Elsevier

The Lancet

Volume 338, Issue 8781, 14 December 1991, Pages 1488-1490
The Lancet

SHORT REPORTS
First-pass metabolism of cyclosporin by the gut

https://doi.org/10.1016/0140-6736(91)92302-IGet rights and content

Abstract

Cyclosporin is thought to be exclusively metabolised in the liver. We instilled cyclosporin into the small bowel of 2 patients during the anhepatic phase of liver transplantation; cyclosporin metabolites were readily detected in portal venous blood. Our findings indicate that the small intestine is a major site of cyclosporin breakdown: such intestinal metabolism might help to explain the poor oral bioavailability and drug interactions of cyclosporin.

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