Blood levels dropped so far the transplant drug dose nearly doubled
Ten stable kidney transplant patients added St John's Wort for two weeks. Their median daily tacrolimus dose had to rise from 4.5 mg to 8.0 mg to hold the graft-protecting level.
What the study found
Transplant patients needed nearly double the anti-rejection dose
Ten stable kidney transplant patients added St John's Wort for two weeks. Their median daily tacrolimus dose had to rise from 4.5 mg to 8.0 mg to hold blood levels in the range that protects the graft. Mycophenolate, the other drug they were taking, was untouched.
The caveat · Doses rose, so rejection went unseen
Nobody rejected in this study, because the doses were actively raised as the levels fell; it shows the size of the correction needed, not what follows when no one makes it. Ten patients, open-label, no control group, with each person compared against himself.