Olestra) may reduce bioavailability and peak levels of ciclosporin
Clinical evidence,mechanism, importance and management
A study in 7 kidney transplant patients aged 9 to 18 years, found that addition of sucrose polyesters (Olestra), in a single 0.35-g/kg dose (maximum of 16 g) reduced ciclosporin AUC and peak levels by almost 19 % and 27%, respectively. Ciclosporin trough levels and elimination rate were not affected by Olestra. The reduced bioavailability was thought to be due to Olestra reducing absorption of ciclosporin. Olestra is marketed as a non-absorbable,non-calorific fat ingredient in snack foods. The authors note that Olestra is mainly consumed by children and adolescents, with age group of 13 to 17-year-olds being reported to eat 16.2 g of Olestra per snack,and therefore this interaction could be of particular significance for young transplant patients taking ciclosporin (See reference number 1). However, note that changes in AUC of ciclosporin of this size are very modest.
1. Terrill CJ,Lill J, Somerville KT, Sherbotie JR. Modifications in cyclosporine (CsA) microemulsion blood concentrations by Olestra. J Ren Nutr (2003) 13, 26–30.