Evidence map›Paper›PMID 30218442›Full record

ArticleBritish journal of clinical pharmacology2018

Increased tacrolimus blood concentration by Beni-Madonna - a new hybrid citrus cultivar categorized as 'Tangor', in a liver transplant patient: likely furanocoumarin-mediated inhibition of CYP3A4 or P-glycoprotein.

Kentaro Ushijima, Koichi Mizuta, Shinya Otomo, Keiko Ogaki, Yukihiro Sanada, Yuta Hirata, Yoshiyuki Ihara, Taizen Urahashi, Yasushi Imai, Akio Fujimura

Open access · bronzeAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Kentaro UshijimaDivision of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Shimotsuke, Japan.ORCID 0000-0003-2637-3916
Koichi MizutaDivision of Transplant Surgery, Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Shinya OtomoDepartment of Pharmacy, Jichi Medical University Hospital, Shimotsuke, Japan.
Keiko OgakiDepartment of Pharmacy, Jichi Medical University Hospital, Shimotsuke, Japan.
Yukihiro SanadaDivision of Transplant Surgery, Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Yuta HirataDivision of Transplant Surgery, Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Yoshiyuki IharaDivision of Transplant Surgery, Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Taizen UrahashiDivision of Transplant Surgery, Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Yasushi ImaiDivision of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Shimotsuke, Japan.
Akio FujimuraDivision of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Shimotsuke, Japan.ORCID 0000-0002-5160-5777
Jichi Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

adverse eventA drug interaction leading to greater exposure to tacrolimus. DRUG IMPLICATED: Tacrolimus and Beni-Madonna (a new cultivar citrus categorized as 'Tangor'). THE PATIENT: A 9-month-old girl with biliary atresia (body weight, 7.5 kg) taking tacrolimus after liver transplantation. EVIDENCE THAT LINKS THE DRUG TO THE EVENT: The time course was consistent with the appearance of the interaction, which was confirmed by an increase in the blood concentration of tacrolimus. Dihydroxybergamottin was detected in peel of Beni-Madonna and in peel and fruit pulp of grapefruit. MANAGEMENT: Avoiding Beni-Madonna intake. MECHANISM: Inhibition of activity of CYP3A4, P-glycoprotein, or both, by Beni-Madonna. IMPLICATION FOR THERAPY: Clinicians should be aware of this potential interaction, and patients taking drugs such as tacrolimus (the kinetics of which are affected by grapefruit juice) should avoid Beni-Madonna intake. HYPOTHESIS TO BE TESTED: Further study is required to determine if other Citrus species categorized as Tangor contain furanocoumarins.

Indexed as

CitrusFood-Drug InteractionsLiver TransplantationATP Binding Cassette Transporter, Subfamily B, Member 1Citrus paradisiCytochrome P-450 CYP3ACytochrome P-450 CYP3A InhibitorsFemaleFurocoumarinsHumansImmunosuppressive AgentsInfantTacrolimusATP Binding Cassette Transporter, Subfamily B, Member 1Cytochrome P-450 CYP3ACytochrome P-450 CYP3A InhibitorsFurocoumarinsImmunosuppressive AgentsTacrolimusdrug interactionliver transplantationtacrolimus

Identifiers

PMID30218442
PMCPMC6255997
OpenAlexW2891186205

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.