Fruits + vegetables can increase or decrease the activity +t oxicity of orally a

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Fruits and vegetables can increase or decrease the activity and

toxicity of orally-administered drugs

http://www.news-medical.net/?id=13593

Eating fruits and vegetables is essential to living a long and

healthy life, yet research has shown they can cause dangerous

interactions with medicines. According to the July issue of General

Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-

reviewed journal, foods can increase or decrease the activity and

toxicity of orally-administered drugs (intravenous drugs are not

altered).

One of the most studied of these interactions is the inhibition of

CYP3A4 enzymes caused by grapefruit or its juice. CYP3A4 enzymes are

responsible for the metabolism of more than 60 percent of orally-

administered drugs. Drugs that interact with grapefruit include anti-

infectives, anti-inflammatories, cardiovascular agents, central

nervous system agents, estrogens, gastrointestinal agents, Histamine

H1 antagonists, immunosuppressives, and erectile dysfunction drugs.

Dental patients in particular should be aware of interactions with

the sedatives triazolam, midazolam and diazepam which could cause

excessive sedation.

As little as 6.0 oz of grapefruit juice may lower the amount of a

drug needed to produce the desired effect, which could cause an

overdose. The blood that absorbs nutrients passes through the liver

before reaching the general circulatory system (the first-pass). The

ability of a drug to successfully pass from the GI tract to the

plasma is called its bioavailability. Grapefruit juice inhibits first-

pass drug metabolism, increasing bioavailability.

Many elderly patients vacation or spend winters in southern states

such as Florida, where they may be more likely to consume grapefruit

and other fruits that may interact with prescribed medicines. The

components of grapefruit juice believed to be clinically active are

also found in limes, pumellos, and Seville oranges. Natural food

products, citrus products and cabernet sauvignon wine are also known

to interact with drugs. This interaction can increase the

concentration of drugs in the bloodstream and enhance their potency,

which can result in toxicity.

While most people know to ask their pharmacists about possible

interactions between medicines, many don't realize they should also

be asking about the foods in their refrigerator, according to Dennis

Flanagan, DDS, MAGD. He advises that patients use caution because

there are probably more food and beverage interactions that have not

yet been discovered. There are ways to protect against food/drug

interactions. Patients should refrain from grapefruit consumption for

24 to 48 hours before and during drug therapy, says Dr. Flanagan. He

also suggests that " Patient should read the drug information flyer

provided in every prescribed drug and question their pharmacist.

[They] should also be advised to report any unusual drug effect. "

http://www.agd.org/