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Garlic is said to be an inducer of CYP3A4, Tacrolimus is metabolized by CYP3A4.

The list of drugs (and some foods) interacting with Tacrolimus is long but nowhere I found a note on garlic. Grapefruit juice is always mentioned, but regarding the fact that it is an inhibitor of CYP3A4 at least there would be no graft rejection when exposed.

Is garlic in this context not mentioned because it has absolutely no effect or because there are no studies available? Green tea for example is also not mentioned but according to current studies it may have an effect and the university of Munich for example advices transplant patients treated with calcineurin inhibitors to avoid it.

What is the current situation with foods like garlic or ginger?

  • Can you present some references for the claims you mention? Liver PK isn't my area of expertise so I'm not sure if there is a consensus on this I am unaware of, but in some quick searches looking at garlic extract and CYP3A4 it seems like the effect is minimal if it exists at all. – Bryan Krause Feb 1 '19 at 16:34

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