Table 2.
The effects of the selected food substances on pharmacokinetics and pharmacodynamics [7,8,11,12,13,15,18,23,26].
| Food | Active Component | Relevant Metabolizing Enzymes/Transporters/Mechanism of Actions | Pharmacokinetics of Tacrolimus | Adverse Effects |
|---|---|---|---|---|
| Grapefruit | Furanocoumarins: bergamottin 6′7′-dihydroxybergamottin |
Inhibition of intestinal CYP3A4 Inhibition of P-gp |
Elevation of TAC serum level | Aggravation of TAC toxicity |
| Pomelo | Naringin, Naringenin, Neohesperidin 6′7′-dihydroxybergamottin |
Inhibition of intestinal CYP3A4 Inhibition of P-gp |
Elevation of TAC serum level | Aggravation of TAC toxicity |
| Clementine | - | Inhibition of CYP3A4 | Elevation of TAC serum level | Aggravation of TAC toxicity |
| Turmeric | - | - | Elevation of TAC serum level | Aggravation of TAC toxicity |
| Ginger | - | - | Elevation of TAC serum level | Aggravation of TAC toxicity |
| Pomegranate | Quercetin | Inhibition of CYP3A4 | Elevation of TAC serum level | Aggravation of TAC toxicity |
| Cranberry | - | Influence on CYPs | Inconclusive data | Inconclusive data |
TAC—tacrolimus; P-gp—P-glycoprotein.