If you’ve ever heard of “The Grapefruit Effect,” then you’ll know that you can’t eat grapefruit at all if you take statins like Lipitor and Zocor.
However, what you might not know is that the actual number of drugs that are rendered completely useless when grapefruit is consumed has almost tripled in recent years- and it’s not just cholesterol drugs.
A lot of people have, by now, heard of “The Grapefruit Effect” with medications. This is where an enzyme (called CYP3A4) that is absolutely critical for the body to break down medications and metabolize them is rendered useless when grapefruit is consumed.
Warnings on medication labels might tell you not to eat grapefruit or drink grapefruit juice while taking the drug. And it’s not just because the medicine can’t do its job because of the furanocoumarins (the chemicals that stop the metabolism of the drug).
The drug actually builds up in the bloodstream when it can’t be metabolized and becomes toxic- which can even be deadly.
Just 5 years ago there were only 17 drugs that were known to have dangerous interactions with grapefruit and other fruits, like the Stella oranges used to make marmalade.
Now, there are at least 43, including some for high blood pressure, some antibiotics, and a number of immunosuppresants.
More disturbing is that there are at least 85 other drugs that are considered to have disruptive interactions with grapefruit, but aren’t considered potentially fatal.
Even one glass of grapefruit juice is enough to cause a reaction that is dangerous to the 43 different drugs listed as having a highly dangerous interaction.
If you’re taking any kind of medications, I’d advise you not to drink grapefruit till you have cleared it 100% with your doctor.
Even more effectively, I’d advise you to seek natural solutions to cure high cholesterol and high blood pressure.
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It is a good infomation! but why don’t you list all the names of the
medicines? It can help lots of people.
CAN YOU LIST THE DRUGS KNOWN SO FAR PLEASE?
Where is the list of drugs that interact with grapefruit in a harmful way? I do not see it anywhere in this article. I am on cholesterol meds and high blood pressure meds. It would be good to know, since I love grapefruit.
So was Bill Clinton . That is why he almost died
I also was wondering where the list is, can't find it.
I am on my high blood pressure meds. dried grapefruits tidbits I love to eat,, advice me pls,
What good is it to write an article like this and leave out critical information? I feel like you are sensationalizing the information, making claims that you can't back up with facts…I know that this "grapefruit effect" is real, but without substance, what good are you doing? Please, give us the list, or where we might find it.
They always do this and then flood you with more emails once you click the links. Just Google "grapefruit interaction with drugs". Xanax is one of them, for sure.
I am on cholesterol meds and high blood pressure meds. It would be good to know about the list and at the same time
I would like to if Pumlo which is also like Grape fruit but much bigger in size and plenty found in Thailand as well as China come under the same restriction as Grapefruit.
here's a list i found on google:
http://www.rxlist.com/grapefruit-page3/supplements.htm
Article is incomplete as it fails to address an obvious question; how long after eating / drinking grapefruit can one safely take one’s meds?
I find your grapefruit information not exactly accurate. I take fenofibrate and the information states grapefruit in fine in moderate consumption.
Thanks for all the information you supply. I would love to have the list of drugs that are affted by grapefruit/juice.
Thank You
Here is a list of many of the drugs that negatively interact with Grapefruit. This list is NOT complete so it’s very important that you ask your doctor if you’re taking any drugs:
• The benzodiazepines triazolam (Halcion), orally administered midazolam (Versed), orally administered triazepam (Mogodon), diazepam (Valium), alprazolam (Xanax) and quazepam
• ritonavir (Norvir) inhibits CYP3A4 preventing the metabolism of protease inhibitors
• sertraline (Zoloft and Lustral)
• Some statins such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor, Simlup, Simcor, Simvacor) but not Pravastatin (Pravachol), fluvastatin (Lescol) or rosuvastatin (Crestor) which are unaffected by grapefruit.
• Dihydropyridines including felodipine (Plendil), nicardipine (Cardene), nifedipine, nisoldipine (Sular), nitrendipine (Bayotensin)
• losartan (Cozaar)
• The cough suppressant dextromethorphan
• modafinil (Provigil, Alertec, Modavigil, Modalert, Modiodal, Modafinilo, Carim, Vigia)
• repaglinide (Prandin)
• verapamil (Calan SR, Covera HS, Isoptin SR, Verelan)
• buspirone (Buspar) Grapefruit juice increased peak and AUC plasma concentrations of buspirone 4.3- and 9.2-fold, respectively, in a randomized, 2-phase, ten-subject crossover study.
• levothyroxine (Eltroxin, Levoxyl, Synthroid) Effects of grapefruit juice on the absorption of levothyroxine.
• Antiarrhythmics including amiodarone (Cordarone), dronedarone (Multaq), quinidine (Quinidex, Cardioquin, Quinora), disopyramide (Norpace), propafenone (Rhythmol), and carvedilol (Coreg)
• Antihistamines astemizole (Hismanal) and terfenadine (Seldane) – now removed from the US and Canadian markets
• cisapride (Prepuslid, Propulsid) (which treats GERD) – now removed from the US and Canadian markets
• Erectile dysfunction drugs sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
• The anti-migraine drugs ergotamine (Cafergot, Ergomar), amitryptiline (Elavil, Endep, Vanatrip) and nimodipine (Nimotop)
• Fluvoxamine (Luvox, Faverin, Fevarin and Dumyrox)
• Codeine and Tramadol.[13] It reduces the amount of codeine converted by CYP3A4 into norcodeine thus increasing the amount metabolized into morphine. Morphine itself, however, is not affected by grapefruit juice, as it is not metabolized by the cytochrome P450 system.
• Cyclosporine (Neoral). Blood levels of cyclosporine are increased if taken with grapefruit juice. A plausible mechanism involves the combined inhibition of enteric CYP3A4 and P-glycoprotein, which potentially leads to serious adverse events (e.g., nephrotoxicity).Blood levels of tacrolimus (Prograf) can also be equally affected for the same reason as with cyclosporine. [both drugs are calcineurin inhibitors]
• omeprazole (Losec, Prilosec)
• zolpidem (Ambien) Little or no interaction with grapefruit juice.
• oxycodone (Oxycodone is metabolized by the cytochrome P450 system, specifically CYP3A4, of which the bergamottin flavonoid is a strong inhibitor)
• hydrocodone (The hepatic cytochrome P450 enzyme CYP2D6 converts it into hydromorphone, a more potent opioid.)
• dihydrocodeine
• quetiapine (Seroquel)
• methadone Inhibits the metabolism of methadone and raises serum levels.
• buprenorphine Metabolized into norbuprenorphine by cytochrome-P450 isoenzyme 3A4
• Tyrosine kinase inhibitors, including imatinib (Gleevec) and nilotinib (Tasigna), used to treat chronic myelogenous leukemia and gastrointestinal stromal tumors.
• trazodone (Desyrel) Little or no interaction with grapefruit juice.
• Anthelmintics (Used for treating certain parasitic infections, includes praziquantel albendazole and mebendazole)
• carbamazepine (Tegretol) Grapefruit or grapefruit juice slows the breakdown of this drug, increasing the level of it in blood
• imatinib (Gleevec) Although no formal studies with imatinib and grapefruit juice have been conducted, the fact that grapefruit juice is a known inhibitor of the CYP 3A4, suggests that co-administration may lead to increased imatinib plasma concentrations. Likewise, although no formal studies were conducted, co-administration of imatinib with another specific type of citrus juice called Seville orange juice (SOJ) may lead to increased imatinib plasma concentrations via inhibition of the CYP3A isoenzymes. Seville orange juice is not usually consumed as a juice because of its sour taste, but it is found in marmalade and other jams. Seville orange juice has been reported to be a possible inhibitor of CYP3A enzymes without affecting P-glycoprotein when taken concomitantly with cyclosporine.
• Loperamide (Imodium)
• colchicine (Colcrys)
• erlotinib (Tarceva)
• In a mouse study, blood concentrations of acetaminophen/paracetamol (Tylenol) were found to be increased by white and pink grapefruit juice, with the white juice acting faster.
Here is a list of many of the drugs that negatively interact with Grapefruit. This list is NOT complete so it's very important that you ask your doctor if you're taking any drugs:
• The benzodiazepines triazolam (Halcion), orally administered midazolam (Versed), orally administered triazepam (Mogodon), diazepam (Valium), alprazolam (Xanax) and quazepam.
• ritonavir (Norvir) inhibits CYP3A4 preventing the metabolism of protease inhibitors.
• sertraline (Zoloft and Lustral).
• Some statins such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor, Simlup, Simcor, Simvacor) but not Pravastatin (Pravachol), fluvastatin (Lescol) or rosuvastatin (Crestor) which are unaffected by grapefruit.
• Dihydropyridines including felodipine (Plendil), nicardipine (Cardene), nifedipine, nisoldipine (Sular), nitrendipine (Bayotensin).
• losartan (Cozaar)
• The cough suppressant dextromethorphan.
• modafinil (Provigil, Alertec, Modavigil, Modalert, Modiodal, Modafinilo, Carim, Vigia).
• repaglinide (Prandin)
• verapamil (Calan SR, Covera HS, Isoptin SR, Verelan).
• buspirone (Buspar) Grapefruit juice increased peak and AUC plasma concentrations of buspirone 4.3- and 9.2-fold, respectively, in a randomized, 2-phase, ten-subject crossover study.
• levothyroxine (Eltroxin, Levoxyl, Synthroid) Effects of grapefruit juice on the absorption of levothyroxine.
• Antiarrhythmics including amiodarone (Cordarone), dronedarone (Multaq), quinidine (Quinidex, Cardioquin, Quinora), disopyramide (Norpace), propafenone (Rhythmol), and carvedilol (Coreg).
• Antihistamines astemizole (Hismanal) and terfenadine (Seldane) – now removed from the US and Canadian markets.
• cisapride (Prepuslid, Propulsid) (which treats GERD) – now removed from the US and Canadian markets.
• Erectile dysfunction drugs sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
• The anti-migraine drugs ergotamine (Cafergot, Ergomar), amitryptiline (Elavil, Endep, Vanatrip) and nimodipine (Nimotop).
• Fluvoxamine (Luvox, Faverin, Fevarin and Dumyrox).
• Codeine and Tramadol.[13] It reduces the amount of codeine converted by CYP3A4 into norcodeine thus increasing the amount metabolized into morphine. Morphine itself, however, is not affected by grapefruit juice, as it is not metabolized by the cytochrome P450 system.
• Cyclosporine (Neoral). Blood levels of cyclosporine are increased if taken with grapefruit juice. A plausible mechanism involves the combined inhibition of enteric CYP3A4 and P-glycoprotein, which potentially leads to serious adverse events (e.g., nephrotoxicity).Blood levels of tacrolimus (Prograf) can also be equally affected for the same reason as with cyclosporine. [both drugs are calcineurin inhibitors].
• omeprazole (Losec, Prilosec).
• zolpidem (Ambien) Little or no interaction with grapefruit juice.
• oxycodone (Oxycodone is metabolized by the cytochrome P450 system, specifically CYP3A4, of which the bergamottin flavonoid is a strong inhibitor).
• hydrocodone (The hepatic cytochrome P450 enzyme CYP2D6 converts it into hydromorphone, a more potent opioid.)
• dihydrocodeine
• quetiapine (Seroquel)
• methadone Inhibits the metabolism of methadone and raises serum levels.
• buprenorphine Metabolized into norbuprenorphine by cytochrome-P450 isoenzyme 3A4.
• Tyrosine kinase inhibitors, including imatinib (Gleevec) and nilotinib (Tasigna), used to treat chronic myelogenous leukemia and gastrointestinal stromal tumors.
• trazodone (Desyrel) Little or no interaction with grapefruit juice.
• Anthelmintics (Used for treating certain parasitic infections, includes praziquantel albendazole and mebendazole).
• carbamazepine (Tegretol) Grapefruit or grapefruit juice slows the breakdown of this drug, increasing the level of it in blood.
• imatinib (Gleevec) Although no formal studies with imatinib and grapefruit juice have been conducted, the fact that grapefruit juice is a known inhibitor of the CYP 3A4, suggests that co-administration may lead to increased imatinib plasma concentrations. Likewise, although no formal studies were conducted, co-administration of imatinib with another specific type of citrus juice called Seville orange juice (SOJ) may lead to increased imatinib plasma concentrations via inhibition of the CYP3A isoenzymes. Seville orange juice is not usually consumed as a juice because of its sour taste, but it is found in marmalade and other jams. Seville orange juice has been reported to be a possible inhibitor of CYP3A enzymes without affecting P-glycoprotein when taken concomitantly with cyclosporine.
• Loperamide (Imodium)
• colchicine (Colcrys)
• erlotinib (Tarceva)
• In a mouse study, blood concentrations of acetaminophen/paracetamol (Tylenol) were found to be increased by white and pink grapefruit juice, with the white juice acting faster.
Hi all,
Go to website http://www.rxlist.com/grapefruit-page3/supplements.htm as there are far too many drugs can’t be taken with grapefruit !!
Thank you Donna Steckling for so kind by giving us this website !!
On November 29, 2012, The CBC, Canada's National Broadcasting Corporation, produced a documentary revealing that some 85 prescription drugs sold the world over can cause serious side effects and even death when consumed with foods like grapefruit, oranges, limes and pomelos. Two cholesterol drugs , Lipitor and Zocor are rendered useless when consumed with grapefruit. They then build up in the body and turn toxic. When I sent a letter to our local Newspaper in Victoria, BC, refused to be printed. My suggestion was that the prescription drug conglomerates should have no problem doing the right thing and to take them off the market asap. I concluded my article by suggesting that wholesome foods must take priority over taking dangerous drugs. Might as well talk to a brick wall! It has also been found that garlic, the centuries old wonderful food and its many benefits, also creates serious contraindications with a number of drugs and therefore should be avoided. What's our world coming to?
Lest I be misunderstood. I am aware that many drugs do great things, but there are natural real cures for many health problems. Do your own research and make up your own minds. I am 77 and have taken a few prescription drugs that never cured anything and have consistently turned to eating the right wholesome foods that help, continue to be physically active, keep my immune and digestive system in shape, get at least 7 hours of sleep, avoid junk foods, drink in moderation,keep my brain active,avoid pain killers and I have never had a flu shot and never intend to. Please research the active and lethal components in flu shots and you’ll get the picture.On a final note, I have had 3 illustrious different careers and retired at age 75 after 60 years in the workforce. I am deeply concerned about where our society has been led.
The issue is very straightforward, and applies to a lot more than just grapefruit. But it is very common.
Main issue is what is known as the Cytochrome P450 System. This system is responsible for the metabolic breakdown or enhancement of at least 70% of medications. Other things can change the outcome, even broccoli, St. Johns Wort, and it goes on. It can even modify the outcome of anti-rejection medications, tranquilizers, blood thinners, etc. For serious scrutiny, get the categories and their contents of the Cytochrome P450 System.
Would like to have the list of drugs that are affected by grapefruit and grapefruit juice.
Many thanks
Seems like the key is to eat lots of grapefruit and not use those poisonous drugs with their 40 million side effects.
At least morphine is ok!! Lol
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