Possible Interaction: Berberine and Cyclosporine

“The present results suggest that BBR can increase the oral bioavailability of CsA at the dosage of 3 mg/kg.”

“Interestingly, the concomitant therapy of BBR and CsA was more potent than either BBR or CsA and effectively elevated the survival rate of GVHD models.”

“Our studies indicated that erberine uptake was significantly suppressed by rifampicin, c yclosporine A and glycyrrhizic acid, which act as specific inhibitors of different Oatp isoforms (Oatp1a1, Oatp1a4 and Oatp1b2) in rat hepatocytes.”

“In …, berberine serosal-… by cyclosporin A. In Ussing-type chambers, the rate of serosal-to-mucosal transport across rat ileum was 3-times greater than in the … decreased by cyclosporin A. In Caco-2 cells, berberine uptake was significantly increased by P-glycoprotein inhibitors and by monoclonal antibody C219.”

“After co-administration of BBR in six patients for 12 days, the mean AUC of CsA was increased by 34.5% (P<0.05).”

“In addition, the average percentage decrease in CL/F was 40.4% (P<0.05) and the peak-to-through fluctuation index was significantly reduced (P<0.01).ConclusionThe BBR can markedly elevate the blood concentration of CsA in renal-transplant recipients in both clinical and pharmacokinetic studies.”

“In conclusion, berberine produced a dose‐dependent increased bioavailability of digoxin and cyclosporine A by inhibition of intestinal P‐gp.”

“administered CsA with a 2‐week pretreatment with BBR increased by 62% and 43% (BBR 30 mg/kg, p < 0.05), 96% and 60% (BBR 100 mg/kg, p < 0.01), compared with the control.”

“Moreover, berberine was processed through hepatobiliary excretion against a concentration gradient based on the bile-to-blood …(blood)); the active berberine efflux might be affected by P-gp and OCT since coadministration of berberine … CsA or quinidine at the same dosage of …) significantly decreased the berberine amount in bile.”

“Incorporation of rifampicin, berberine , and monthly GCP into cyclosporine can enhance the immunosuppressive effect.”

“Increased CyA concentration has been reported in patients with grapefruit juice, chamomile, or berberine , and with cannabidiol or resveratrol in animal studies.”