Low bioavailability of cyclosporine microemulsion and tacrolimus in a small bowel transplant recipient: Possible relationship to intestinal P- glycoprotein activity

Bruce Kaplan, Ken Lown, Robert Craig, Michael Abecassis, Dixon Kaufman, Joseph Leventhal, Frank Stuart, Herwig Ulf Meier-Kriesche, Jonathan Fryer

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

With intestine transplants the allograft is dependent on itself for maintenance of adequate immunosuppression. We evaluated an intestinal transplant recipient who required very large doses of either tacrolimus or cyclosporine emulsion to achieve acceptable blood concentrations. Pharmacokinetic studies revealed bioavailabilities of 2% and 6% respectively, while D-xylose and B12 absorption were found to be within normal limits and fecal fat was only slightly increased, suggesting that there was a selective absorptive defect for these drugs. Biopsies of the allograft ileum revealed a high P-glycoprotein activity compared to the jejunum or to intestinal biopsies from other normal subjects. This may be a contributing factor to poor immunosuppressive drug absorption in this patient and others.

Original languageEnglish (US)
Pages (from-to)333-335
Number of pages3
JournalTransplantation
Volume67
Issue number2
DOIs
StatePublished - Jan 27 1999
Externally publishedYes

Fingerprint

P-Glycoprotein
Tacrolimus
Cyclosporine
Biological Availability
Allografts
Biopsy
Xylose
Jejunum
Immunosuppressive Agents
Emulsions
Ileum
Pharmaceutical Preparations
Immunosuppression
Intestines
Pharmacokinetics
Fats
Transplants
Transplant Recipients

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Low bioavailability of cyclosporine microemulsion and tacrolimus in a small bowel transplant recipient : Possible relationship to intestinal P- glycoprotein activity. / Kaplan, Bruce; Lown, Ken; Craig, Robert; Abecassis, Michael; Kaufman, Dixon; Leventhal, Joseph; Stuart, Frank; Meier-Kriesche, Herwig Ulf; Fryer, Jonathan.

In: Transplantation, Vol. 67, No. 2, 27.01.1999, p. 333-335.

Research output: Contribution to journalArticle

Kaplan, B, Lown, K, Craig, R, Abecassis, M, Kaufman, D, Leventhal, J, Stuart, F, Meier-Kriesche, HU & Fryer, J 1999, 'Low bioavailability of cyclosporine microemulsion and tacrolimus in a small bowel transplant recipient: Possible relationship to intestinal P- glycoprotein activity', Transplantation, vol. 67, no. 2, pp. 333-335. https://doi.org/10.1097/00007890-199901270-00026
Kaplan, Bruce ; Lown, Ken ; Craig, Robert ; Abecassis, Michael ; Kaufman, Dixon ; Leventhal, Joseph ; Stuart, Frank ; Meier-Kriesche, Herwig Ulf ; Fryer, Jonathan. / Low bioavailability of cyclosporine microemulsion and tacrolimus in a small bowel transplant recipient : Possible relationship to intestinal P- glycoprotein activity. In: Transplantation. 1999 ; Vol. 67, No. 2. pp. 333-335.
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