It is important to discuss your medications with your doctor to determine if any of your medications could have this dangerous interaction. The coadministration of these drugs with grapefruit juice can markedly elevate drug bioavailability, and can alter pharmacokinetic and pharmacodynamic. The grapefruit warning simply means that you shouldnt take that medication with grapefruit juice. Reducing your intake of these citrus products or simply choosing alternative fluids (including water) may be advisable to prevent such potentially dangerous side effects. Grapefruit is known to inhibit the CYP3A4 enzyme, which means that it can delay or prevent the absorption of drugs that rely on that enzyme.
There are large inter-individual differences in enzyme efficiency. The bottom line is that you should be careful when consuming citrus juice, especially grapefruit juice, if you require certain classes of medications (which have the potential for these serious reactions). Drugs interacting with grapefruit and inducing serious clinical consequences (confirmed or very probable) include: immunosuppressants, some statins, benzodiazepines, most calcium channel blockers, indinavir and carbamazepine.
In this way, there can be some medications that could be safer to take with grapefruit juice. It is important to realize that the grapefruit interaction is specific to only certain medications within a drug class and not the entire class of drugs. The toxic effect can potentially occur even if grapefruit is consumed many hours before taking the medication.Īs an example simvastatin taken daily with a 7 ounce glass of grapefruit juice, can result in up to a 330 percent higher concentration of drug in the body compared to taking it with water alone, potentially leading to a serious and and potentially life threatening complication called rhabdomyolysis which can lead to kidney failure. The degree of the grapefruit interaction is variable, with the potential for a toxic effect of a medication to occur from just one serving of grapefruit juice.
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