Effect of Orange and Tangerine Juice on Cyclosporine Levels in Renal Transplant Recipients

Abstract Introduction Cyclosporine Neoral is a major immunosuppressive agent widely used in organ transplant populations. Its pharmacokinetics are influenced by various factors. The aim of this study was to investigate the effects of orange or tangerine juice on the pharmacokinetic pattern of cyclosporine Neoral among renal transplanted patients. Materials and methods Ten renal transplant recipients on cyclosporine Neoral-based immunosuppressive therapy were included in this crossover controlled study. Patients were given their individualized morning dose of cyclosporine with either 250 mL water or 250 mL orange or tangerine juice; 12-hour cyclosporine pharmackinetic investigations were performed. The three investingation days were separated by at least 7 days. Results The intake of orange juice did not have any significant influence on the area under the curve in the interval from 0 to 12 hours (AUC 0–12; 95% confidence interval [CI]: −769 to 734, P = .77), or the maximum whole blood concentration (Cmax; 95% CI: 264 to 74; P = .32). Similarly, after coadministration of cyclosporine Neoral with tangerine juice, no significant changes were observed in AUC 0–12 (95% CI: −453 to 1166; P = .28) or Cmax (95% CI: −239 to 179; P = .37). Conclusion Coadministration of orange (var Tampson) or tangerine (var Unshiu) juice with cyclosporine compared with water did not influence exposure to cyclosporine in renal transplant recipients.