The study authors urge physicians to learn more about drug interactions with grapefruit (Thompson, " Shots," NPR, 11/27 United Press International, 11/27 Brown, " Booster Shots," Los Angeles Times, 11/27). The study notes that grapefruits are not the only fruits to cause problems with medications: Seville oranges, pomelos, and limes also contain the same family of disruptive compounds. Popular drugs that interact negatively with grapefruit include various antibiotics, as well as drugs that treat hypertension, high cholesterol, and cancer. "Taking one tablet with a glass of grapefruit juice is like taking five tablets with water," Bailey says. This can effectively cause a medication overdose. Eating up to 35 grams of fiber per day may help control blood glucose levels. When the enzyme doesn't function normally, medications may not degrade and instead circulate in the blood at higher levels than normal. Learn the health benefits, potential risks, and interactions between grapefruit and other medications. The chemical culprits in grapefruits are called furanocoumarins, which deactivate an enzyme found in the small intestine and liver that breaks down various toxins and an estimated 50% of all drugs. Writing in the Canadian Medical Association Journal, Lawson Health Research Institute's David Bailey-who first discovered that the bitter fruit can interact with drugs more than 20 years ago-and colleagues reported that the number of drugs that can interact harmfully with grapefruit has increased from 17 to 43 in the last four years. Other citrus fruits (e.g., lemon, Navel or Valencia sweet orange, tangerine and clementine) do not cause this interaction.Ĭonsumption of other fruits or their juices combined with other medications should also be avoided, such as:īe alert and avoid taking your medications with grapefruit before checking with your pharmacist or physician.A new study identifies as many as 85 common medications that interact with grapefruit, and at least 43 such interactions can have serious side effects-including sudden death, kidney failure, and internal bleeding. Blood pressure medications that are affected by grapefruit juice include calcium channel blockers such as nifedipine. Other citrus fruits may produce similar effects to grapefruit, including: To minimize the risk of drug interaction, refrain from eating grapefruits or drinking grapefruit juice before checking with your pharmacist. Not everyone will react the same way it depends on which drug is involved, the grapefruit itself, and how sensitive you are to these effects. Grapefruit interactions are highly unpredictable. The original studies linking grapefruit ingestion to delayed statin metabolism involved large quantities of grapefruit juice daily (over a quart), and only showed that blood levels of the medications were increased, raising the potential for side effects. Drinking grapefruit juice in the morning, for example, and then taking your medication at night will not eliminate the risk of interaction. Because the effects of grapefruit last a long time, they cannot be avoided by spacing medication and grapefruit apart. Consuming grapefruit or its juice (fresh or frozen) can increase, or less commonly decrease, the effects of some drugs. The effects of grapefruit can last up to 3 days, sometimes even longer. Grapefruit contains substances that can interfere with the transformation and elimination of certain drugs resulting in serious adverse reactions.Īs little as 200 mL (less than a cup) of juice or a whole grapefruit can cause a significant increase of blood levels of certain drugs. Grapefruit and its juice (fresh or frozen) can either increase or, less frequently, decrease the effects of some drugs. With most drugs that are affected by grapefruit juice, the juice lets more of the drug enter the blood, says Shiew Mei Huang, Ph.D., of the FDA.
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