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Grapefruit juice: Can it cause drug interactions?

I like to drink grapefruit juice. Could the juice interfere with my medications?

- Albert / Texas

Mayo Clinic dietitian Katherine Zeratsky, R.D., L.D., and colleagues answer select questions from readers.

Answer

Grapefruit juice provides many nutrients, including vitamin C, potassium and lycopene. But chemicals in grapefruit juice and grapefruit pulp interfere with the enzymes that break down (metabolize) various drugs in the digestive system — including certain calcium channel blockers and cholesterol-lowering drugs. The result can be excessively high levels of these drugs in the blood and an increased risk of potentially serious side effects. Pomelos and Seville oranges, a type of bitter orange often used to make marmalade and compotes, may have a similar effect.

Here's a sampling of drugs known to have potentially serious interactions with grapefruit products:

Drug name Type of drug
Amiodarone (Cordarone) A drug used to treat and prevent abnormal heart rhythms (arrhythmias)
Buspirone (BuSpar), sertraline (Zoloft) Antidepressants
Carbamazepine (Carbatrol, Tegretol) An anti-seizure medication
Cyclosporine (Neoral, Sandimmune), tacrolimus (Prograf) Immunosuppressant drugs
Felodipine (Plendil), nifedipine (Procardia), nimodipine (Nimotop), nisoldipine (Sular) Calcium channel blockers used to treat high blood pressure
Saquinavir An HIV medication
Simvastatin (Zocor), lovastatin (Mevacor), atorvastatin (Lipitor) Statins used to treat high cholesterol

If you're concerned about the effect grapefruit juice may have on your medications, talk to your doctor or pharmacist. In some cases, it may be important to avoid grapefruit and grapefruit products, as well as pomelos, Seville oranges and products made with these fruits. Waiting to take these medications — even up to 24 hours — after you drink grapefruit juice won't prevent an interaction. In other cases, it may be possible to switch to an alternative medication that won't interact with these fruits.

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Jan 6, 2009