Medications that interact adversely with grapefruit

[Amigo]

I realise many people will be aware of the contra-indications of having grapefruit with statins and certain other medications but on a different thread yesterday, it became clear that it's not immediately obvious to everyone. It was suggested that it may be useful if I post this comprehensive list of medications to be avoided or taken cautiously with grapefruit. It's obviously important to read the explanatory leaflet that accompanies medications for specific advice.

I had to look up torsades de pointes and in simplistic terms, it's an abnormal heart rhythm which can be very dangerous.

http://www.cmaj.ca/content/suppl/2012/11/26/cmaj.120951.DC1/grape-bailey-1-at.pdf

Also NHS advice;

http://www.nhs.uk/chq/Pages/2474.aspx?CategoryID=73

 

[Diabeticliberty]

Amigo thank you so much for posting this really important message. It was a subject of which I was blissfully and quite possibly dangerously unaware as I take statins and do like grapefruit juice. A warning offered and very much a lesson learned 🙂

 

[Sally71]

This is why Triludan was banned - I can't remember its generic name, but it was the only antihistamine which completely killed my hay fever symptoms for several hours. None of the others are anywhere near as effective. Couldn't they just have printed a warning on the packet instead of banning it completely, I don't even like grapefruit so that wouldn't be a problem for me!

 

[KateR]

Thanks for that Amigo. I knew I couldn't eat it with Metformin but I didn't realise it included Amlodipine as well. Just as well I don't like grapefruit!

 

[Owen]

Just glad my Gastroenterologist was on the ball and warned me of this years ago.

 

[Amigo]

Thanks for that Amigo. I knew I couldn't eat it with Metformin but I didn't realise it included Amlodipine as well. Just as well I don't like grapefruit!

Yes I take that too Kate but fortunately I hate grapefruit with a passion. Apparently you also need to be aware of products using grapefruit and cocktails.

 

[mikeyB]

Well done Amigo.

I knew about the statin thing, so I don't eat or drink grapefruit, but what's amazing is the number of medications that are affected. There are so many people who could benefit from this post. Might spoil their breakfast, mind.🙂

 

[robert@fm]

I'm on at least four different meds on that list. 😱 One thing that annoys me is, there are plenty of full-sugar fizzy pineapple drinks, but in low/zero sugar pineapple is only available in combination with grapefruit. 🙄

 

[Amigo]

I'm on at least four different meds on that list. 😱 One thing that annoys me is, there are plenty of full-sugar fizzy pineapple drinks, but in low/zero sugar pineapple is only available in combination with grapefruit. 🙄

Yes I'd never considered that Robert! Good point.

 

[graj0]

Glad I don't take statins any more, but when I did I was interested in knowing why grapefruit was frowned upon and found this.

Do not drink grapefruit juice if you're taking simvastatin. Grapefruit juice increases the level of simvastatin in your blood and makes side effects more likely. Atorvastatin interacts with grapefruit juice if you drink large quantities (greater than 1.2 litres daily), but an occasional glass is thought to be safe.

OK, that refers to Simvastatin only, and it's more effective if you consume grapefruit, shame they can't gauge how much it affects the efficacy so one could take less. Of course the next logical question was how does it work that way and found this.

Grapefruit contains compounds known as furanocoumarins that block the CYP3A4 enzymes. When grapefruit juice is consumed, the enzyme's ability to break down the drug for elimination is decreased. Blood levels of the drug may rise, resulting in the risk for new or worsened side effects.

So then my head says, what other food stuffs contain furanocoumarins and that's where I decide to just read the labels on anything I take.

 

[grovesy]

This is why Triludan was banned - I can't remember its generic name, but it was the only antihistamine which completely killed my hay fever symptoms for several hours. None of the others are anywhere near as effective. Couldn't they just have printed a warning on the packet instead of banning it completely, I don't even like grapefruit so that wouldn't be a problem for me!

I liked that one too!

 

[Robin]

This is why Triludan was banned - I can't remember its generic name, but it was the only antihistamine which completely killed my hay fever symptoms for several hours. None of the others are anywhere near as effective. Couldn't they just have printed a warning on the packet instead of banning it completely, I don't even like grapefruit so that wouldn't be a problem for me!

I liked that one too!

Gosh, I'd forgotten about Triludan. Agree, I used to take it and it was the best thing I ever found for my hay fever.

 

[Vicsetter]

As far as I know you can take Rosuvastatin with grapefruit(its the only statin that you can).
Also there is no study that says you should'nt eat grapefruit with Metformin, it's been shown to raise lactic acid in rats but it has also been shown to decrease blood glucose as effectively as Metfornin.

 

[trophywench]

I remember being told about grapefruit in early discussions with my GP about statins, so have always known that. I wasn't told about it re Clopidogrel though, though it is on the PIL which I will always read when starting anything new. I was on sertraline at one time and wasn't told and don't recall seeing it mentioned before - but anyway it didn't work so I swapped to Citalopram in any case. As Clop causes/exacerbates stomach acid and you're so likely to suffer awful heartburn from it anyway, my GP always automatically prescribes Omeprazole alongside it which I've never found it necessary to take (so don't fill the scrips, still got the original packet) - but would be extra wary if faced with grapefruit or its juice, which aren't staples of my usual diet in any case.

 

[BigMalc]

I asked again recently about grapefruit as I used to like it occasionally for brekkie and even more occasionally with G+T. I was told by DSN that if I only had it occasionally and not much of it then nothing to worry about.

 

[Amigo]

I asked again recently about grapefruit as I used to like it occasionally for brekkie and even more occasionally with G+T. I was told by DSN that if I only had it occasionally and not much of it then nothing to worry about.

No disrespect BigMalc but I wouldn't consider advice on pharmaceutical interactions with grapefruit from a DSN sound, definitive scientific advice to be honest. There's some situations where qualified pharmacists are hard to beat for advice.

 

[mikeyB]

I agree with Amigo on this BigMalc. The effect of grapefruit on medication is instant, not cumulative, so if you are taking any medication which is affected, the level of that medication in your system is higher than it should be, so any side effects of that medication - be it drowsiness or something else - will be exaggerated. That's why I avoid grapefruit totally, though I would love it once in a while.

 

[Diabeticliberty]

I agree with Amigo on this BigMalc. The effect of grapefruit on medication is instant, not cumulative, so if you are taking any medication which is affected, the level of that medication in your system is higher than it should be, so any side effects of that medication - be it drowsiness or something else - will be exaggerated. That's why I avoid grapefruit totally, though I would love it once in a while.

I personally do like grapefruit and looking at the information from the link that Amigo posted my own statin (Atorvastatin) is ok providing you are not drinking more than 1.2 litres per day. I have been thinking about this today and have decided that fir me at least, it just isn't worth the potential risk and have just poured a the remainder of a carton down the sink. There is enough dietary choice available to me today not to have to take the risk no matter how measured that risk is. For your own part Dr Introuble, it was you who first started alarm bells ringing on this subject last night in another thread elsewhere on the forum and I cannot thank you enough for it. None of my doctors nor my own pharmacist have ever explained the potential risks and unusually for me I never read the notes that came with the medication when I first started taking it. What a clot I am (please feel free to step in and tell me I'm not really any time you like😛)

 

[mikeyB]

One mistake, DL, no harm, no foul. You aren't a clot, because if anybody on this forum can stand up and say they've never made a mistake they're a fibber. Doctors, of course, bury their mistakes.😎

 

[Hazel]

Now I know it's not the statins, but the high blood pressure

Thanks for sharing