Grapefruit can affect how fast some drugs — like statins — are absorbed into the bloodstream. However, it can interact with some common medications, altering their effects on your body. With that in mind, here is detailed information about 32 common medications that may interact with grapefruit, categorized by use. According to the United States Department of Agriculture, Americans consume 164 million gallons of grapefruit juice every year, a statistic that may be of concern to doctors and pharmacists. Although antimicrobials are one of the most diverse categories of medications, there are only a few medications with known important grapefruit interactions: Erythromycin is used to treat several types of bacterial infections. Lime is a citrus fruit. 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, 17). Pomegranate juice is highly concentrated with antioxidants that have health promoting properties. Eating grapefruit or drinking grapefruit juice while taking these medications can lead to higher levels of them in your blood — and more side effects. It showed that grapefruit can increase these drugs’ effects, resulting in excessive drowsiness (12). Examples of drugs include statins, pain medications, calcium channel blockers, and antihistamines. This may affect heart rhythm or function (1). The last two medications in this list work by decreasing the activity of a hormone called angiotensin 2, which naturally increases blood pressure. Grapefruit juice can interact with drugs. Grapefruit also increases levels of the HIV medications rilpivirine and maraviroc, in addition to primaquine-related antimalarial drugs. And some of these medications may have serious side effects when they interact with grapefruit. Read the Medication Guide or patient information sheet that comes with your medication to see if there are known interactions with grapefruit or other citrus fruits. IN. A study of 7 patients taking clopidogrel with 200 mL of either grapefruit juice or water showed lower activation of the drug with the juice. Statins work by limiting the natural production of cholesterol. Multiple pain medications are affected by grapefruit: Fentanyl and oxycodone are narcotic pain relievers. These include many drugs used to treat blood vessel and…. Drug-drug, drug-dietary supplement, and drug-citrus fruit and other food interactions: what have we learned? During the consumption of drugs with fruits or vegetables, the ADME properties of drug (absorption, distribution, metabolism, and excretion) can be modified by drug–phytochemical interaction. Seville oranges (often used to make orange marmalade) and tangelos (a cross between tangerines and grapefruit) affect the same enzyme as grapefruit. Collectively called antimicrobials, these anti-infection medications vary widely in their actions and breakdown in the body. J Clin Pharmacol 2004;44:559-69. If the label on your medicine reads "DO NOT TAKE WITH GRAPEFRUIT" or something similar, heed the warning and just avoid the foods altogether. Lime is a citrus fruit. However, it can interact with some common medications, altering their effects on your body. Consult your physician or pharmacist about drinking pomegranate juice with medications you take. Some foods and beverages might be made with varying amounts of these fruits. Some anti-infection medications should not be used with grapefruit, as they can lead to disrupted heart rhythm or function. There are three things to know to understand if and how you can safely consume grapefruit with these medications. Colchicine is an older medication used to treat gout. Contrarily, grapefruit increases the blood levels of other medications on this list, which can result in bleeding (14). The irreversible inhibition of intestinal cytochrome P450 (CYP)3A4 enzymes by grapefruit juice is the most commonly identified mechanism mediating grapefruit drug interactions. Fruits, like orange, grapefruit, clementine, etc., are termed as citrus fruits. It should advise whether you can have grapefruit or other fruits with it. While part of a balanced diet, grapefruit and some other citrus fruits can have serious interactions with certain medications. Learn more about what this may mean for you. Hesperidin is a bioflavonoid, a type of plant pigment with antioxidant and anti-inflammatory effects found primarily in unripe citrus fruit. More prescription drugs are on the market that can interact with grapefruit juice with potentially serious effects such as sudden death, Canadian doctors warn. Talk to your physician before changing your use of any medication. Statins can cause rhabdomyolysis, or the breakdown of muscle tissue. Alternatives: Pravastatin (Pravachol), rosuvastatin (Crestor), and fluvastatin (Lescol) do not interact with grapefruit (1). The website does not list other citrus fruits, such as blood oranges, as having a negative interaction with Lipitor. Avocado tends to intervene in the way Warfarin works in the human body which can be risky. Read the Drug Facts label on your non-prescription medicine. In other cases, there may not be any adverse interactions but instead zero benefit from taking the medications. If you’re curious about the grapefruit warning on many medicines, this article will help you understand why it’s there and what your options are. However, several mood medications do interact with it, including: Drugs like quetiapine and lurasidone are used to treat mood and behavioral disorders. It really doesn't take much to affect your medications. Additionally, Rxlist.com lists some less common medications that interact with grapefruit. This can lead to bleeding or less effective prevention of blood clots. In fact, studies show that they increase the blood levels of over 85 medications (1). Ask your pharmacist or other health care professional if there are any known interactions between your medication and any foods, particularly grapefruit and other citrus fruits. It’s important to remember that just one whole grapefruit or about one large glass of juice is enough to change the blood levels of many drugs. Some cholesterol medications called statins are affected by grapefruit. Grapefruit juice may seem like the ideal drink for a good, old-fashioned American breakfast, but when it comes to washing down your bipolar medications, think again. Does it work for weight loss, and is it safe? CYP3A4 metabolizes furanocoumarins found in grapefruit to reactive intermediates that then bond covalently to the active site of the enzyme, causing irreversible inactivation. Grapefruit is not the only citrus fruit that can interact with medications. For instance, if you’re taking medication that contains fexofenadine , grapefruit juice will prevent the required amount of drug from entering the blood stream, thus minimizing its efficiency. Increased levels of these drugs can cause heart rhythm changes or sleepiness (1). Should I Avoid Mixing Grapefruit and Statins? These medications may interact and cause very harmful effects. Eating grapefruit or drinking grapefruit juice affects how your body processes certain medicines. Grapefruit should not be consumed with erectile dysfunction medications or certain prostate enlargement medications. Is it safe to have grapefruit and metformin together? 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. Could you mention the name of the drug please. Amlodipine interaction with Food, Herbs and Alcohol - It is important to know how to take the medication to avoid the drug-food interaction. Amlodipine (Norvasc) is a calcium channel blocker like felodipine and nifedipine, which also does not interact with grapefruit (6, 8). Having too much medicine in your blood could result in serious side effects or a drug overdose. Note: This article contains general information — not specific medical advice. They work by changing the way your blood vessels use calcium, relaxing the vessels, and relieving blood pressure. Grapefruit is a delicious citrus fruit with many health benefits. Doxycycline is both an antibiotic and antimalarial drug that also does not interact with it (1). Because other blood vessels relax with these medications as well, increased blood levels of these drugs caused by grapefruit can decrease blood pressure (8). Even if you eat these foods several hours before or several hours after you take your medication, you can still have interactions. They can help you decide whether it’s safe to consume it while on certain medications. Grapefruit is a delicious citrus fruit with many health benefits. Foods To Avoid When Taking Warfarin These interactions can be particularly dangerous and include: A study gave 11 men who were taking amiodarone a glass of grapefruit juice (about 300 mL). Furanocoumarins disrupt the normal function of CYPs. The fruit juice also interferes with anticonvulsants and anticoagulants, drugs that treat and prevent seizures and blood clots, respectively. Grapefruit, pomelo and orange fruits and fruit juices can be a problem when taking some prescription medications. Some can cause potentially dangerous health problems. Excess levels of this medication can disrupt heart rhythm (11). Your pharmacy may mark these drugs with a grapefruit interaction warning. Regards pledge. Grapefruit and a few of its close relatives, such as Seville oranges, tangelos, pomelos, and Minneolas, contain a class of chemicals called furanocoumarins. Excessive eplerenone levels can cause too much potassium in the blood, which can interfere with heart rhythm (1). Serious Interactions. These two medications play a critical role in managing the health of patients with heart rhythm disorders. Although only a few heart rhythm medications interact with grapefruit, the side effects can be dangerous. While the fruit causes some drugs to stay in the body for a longer period of time, it has an opposite effect on some other drugs. Drugs.com offers a drug interaction checker that you can use to check your medications for interactions. While it doesn't seem to cause any health issues, you won't see much, if any, help for your allergy symptoms. Grapefruit-related changes in levels of these drugs have occasionally caused dangerous heart rhythm changes (10). A citrus flavonoid, nobiletin, suppresses production and gene expression of matrix metalloproteinase 9/gelatinase B in rabbit synovial fibroblasts. Though grapefruit does not interfere with most blood pressure medications, it can cause a few medications to overcorrect blood pressure. One study compared some of these drugs in nine patients, some of whom consumed grapefruit. Learn more about Lime uses, benefits, side effects, interactions, safety concerns, and effectiveness. Inactive 4 Feb 2013. Grapefruit, and sometimes orange juice and apple juice, can cause much less of the drug to enter the bloodstream. You should always be checking the labels on your medications, as well as any safety information sheets the come with them. Because antimicrobials are generally taken for a limited time, perhaps it’s easiest to simply avoid grapefruit while taking these medications. So why don't doctors simply prescribe lower amounts of the drug if you regularly eat these fruits? The citrus fruit pomelo as well as Seville oranges, known as bitter orange, also may interfere with the metabolism of Lipitor, according to MayoClinic.com. These fruits affect the way this enzyme works, which means you can have much more of the drug enter your bloodstream where it increases dangerous side effects. If your medication interacts with grapefruit, you should also avoid these fruits. And these food-drug interactions can range from mild to severe. 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