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1322157 tn?1279660281
Before You Drink That Grapefruit Juice!!!
So, I just poured myself a glass of grapefruit juice and took my medicine - then for some reason I remembered that grapefruit juice interacts with some medications. I just did a quick search online and here is a list (probably not complete) of some medications that interact badly with grapefruit juice. Including some opiates.... Please be careful!



a small part of the piece I read:

"Amy Karch, R.N., M.S., of the School of Nursing at the University of Rochester Medical Center, an expert on drug interactions, explains that grapefruit juice is one of the foods most likely to cause problems with drugs, because it is metabolized by the same enzyme in the liver that breaks down many drugs. The cytochrome P-450 3A4 enzyme breaks down grapefruit juice into useful components for body, just like it breaks down dozens of medications. Karch says when the system is overloaded, the grapefruit juice can “swamp” the system, keeping the liver busy and blocking it from breaking down drugs and other substances.

Drugs that use the same pathway and interact with grapefruit juice target some of the most common health problems doctors see today. The list consists of more than 50 medications, including some drugs used to treat high cholesterol, depression, high blood pressure, cancer, depression, pain, impotence, and allergies.

Karch notes that interactions with grapefruit juice are well known and documented among drug researchers, and that an appropriate warning label is included with each prescription. Nevertheless, she says that many patients, nurses and doctors aren’t aware of the interactions or the potential serious consequences, and that many people fail to read the warning labels about drug-food interactions.

The consequences of an interaction depend on the drug involved. A person on an anti-depressant might have too much or too little energy, depending on the specific medication. Someone on antibiotics might end up with diarrhea or could be ill longer than usual because the some drugs won’t work as well as they should. A heart patient might not get the lowered blood pressure that a medication should deliver, or the heart’s rhythms might become irregular if an anti-arrhythmia drug can’t do its job. The juice could also affect the effectiveness of a woman’s hormone-replacement-therapy medication.

The most severe effects are likely with some cholesterol-lowering medications, Karch says. While the liver devotes its resources to grapefruit juice, the medication could build up to dangerous levels, causing a breakdown of the body’s muscles and even kidney failure. "


Please be aware!

Drugs that Interact with Grapefruit Juice:

(from the December 2004 issue of the American Journal of Nursing)

Antibiotics: clarithromycin, erythromycin, troleandomycin

Anxiolytics: alprazolam, buspirone, midazolam, triazolam

Antiarrhythmics: amiodarone, quinidine

Anticoagulant: warfarin

Antiepileptic: carbamazepine

Antifungal: itraconazole

Anthelmintic: albendazole

Antihistamine: fexofenadine

Antineoplastics: cyclophosphamide, etoposide, ifosfamide, tamoxifen, vinblastine, vincristine

Antitussive: dextromethorphan

Antivirals: amprenavir, indinavir, nelfinavir, ritonavir, saquinavir

Benign prostatic hyperplasia treatment: finasteride

blockers: carvedilol

Calcium channel blockers: diltiazem, felodipine, nicardipine, nifedipine, nimodipine, nisoldipine, verapamil

Erectile dysfunction drugs: sildenafil, tadalafil

Hormone replacement: cortisol, estradiol, methylprednisolone, progesterone, testosterone

Immunosuppressants: cyclosporine, sirolimus, tacrolimus

HMG-CoA reductase inhibitors: atorvastatin, fluvastatin, lovastatin, simvastatin

Opioids: alfentanil, fentanyl, sufentanil

Selective serotonin reuptake inhibitors: fluvoxamine, sertraline

Xanthine: theophylline
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12 Answers
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1322157 tn?1279660281
I just replaced my grapefuit juice with lemonade. :)
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655875 tn?1295698707
I have actually seen this warning on some of my prescription bottles.  This is a good reminder and thank you for posting this. :)
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One of the BIGGEST "NO-NO's with Grapfruit Juice is that FENTANYL PATCH!!!


HUGE NO_NO!!

Great reminder Mummy3too. Thank You!!....Sherry

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356518 tn?1322267242
This is correct. Grapefruit juice will breakdown some pain medications to fast an can cause you to get too much at one time. You should never take any type of pain medication with grapefruit juice.
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356518 tn?1322267242
I wanted to add that I was on the grapefruit diet when I  was first put on Oxycontin and my doctor and pharmacist said NO! You can NOT take this medication with the grapefruit juice at all. Do not even drink it at all when taking this medication.
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Yeah it says on my Zoloft bottle not to drink grapefruit juice. It's fine by me since I can't drink acidic juices.
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82861 tn?1333457511
Good thing I can't stand grapefruit!  :-)
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methadone is another pain med that is a no-no with grapefruit juice, thought i would add this in case some of you are on this med.
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1322157 tn?1279660281
Truthfully, I had no idea.... I had heard that it interacted with antibiotics - but to find out it also interacted with pain meds (and everything else listed..) WOW....

I certainly surprised me!

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1187071 tn?1279373298
Good thing I dont drink any juice lol
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I knew grapefruit juice caused problems with some medications but never new it happened with narcotics.  So, I'm on the Fentanyl patch.  What would happen if I drank grapefruit juice?

I actually don't drink it regularly, but I do at times.  And what about eating a grapefruit itself, is that okay?

I am addicted to juices, though they change from month to month for some reason.  Right now I'm loving orange mango.
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Thanks for reminding me as I had forgotten about grapefruit juice.I sure do miss it though.
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