Subsequently, different mutant and hybrid varieties were developed. It was first bred in Barbados and brought to Florida in 1820s. Grapefruit (Citrus paradise) is thought to have originated as a cross between the Jamaican sweet orange (Citrus sinensis) and the Indonesian pomelo (Citrus maxima) fruit. More research is necessary to identify the mechanism of such interactions and to identify the active ingredients. Therapeutic doses of the affected drugs may produce serious adverse reactions. Grapefruit juice inhibits the CYP3A4 enzyme of the cytochrome P450 system in the intestinal mucosa, increasing the bioavailability of drugs with a high first pass metabolism. It is necessary for all medical practitioners to be aware of the potential for enhanced serum levels of the affected drugs and the possibility of serious adverse effects. However there has been a lack of awareness of its effects on other medications in patients as well as physicians. Since the accidental discovery of its interaction with felodipine, more than 85 drugs have been identified to have the potential to cause serious adverse reactions. The use of grapefruit juice on its own or in a mixture with other juices is gradually increasing in UK and grapefruit juice is now a regular part of breakfast consumption in most of Western Europe and America. Grapefruit juice sales are gradually increasing since 1970s and reached an average of 24.9 million litres per annum between 20.
EATING GRAPEFRUIT AND MEDICATIONS PROFESSIONAL
If individuals have any questions or concerns about interactions between certain medications and grapefruit, consulting a pharmacist or health care professional is recommended.Cite this article as: BJMP 2012 5(4):a538
EATING GRAPEFRUIT AND MEDICATIONS PATCH
Fentanyl, including the fentanyl transdermal patch.Common chronic pain medications affected by grapefruitĬommon chronic pain medications that can interact with grapefruit include, but are not limited to, the following:
It is important to note that other fruit juices or drinks flavored with fruit juice should be checked to ensure grapefruit juice is not an ingredient. Over-the-counter medications have “drug facts” labels that provide a warning if grapefruit or grapefruit juice should be avoided. Prescription medications include medication guides or information sheets that provide important safety instructions, including grapefruit interaction warnings. Grapefruit's ability to alter the absorption of medication lasts from 1 to 3 days therefore, eating grapefruit or drinking grapefruit juice at a different time than taking a medication that is affected by the fruit should also be avoided.
Seville oranges and tangelos interfere with the same enzyme as grapefruits, so they should also be avoided. Grapefruit can also interfere with digestive enzymes that break down medications, resulting in the body absorbing too much of the drug.Įven small amounts of grapefruit, such as two wedges or one cup of grapefruit juice, can delay, decrease, or increase the absorption of certain medications. Grapefruit can interfere with intestinal transporters that help absorb medication, resulting in less of a medication’s active ingredients reaching the bloodstream. Food and Drug Administration (FDA) currently lists over 50 prescription and over-the-counter medications that may negatively interact with grapefruit in the body. How does grapefruit affect certain medications? Serious health consequences can develop if certain medications are taken with grapefruit. Several medications contain a warning label that states, “Do not take with grapefruit” (or similar wording). Warning labels on medications should always be taken seriously.
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