The effect of orange juice on Cyclosporine A serum levels in pediatric renal Transplant Recipients

Iranian Journal of Kidney Diseases

Volume 1 - Number Suppl.1

Article Type: Original Article
Abstract: Introduction. The aim of the present study was to invest igate the ef fect of orange juice on the pharmacokinetic (PK) of cyclosporine A (CsA) in children receiving renal transplantation. Methods. This was a placebo-controlled, three-way crossover study performed in the university departments of kidney transplant and pharmacology. On three study occasions, 10 kidney transplant recipients with stable CsA trough levels received either orange juice or water. Patients were given their individualized morning dose of CsA that administered with either 250 mL of water or 250 mL of the juice. Then, 12-hour CsA level and pharmacokinetic investigations were performed. The three investigations days were separated by at least 7 days. The main outcome measures were peak concentration and time to peak, area under the concentration-time curve, terminal half-life, and renal clearance and 24-hour trough levels of CsA. Results. Administration of CsA with orange juice compared with water did not significantly increase the area under the whole blood concentration versus time curve in the interval from 0 to 12 hours (AUC 0-12) of CsA (Orange juice, 2833 ± 553 [P = .059]; water, 2719 ± 1713). Results in these children showed increases in the AUC 0-12, but intake of the juice did not have any significant influence on maximum whole blood concentration (C max) or time to C max (T max) of CsA. Conclusions. Co-administration of orange (Thompson Novel) juice with CsA, compared with water, have no significant effects on the AUC 0-12, C max and T max of the CsA in renal transplant children. On the other hand, the juice compared with water significantly increased renal clearance of the CsA and prolonged its elimination rate.