Grapefruit Juice: What Interaction With Drugs

Citrus fruits are not seasonal fruits because they dominate the table all year round. Especially in winter, their health record makes them even more coveted. Today, on the eve of the holidays, oranges and grapefruits are even part of the Christmas decoration. Thanks to the high content of vitamin C, citrus juice is preferred when there is a need for strengthening the immune system. But few are familiar with the benefits of grapefruit juice and its interactions with certain medications. So, for you to be warned, read our article and consume this exotic fruit moderately.

Grapefruit juice: health benefits

While you're curious about our disclaimer about grapefruit juice, be honest and reiterate its benefits. When we talk about citrus fruits and, where appropriate, grapefruit, we should not ignore its main asset: the vitamin C content. Thanks to this fact, the fruit is popular in large quantities in winter. A 100g glass of juice contains half the daily allowance of vitamin C for adults. It is recommended for infections of the nasal passages and fatigue. Among the antioxidants that grapefruit juice contains, there is lycopene, with anti-cancer properties.

As for the 2 g of fiber, this is a modest contribution to the 25 g required per day. Low in calories and hydrating, this citrus fruit is often present in slimming diets. As a result, the grapefruit juice and calories formula works well and it puts it in the list of coveted fruits. Additionally, weight reduction has an impact on insulin levels and cardiovascular health. If you eat grapefruit, you will lower your blood pressure considerably. And now the question arises: "What happens if you regularly take medication for high blood pressure and eat grapefruit?" There is the big downside and our article claims to be exhaustive on this subject.

Note: This is general information only and not specific medical advice. So talk to your doctor before changing anything about your medical treatment.

Grapefruit juice and drugs: effects on the body

Since consuming grapefruit juice and taking 31 common medications at the same time can be dangerous, alternatives should be explored. What changes does the body go through? How does grapefruit interact with medications?

No one doubts the role of the liver and the small intestine in drug processing. There is a specialized group of proteins called cytochrome P450 (CYP) that break down drugs that lower the blood levels of many of them.

Grapefruit and some of its family, such as Seville oranges, tangelos, pomelos, and Minneolas, contain a class of chemicals called furanocoumarins. These disrupt the normal functioning of CYPs. In fact, studies show that they increase blood levels of more than 85 drugs. By slowing down the way CYPs normally break down drugs in your gut and liver, grapefruit may increase the side effects of these drugs.

In short, to safely consume grapefruit with certain medications, you need to be aware of the effects and changes that this citrus has on your body.

A whole grapefruit or a glass of grapefruit juice is enough to change the way these medications affect you. The effects can last for several days. The ability of grapefruit to act on drugs lasts for 1 to 3 days. Taking your medicines a few hours before consumption does not guarantee you safety.

Grapefruit juice consumption and cholesterol

Note that some cholesterol lowering drugs called statins are affected by grapefruit. Since statins work by limiting the natural production of cholesterol, this improves the profile of lipoproteins in the blood and decreases deaths from heart disease in patients at risk. Statins, on the other hand, can cause muscle tissue breakdown, resulting in muscle weakness, pain and sometimes kidney damage. In this case, the role of grapefruit is harmful because it greatly increases the blood levels of three common statins.

According to a reliable study, drinking a glass of grapefruit juice with simvastatin or lovastatin increases the blood levels of these statins by 260%. Fortunately, there are alternatives that don't interact with grapefruit, including: pravastatin (Pravachol), rosuvastatin (Crestor), and fluvastatin (Lescol).

In short, to avoid causing muscle damage, be careful with the combination of drugs-statins and grapefruit juice.

* Find the drugs concerned in the link at the bottom of the article.

The interaction of the duo: grapefruit juice and blood pressure medication

Admitting that most types of blood pressure medications are not influenced by grapefruit, however, there are four that should be used with caution. The Felodipine and Nifedipine (Procardia) are called calcium channel inhibitors and act by modifying the way your blood vessels use calcium, by relaxing the blood vessels and relieving blood pressure. The other two (Losartan and Eplerenone) decrease the activity of a hormone called angiotensin 2 which is the cause of high blood pressure.

For this reason, a study sought to reveal the relationship between citrus fruit and these drugs. When combining 2 cups (500 ml) of grapefruit juice with nifedipine, the blood levels of the latter increase dramatically. This causes a rapid drop in blood pressure which could be dangerous if not monitored.

As for losartan, the study showed that grapefruit decreased its effects, potentially limiting its ability to control blood pressure.

Excessive levels of eplerenone can cause too much potassium in the blood, which can disrupt the heartbeat.

In this sense, the harmless alternatives are: spironolactone (Aldactone), a drug similar to losartan and eplerenone which does not interact with grapefruit and amlodipine (Norvasc) which is a calcium channel blocker and does not no longer interacts with grapefruit.

It can be concluded that although grapefruit does not interfere with most blood pressure medications, it can lead to overcorrection of the blood pressure of some medications.

* Find the drugs concerned in the link at the bottom of the article.

What happens with the heartbeat following the combination of some drugs and grapefruit?

By studying two drugs (Amiodarone and Dronedarone) that play an essential role in managing the health of patients with heart rhythm disturbances, the researchers found an unhealthy effect. Notably, changes in the levels of these grapefruit-related drugs have sometimes caused dangerous heart rhythm disturbances. In the study participated patients who took amiodarone with a glass of grapefruit juice (about 300 ml). Drug levels up to 84% have been noticed. Therefore, the side effects can be dangerous.

What interaction between grapefruit juice and certain anti-infective drugs?

Collectively referred to as antimicrobials, these anti-infective drugs vary widely in their actions and breakdown in the body.

Starting from erythromycin which is used to treat several types of bacterial infections, it should be noted that combined with grapefruit, it increases its blood levels by 84%. If this happens, the heart rhythm may be disturbed. The similar effect is seen when grapefruit is taken together with anti-HIV drugs (Rilpivirine and Maraviroc), in addition to the antimalarials linked to primaquine. Since antimicrobials are usually taken for a limited time, it may be easier to just avoid grapefruit.

If all the same, you cannot deprive yourself of the daily dose, replace the drugs mentioned above with clarithromycin and doxycycline which is both an antibiotic and an antimalarial.

* Find the drugs concerned in the link at the bottom of the article.

A cocktail of grapefruit juice and several antidepressant medications

Even though a large portion of anti-anxiety medications can be used safely with grapefruit, there are a few that cannot brag about it.

As a result of consuming the fruit and taking anti-depressant drugs, one can end up with excessive drowsiness. So a little more caution with quetiapine and lurasidone, diazepam, midazolam and triazolam which are basically sedatives.

* Find the drugs concerned in the link at the bottom of the article.

Combination with certain anticoagulants

If you are using blood thinners to treat or prevent blood clots, you should know that clopidogrel, for example, depends on CYPs (the proteins that grapefruit limits) to work. So when mixed with grapefruit it becomes less active. This can lead to bleeding in some cases and less effective prevention of blood clots.

* Find the affected drugs and their alternatives in the link at the bottom of the article.

Does grapefruit juice affect pain relievers?

The fentanyl and oxycodone are narcotic analgesics. Although their blood levels are only slightly affected by small amounts of grapefruit, it can change how long they stay in the body. The colchicine is an older drug used to treat gout. It is transformed by CYPs and may interact with grapefruit. Nonetheless, a 2012 study found that drinking 240ml of grapefruit juice had only a minimal effect on her levels. As alternatives, we recommend the use of morphine and Dilaudid which are not affected by grapefruit.

Some erectile dysfunction and prostate drugs

There are a few erectile dysfunction and prostate drugs that deserve special attention regarding interactions with grapefruit. By relaxing the blood vessels, sildenafil and tadalafil work, which increases blood flow to an erection. Since other blood vessels relax with these medicines as well, increased blood levels caused by grapefruit may lower blood pressure. Additionally, drugs for prostate enlargement such as tamsulosin can also cause increased dizziness and hypotension when taken with grapefruit.

Should you reject grapefruit from your menu?

It is important to remember that a single whole grapefruit or about a full glass of juice is sufficient to change the blood levels of many drugs. Some of them can have serious side effects when they interact with the fruit. If you are currently taking medications with grapefruit interactions, switch to another medication or stop consuming this citrus fruit.

In any case, grapefruit juice does not affect all drugs of the above categories. The severity of the interaction may be different depending on the person, the medicine, and the amount of juice you drink. Talk to your doctor, pharmacist, or other health care provider and read any information that came with your prescription or over-the-counter medicine to find out more.

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