{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:18:55Z","timestamp":1784625535198,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p><jats:styled-content style=\"fixed-case\"><jats:italic>Cassia angustifolia<\/jats:italic><\/jats:styled-content> is a species of plant from the Senna family that has traditionally been used as a laxative in different herbal products and commercial medicines. Even though there are few documented drug\u2013plant interactions, the use of <jats:styled-content style=\"fixed-case\"><jats:italic>C.\u00a0angustifolia<\/jats:italic><\/jats:styled-content> with different drugs may have additive effects, such as with other laxatives or potassium\u2010depleting diuretics. Its use also increases peristalsis which, may reduce drug absorption. The combination with digoxin has been associated with an increased risk of digoxin toxicity, probably due to an increase in plasma digoxin concentrations and hypokalaemia. We present a case with supratherapeutic trough concentration of tacrolimus, an immunosuppressive agent, and a herbal product in a liver transplant patient after concomitant intake of tacrolimus and a herbal product based on <jats:styled-content style=\"fixed-case\"><jats:italic>C.\u00a0angustifolia<\/jats:italic><\/jats:styled-content>, suggesting a possible drug\u2013lant interaction through by P\u2010glycoprotein. We observed an increase in the patient\u2019s blood concentration 2.8\u2010fold and the area under the curve at\u00a0steady state\u00a02.1\u2010fold. This interaction could be of clinical relevance, given the dose\u2010dependent side effects of tacrolimus, such as nephrotoxicity, neurotoxicity, hypertension, hyperglycaemia, or electrolyte alterations.<\/jats:p>","DOI":"10.1111\/bcp.16079","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T22:40:58Z","timestamp":1713998458000},"page":"1745-1750","source":"Crossref","is-referenced-by-count":4,"title":["<scp><i>Cassia angustifolia<\/i><\/scp> and tacrolimus interaction in a liver transplant patient, a case report"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4576-8008","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Beltr\u00e1\u2010Pic\u00f3","sequence":"first","affiliation":[{"name":"Pharmacy, Clinical Pharmacokinetics Unit Dr.Balmis General University Hospital  Alicante Spain"},{"name":"Alicante Institute for Health and Biomedical Research (ISABIAL)  Alicante 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