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Blood level of tacrolimus

Question
Dear expert team!
After the transplantation my son take as immunosuppressive drugs tacrolimus, cortisone and mycophenolatmofetil (MMF). Is it right that some kinds of food or fruits (grapefruit) influence the blood level?
Many thanks in advance.
Answer
Hello,
yes, in general it is recommended to avoid the intake of grapefruit juice at the intake of tracrolimus, as the tacrolimus blood level can be increased by the simultaneous intake.
In the package insert it is written therefore: "Grapefruit juice increases the blood level of tacrolimus. Please avoid grapefruit juice."
In former times it was considered that it was only a disturbance of the absorption of the drug from the gut. Indeed certain ingredients of the grapefruit influence the metabolism in such a way, that even a non-simultaneous intake of grapefruit juice leads to increased blood levels. Therefore one should in general avoid grapefruit juice when taking tacrolimus.
Yours sincerely,
Prof. Dr. TOF Wagner
16.06.2009