Ginger significantly decreased the oral bioavailability of cyclosporine in rats

Hsiu Mei Chiang, Pei Dawn Lee Chao, Su Lan Hsiu, Kuo Ching Wen, Shang Yuan Tsai, Yu Chi Hou*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

28 Scopus citations


Ginger (roots of Zingiber officinale ROSCOE) is a popular spice and herbal medicine worldwide. Cyclosporine is clinically used as an important immunosupressant with narrow therapeutic index. This study attempted to investigate the effect of ginger juice on the pharmacokinetics of cyclosporine in rats. Rats were orally administered cyclosporine alone and in combination with ginger juice (5 ml/kg) concomitantly, as well as 2 hours after the ginger juice, respectively, in crossover designs. In addition, rats were intravenously administered cyclosporine with and without an oral dose of ginger juice (5 ml/kg). The blood samples were withdrawn via cardiopuncture at determined time points and cyclosporine concentrations were determined by a specific monoclonal fluorescence polarization immunoassay. The pharmacokinetic parameters of cyclosporine were calculated using a non-compartment model of WINNONLIN. The results indicated that concomitant intake of ginger significantly decreased Cmax and AUC0-t of oral cyclosporine by 70.9% and 63.1%, respectively. The intake of ginger 2 hours before cyclosporine significantly decreased Cmax and AUC0-t by 51.4% and 40.3%, respectively. In contrast, the pharmacokinetics of intravenous cyclosporine not altered by orally in combination with ginger juice. In conclusion, ginger significantly decreased the oral bioavailability of cyclosporine, and the interaction should occur at the absorption phase. Patients treated with cyclosporine should be discouraged from using ginger products to ensure the efficacy of cyclosporine.

Original languageEnglish
Pages (from-to)845-855
Number of pages11
JournalAmerican Journal of Chinese Medicine
Issue number5
StatePublished - 2006
Externally publishedYes


  • Cyclosporine
  • Herb-drug interaction
  • Pharmacokinetics
  • Zingiber officinale


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