First-pass metabolism of cyclosporin by the gut.

  title={First-pass metabolism of cyclosporin by the gut.},
  author={Joseph Kolars and Walid M. Awni and Robert M. Merion and Paul B Watkins},
  volume={338 8781},
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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