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Medically Speaking
Can I Take My Medicine With Grapefruit Juice?
By Beverly K. Dolberg, M.D.As more and more people take prescription drugs to treat disease, prevent disease, or increase longevity, the concern for problems from “drug to drug” interactions increases. Grapefruits and grapefruit juice have been found to cause some significant drug interactions.
In 1991, grapefruit juice was first found to affect a blood pressure drug, Felodiprine, by making the drug level in the blood stream higher than expected. Since then more than twenty-five other drugs have been found to be affected by grapefruit juice. Some drugs are made more potent and some are made less potent (just as harmful to a heart or cancer patient).
Unfortunately, all drugs within a class of medications do not interact in the same way, so we cannot pick a class of medication and say it is safe or not safe with grapefruit juice. There is not an equal affect for all drugs in the same class. Most statin drugs (used for cholesterol lowering) are a problem, but not all, and some have not been tested thoroughly. Each drug has its own individual pathway for breakdown in our intestines, where the grapefruit juice affects the metabolism. It affects the enzymes which breakdown the drug into usable components. That is why drugs given intravenously (into the vein) or subcutaneously (under the skin) are not affected by grapefruit juice.
There are currently more than twenty-five drugs with significant interactions to grapefruit juice. These include blood pressure lowering medications, medications to prevent heart arrhythmias, cholesterol lowering medication, erectile dysfunction drugs, allergy medication, seizure drugs, sleeping medications, and more.
The interaction of grapefruit juice and herbal products is also being studied but would be expected to have the same variability of increase in potency – decrease in potency – or no affect at all. Patients should not take their medicine in the morning and eat a grapefruit with dinner because the effects on the enzyme system last for 24 hours.
Since some drugs are not affected by grapefruit juice, perhaps a discussion with your physician can return that delicious fruit to your menu.
-end-Note: this article is presented through the efforts of the Delaware County Medical Society and is intended for informational purposes only, the contents should not be intended as medical advice. “You and Your Doctor – Preserve the Relationship”.
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