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Grapefruit juice
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Grapefruit juice


  I am taking many meds for heart failure including digoxin, quinidex, mexitil and demadex.
  I have heard that grapefruit juice causes some of these drugs to be increased in their blood levels.
  Is this a fact?? If so, does eating grapefruit cause the same problem.  Since I am very fond of both is there a way I could continue to eat/drink grapefruit products??
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Dear Joe, thank your for your question.  You are correct.  Grapefruit juice increases serum levels of certain cardiac drugs to dangerous levels.  The mechanism involves up regulation of intestinal receptors by grapefruit juice that bind the drugs to bring them into the circulation.  There is a known problem with quinidex and grapefruit juice while the interactions with mexitil are unknown.  Thus I recommend that you avoid grapefruit juice and grapefruits themselves.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.





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