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Is Grapefruit Affecting Your Medications?
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Is Grapefruit Affecting Your Medications?

Image for grapefruit article Just one glass of grapefruit juice or half of a grapefruit can interfere with the breakdown of several commonly used oral medications. This results in greater levels of the medication in your blood than your doctor intended when writing the prescription. Specifically, "certain compounds in grapefruit juice inhibit the activity of cytochrome P450 3A4 (CYP3A4), which is one of the enzymes that metabolizes medications," explains Maria A. Summa, PharmD, BCPS, Assistant Professor of Clinical Pharmacy and Coordinator of Drug Information Services at the Massachusetts College of Pharmacy and Health Sciences. About 60% of drugs are broken down by CYP3A4.

Higher levels of drugs circulating in the bloodstream can enhance therapeutic effects or increase the risk of toxicity. Some of the many medications affected by grapefruit are listed in the table below. Please be aware that this is not a complete table. Talk to your doctor about the medications you are taking to see if they are affected by grapefruit. Those taken on a regular basis are more likely to be affected than something taken as a one-time dose.

Don't take this information to mean you should avoid grapefruit and its juice; both bring you a healthy dose of vitamins and phytochemicals. Rather, check with your doctor or pharmacist before changing your habits to determine how grapefruit can fit in with your medication regimen.

Type of medicationBrand names of medications
AIDS medications Crixivan
Fortovase
Invirase
Norvir
Viracept
Anti-anxiety medications; sleep aids Ambien
BuSpar
Halcion
Sonata
Valium
Versed
Xanax
AntibioticsErythromycin
AntihistaminesAllegra
Asthma medication Serevent
Singulair
Cancer treatments Oncovin
Paxene
Taxol
Vincasar
Iressa
Cholesterol-lowering drugs Lipitor
Mevacor
Zocor
Nolvadex
And all other drugs in the statin family
Heart medications Adalat
Cardene
Cardioquin
Cardizem
Coreg
Plendil
Procardia
Nimotop
Sular
Hormones Anabolic steroids (testosterone)
Tikosyn
Birth control pills
Pain relievers Actiq
Alfenta
Codeine
Colchicine
Dolophine (methadone)
Duragesic (fentanyl)
Post-transplant medications Neoral
Prograf
Sandimmune
Steroids Glucocorticoids
(Hydrocortisone)
Miscellaneous drugs Dapsone
Dextromethorphan
Tegretol
Flomax
Sporanox

RESOURCES:

Drug Interactions
http://medicine.iupui.edu

U.S. Food and Drug Administration
http://www.fda.gov

U.S. Pharmacopeia
http://www.usp.org

CANADIAN RESOURCES:

Dietitians of Canada
http://www.dietitians.ca/

Health Canada
http://www.hc-sc.gc.ca/index_e.html



Last reviewed January 2008 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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