Table 1
A summary of commonly used herbal extracts, effect of herbal extract-cyclosporine A (CyA) interaction, and the mechanisms involved if known.
| | Herbal supplement or extract | Effect of interaction on CyA bioavailability | Mechanism of interaction | Studies |
| | St John’s wort | Decreased | Hypericin: P-gp
Hyperforin: induces intestinal and hepatic CYP3A4, CYP2B6, and P-gp | Human | | Grapefruit juice | Increased (oral only) | Inhibits intestinal CYP3A4 | Human | | Ginger | Decreased (oral only) | Reduces gastrointestinal motility | Animal | | Cannabidiol | Increased | Inhibits hepatic CYP3A4 | Animal | | Chamomile | Increased | Inhibits CYP3A4 | Human (case report) | | Liquorice | Decreased (oral only) | Induced P-gp and CYP3A4 | Animal | | Scutellariae radix | Decreased (oral only) | Induces CYP3A4 and intestinal P-gp | Animal | | Quercetin | Decreased (oral only) | Induces CYP3A4 and intestinal P-gp | Animal | | Resveratrol | Increased | Induces CYP3A4 | Animal | | Serenoa repens | Increased (speculative) | Potent inhibitor of CYP3A4, 2D6, and 2C9 | In-vitro | | Echinacea | Increased (speculative) | Possible inhibitor of CYP (data inconclusive) | In-vitro | | Berberine | Increased | Inhibits CYP3A4 and intestinal P-gp | Human |
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