Skip to content
My WebMD Sign In, Sign Up

Gengraf oral

Selected Immunosuppressants; Temsirolimus/St. John's Wort (mono deleted 11/01/2012)

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

St. John's wort may cause your body to process your immunosuppressive or temsirolimus more quickly.

What might happen:

St. John's wort may reduce the beneficial effects of your medicine.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking St. John's wort. It may be necessary to measure the amount of your medicine in your blood. Your doctor may want to change the dose of your medicine or you may need to stop taking St. John's wort. Let your healthcare providers know if you stop taking St. John's wort.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Anonymous. From the Food and Drug Administration. JAMA 2000 Apr 5; 283(13):1679.
2.Torisel (temsirolimus) US prescribing information. Wyeth Pharmaceuticals, Inc. June, 2011.
3.Bauer S, Stormer E, Johne A, Kruger H, Budde K, Neumayer HH, Roots I, Mai I. Alterations in cyclosporin A pharmacokinetics and metabolism during treatment with St John's wort in renal transplant patients. Br J Clin Pharmacol 2003 Feb;55(2):203-11.
4.Hebert MF, Park JM, Chen YL, Akhtar S, Larson AM. Effects of St. John's wort (Hypericum perforatum) on tacrolimus pharmacokinetics in healthy volunteers. J Clin Pharmacol 2004 Jan;44(1):89-94.
5.Mai I, Stormer E, Bauer S, Kruger H, Budde K, Roots I. Impact of St John's wort treatment on the pharmacokinetics of tacrolimus and mycophenolic acid in renal transplant patients. Nephrol Dial Transplant 2003 Apr; 18(4):819-22.
6.Alscher DM, Klotz U. Drug interaction of herbal tea containing St. John's wort with cyclosporine. Transpl Int 2003 Jul;16(7):543-4.
7.Turton-Weeks SM, Barone GW, Gurley BJ, Ketel BL, Lightfoot ML, Abul-Ezz SR. St John's wort: a hidden risk for transplant patients. Prog Transplant 2001 Jun;11(2):116-20.
8.Moschella C, Jaber BL. Interaction between cyclosporine and Hypericum perforatum (St. John's wort) after organ transplantation. Am J Kidney Dis 2001 Nov;38(5):1105-7.
9.Beer AM, Ostermann T. St. John's wort: interaction with cyclosporine increases risk of rejection for the kidney transplant and raises daily cost of medication. Med Klin (Munich) 2001 Aug 15;96(8):480-3.
10.Ahmed SM, Banner NR, Dubrey SW. Low cyclosporin-A level due to Saint-John's-wort in heart transplant patients. J Heart Lung Transplant 2001 Jul;20(7):795.
11.Karliova M, Treichel U, Malago M, Frilling A, Gerken G, Broelsch CE. Interaction of Hypericum perforatum (St. John's wort) with cyclosporin A metabolism in a patient after liver transplantation. J Hepatol 2000 Nov; 33(5):853-5.
12.Mai I, Kruger H, Budde K, Johne A, Brockmoller J, Neumayer HH, Roots I. Hazardous pharmacokinetic interaction of Saint John's wort (Hypericum perforatum) with the immunosuppressant cyclosporin. Int J Clin Pharmacol Ther 2000 Oct;38(10):500-2.
13.Barone GW, Gurley BJ, Ketel BL, Lightfoot ML, Abul-Ezz SR. Drug interaction between St. John's wort and cyclosporine. Ann Pharmacother 2000 Sep;34(9):1013-6.
14.Mandelbaum A, Pertzborn F, Martin-Facklam M, Wiesel M. Unexplained decrease of cyclosporin trough levels in a compliant renal transplant patient. Nephrol Dial Transplant 2000 Sep;15(9):1473-4.
15.Breidenbach T, Kliem V, Burg M, Radermacher J, Hoffmann MW, Klempnauer J. Profound drop of cyclosporin A whole blood trough levels caused by St. John's wort (Hypericum perforatum). Transplantation 2000 May 27; 69(10):2229-30.
16.Ruschitzka F, Meier PJ, Turina M, Luscher TF, Noll G. Acute heart transplant rejection due to Saint John's wort. Lancet 2000 Feb 12; 355(9203):548-9.
17.Bolley R, Zulke C, Kammerl M, Fischereder M, Kramer BK. Tacrolimus-induced nephrotoxicity unmasked by induction of the CYP3A4 system with St John's wort. Transplantation 2002 Mar 27;73(6):1009.

See 9 Reviews for this Drug. - OR -

Review this Treatment

Find a Drug:

by name or medical condition or shape/color (Pill Identifier)

(for example: aspirin)

(for example: diabetes)

Report Problems to the Food and Drug Administration
 
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Ask the pharmacist

Questions about medications? Get expert answers by video or live chat about allergies, pregnancy, sleep, and more.
See the Ask the Pharmacist event schedule.

Ask a Question

Popular Slideshows & Tools on WebMD

hands on abdomen
Can you catch one?
Woman sitting in front of UV lights
Is yours working?
woman using breath spray
What's causing yours?
womans hand on abdomen
Are you ready for baby?
MS Overview
Recognizing symptoms.
bowl of yogurt with heart shape
Eat for a healthy heart.
woman doing pushups
To help you get fit.
Colored x-ray of tooth decay
Know what to look for.
Woman sitting with child
Do you know the symptoms?
mosquito
Stings, bites, burns, and more.
Allentown, PA
Are you living in one?
Thyroid exam
See how much you know.

Women's Health Newsletter

Find out what women really need.

WebMD the app

Get trusted health information. Whenever. Wherever... with your iPhone, iPad or Android.

Find Out More

IMPORTANT: About This Section and Other User-Generated Content on WebMD

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatment or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment.

Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.