GRAPEFRUIT JUICE AND DRUG INTERACTIONS
By Salaheldin Elabiad, MPharm

A lot of patients are asking about the potential for drug interactions with grapefruit juice. Some time you can receive a medication prescription container with an affixed warning label that recommends you avoid grapefruit or grapefruit juice while taking the medication. But why is this so important? The Interactions with grapefruit can occur with common and important medications like this one we used for lower cholesterol, and for treat high blood pressure, also with some cancer medication .The Grapefruit juice Can affects how drugs are changed (metabolized) in the body for eventual elimination and can alter the amount of drug in your blood and this can case that you can take the benefit from your drug . for Taking medications at a different time from when grapefruit juice is consumed will not prevent the interaction. The effects of grapefruit juice on certain medications can last for over 24 hours. So, even if you take a medicine that is given only once per day, grapefruit and grapefruit juice should still be avoided for the entire treatment period. This is some Side effects can range from abnormal heart rhythms, stomach bleeding, muscle pain, muscle breakdown, kidney damage, low blood pressure, difficulty breathing, sedation, and dizziness. Other reactions may occur it depends on the drug and the levels of the drug in the blood. common medications that interact with grapefruit juice include certain statin cholesterol drugs such as atorvastatin (Lipitor), lovastatin, simvastatin (Zocor), felodipine (Plendil) and other calcium channel blockers, clarithromycin (Biaxin), and loratadine (Claritin). Some immunosuppressants have been reported to cause kidney damage, and certain pain medications when mixed with grapefruit juice may be linked with depressed breathing.

  • References;
  • - Chen M, Zhou SY, Fabriaga E, et al. Food-drug interactions precipitated by fruit juices other than grapefruit juice: An update review. J Food Drug Anal. 2018 Apr;26(2S):S61-S71. doi: 10.1016/j.jfda.2018.01.009. Epub 2018 Feb 15.
  • - Product Information. Ibrance (palbociclib). Pfizer U.S. Pharmaceuticals Group, New York, NY. Accessed October 6, 2019.
  • - FDA. FDA Consumer Health Articles. Grapefruit Juice and Some Drugs Don't Mix. Accessed August 31, 2019 at https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix
  • - Bailey DG, Malcolm J, Arnold O, et al. Grapefruit juice-drug interactions. Br J Clin Pharmacol 1998;46:101-110. Accessed August 31, 2019 at https://doi.org/10.1046/j.1365-2125.1998.00764.x
  • - Jetter A1, Kinzig-Schippers M, Walchner-Bonjean M, et al. Effects of grapefruit juice on the pharmacokinetics of sildenafil. Clin Pharmacol Ther. 2002 Jan;71(1):21-9.
  • - Horn J, Hansten P. Fruit Juice Interactions. Pharmacy Times. Published Online Dec 1, 2005. Accessed August 31, 2019 at https://www.pharmacytimes.com/publications/issue/2005/2005-12/2005-12-5042