Cassia angustifolia and tacrolimus interaction in a liver
transplant patient, a case report
Cassia angustifolia is a species of a plant from the Senna family
that has traditionally been used as a laxative in different herbal
products and commercial medicines. There are few described interactions
between Senna and drugs, most of them related to electrolyte
disturbances due to concomitant use with other laxatives or due to
increased intestinal transit that may limit the absorption of drugs with
low bioavailability.
We present a case with supratherapeutic trough concentration of
tacrolimus in a liver transplant patient after concomitant intake of
tacrolimus and a herbal product based on Cassia angustifolia ,
suggesting a possible drug-plant interaction by means of P-glycoprotein.
We observe an increase in their plasma concentration 2.8-fold and the
AUC 2.1-fold.