The bad news is that grapefruit juice can interact with dozens of medications, sometimes dangerously. Doctors are not sure which of the hundreds of chemicals in grapefruit are responsible. The leading candidate is furanocoumarin.
It is also found in Seville sour oranges and tangelos; although these fruits have not been studied in detail, the guidelines for grapefruit should apply to them as well. Grapefruit's culprit chemical does not interact directly with your pills. Instead, it binds to an enzyme in your intestinal tract known as CYP3A4 , which reduces the absorption of certain medications. When grapefruit juice blocks the enzyme, it's easier for the medication to pass from your gut to your bloodstream.
Blood levels will rise faster and higher than normal, and in some cases the abnormally high levels can be dangerous.
A variety of medications can be boosted by grapefruit juice; the table below lists some of the most important along with related drugs that are less likely to be influenced.
Statins high cholesterol. It doesn't take much grapefruit juice to boost the levels of drugs that are susceptible. And because this effect of the juice wears off slowly, a third of its impact is still evident after 24 hours.
What are the practical implications of this interaction? If you take one of the affected medications, the simplest solution is to switch to orange juice. A study of 7 patients taking clopidogrel with mL of either grapefruit juice or water showed lower activation of the drug with the juice. However, its ability to treat blood clots was not affected Contrarily, grapefruit increases the blood levels of other medications on this list, which can result in bleeding Alternatives: Warfarin Coumadin is used for purposes similar to those of apixaban and rivaroxaban.
While warfarin is sensitive to foods containing vitamin K, its activation is not affected by grapefruit Several blood thinners are affected by grapefruit.
This can lead to bleeding or less effective prevention of blood clots. Fentanyl and oxycodone are narcotic pain relievers. Although their blood levels are only slightly affected by small amounts of grapefruit, it may change the length of time they remain in the body 16 , Colchicine is an older medication used to treat gout. Nevertheless, a study showed that drinking mL of grapefruit juice only had a minimal effect on its levels Alternatives: Morphine and Dilaudid are narcotic pain relievers that are not affected by grapefruit 1.
A few erectile dysfunction and prostate medications deserve attention regarding grapefruit interactions:. Erectile dysfunction medications like sildenafil and tadalafil work by relaxing blood vessels, which increases blood flow to an erection.
Because other blood vessels relax with these medications as well, increased blood levels of these drugs caused by grapefruit can decrease blood pressure 8. Moreover, prostate enlargement medications such as tamsulosin can also cause increased dizziness and low blood pressure when taken with grapefruit Alternatives: Another class of prostate enlargement medications, which includes finasteride and dutasteride, is not significantly affected by grapefruit Grapefruit should not be consumed with erectile dysfunction medications or certain prostate enlargement medications.
Additionally, Rxlist. And some of these medications may have serious side effects when they interact with grapefruit. If you are currently taking medications with grapefruit interactions, switch to an alternative drug or stop consuming grapefruit.
Even small amounts of grapefruit can interact with some medications and cause serious side effects. Grapefruit interferes with proteins in the small intestine and liver that normally break down many medications.
Eating grapefruit or drinking grapefruit juice while taking these medications can lead to higher levels of them in your blood — and more side effects. With some drugs, with even small amounts of grapefruit can cause severe side effects. Therefore, the combination should be avoided. Make sure your doctor and pharmacist know if you regularly consume grapefruit.
Why this opposite effect? Instead of changing metabolism, grapefruit juice can affect proteins in the body known as drug transporters, some of which help move a drug into our cells for absorption.
As a result, less of the drug enters the blood and the drug may not work as well, Huang says. Grapefruit juice can cause problems with these enzymes and transporters, causing too much or too little drug in the body. Some drugs, like certain statins used to lower cholesterol, are broken down by enzymes. As shown above, grapefruit juice can block the action of these enzymes, increasing the amount of drug in the body and may cause more side effects.
Please try again. Something went wrong on our side, please try again. Show references Grapefruit. Natural Medicines. Accessed Oct. Temple NJ, et al. Drug interactions with food and beverages. Zeratsky KA expert opinion. Mayo Clinic, Rochester, Minn. Grapefruit juice and medicine may not mix. Food and Drug Administration. Auten AA, et al. Hidden source of grapefruit in beverages: Potential interaction with immunosuppressant medications. Hospital Pharmacy.
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