drugs that affect the activities of metabolizing enzymes and transporter proteins. Parsley is a food, spice, and also a medicinal herb. Medicinal herbs are rich sources of natural bioactive compounds that could interact with a prescription drug. We report a case of a renal transplant recipient who had a rise in the blood level of sirolimus due to the ingestion of an excessive amount of parsley to highlight possible herb-drug interaction.
西罗莫司是一种用于预防移植排斥的免疫抑制药物。与其他免疫抑制药物一样，需要进行治疗药物监测。先前的研究表明西罗莫司与影响细胞色素P450 3A4和P-糖蛋白活性的药物之间存在相互作用。在许多国家，使用草药疗法的趋势日益增加。草药是天然生物活性化合物的丰富来源，可能与药物发生相互作用。欧芹既是一种食物、香料，也是一种草药。我们报告一例肾移植受者因食用过量欧芹导致西罗莫司血药浓度高于治疗水平的病例，以强调可能存在的草药-药物相互作用。这是首例描述西罗莫司-欧芹相互作用的病例报告。草药-药物相互作用对于治疗窗较窄的药物尤为重要。因此，医疗保健专业人员应询问所有患者，尤其是移植患者，是否使用草药或草药产品，并报告相互作用情况。
西罗莫司是一种抑制免疫反应的药物，用于预防肾移植患者的器官排斥反应。为了在治疗效果和不良反应之间达到最佳平衡，应密切监测西罗莫司的血药浓度。先前的研究表明西罗莫司与影响代谢酶和转运蛋白活性的药物之间存在相互作用。欧芹既是一种食物、香料，也是一种草药。草药是天然生物活性化合物的丰富来源，可能与处方药发生相互作用。我们报告一例肾移植受者因摄入过量欧芹导致西罗莫司血药浓度升高的病例，以强调可能存在的草药-药物相互作用。
