grapefruit juice...interesting

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>

> Grapefruit juice and your medications

>

> Grapefruit juice boosts the effects of many medications. It contains

> a substance called furanocoumarin that, by some quirk of nature,

> binds with a set of enzymes in the small intestine. Usually those

> enzymes break down a fairly high portion of many medications before

> they're absorbed. But grapefruit juice handcuffs them. More

> medication gets pulled into the bloodstream. And more medication in

> the bloodstream usually means a stronger effect.

>

> This chain of events was first seen with felodipine (Plendil), a

> calcium-channel blocker. Now the list of drugs that get "juiced up"

> by grapefruit juice includes other calcium-channel blockers, anti-

> anxiety drugs, some drugs that suppress the immune system, and many

> of the cholesterol-lowering drugs in the statin family (Lipitor,

> Mevacor, Zocor, other brands). Grapefruit juice doesn't increase the

> effect of pravastatin (Pravachol), however, because it is

> metabolized differently. If you enjoy grapefruit juice and take

> prescription medications, here's what you need to know:

>

> * The absorption-enhancing effect of grapefruit juice tapers off

> with time, so if you drink a glass of grapefruit juice in the

> morning and take your medications at night, there should be

> little effect from the juice.

>

> * If you don't already take your medications with grapefruit

> juice, don't start. Doing so could increase the effects of the

> drugs beyond what your doctor intended.

>

> * If you already take medication with grapefruit juice, and

> haven't experienced ill effects, talk with your doctor. Most

> likely, it isn't a problem, but it's a good idea to inform your

> physician (particularly if he or she decides to change the dose

> of your prescription).

>

> Most of the oranges and orange juice consumed in the United States

> don't have the same effect as grapefruit and its juice. But Seville

> oranges (which are sour and used to make marmalade) and tangelos

> (hybrids of grapefruit and other citrus fruits, usually tangerines)

> do, and so may also affect the absorption of some drugs.

>

> To date, almost all of the research has been on grapefruit juice.

> But several years ago, Canadian researchers compared grapefruit

> juice with segments from a whole grapefruit and a concoction that

> included grapefruit peel. The juice, the whole fruit, and the peel

> concoction all boosted blood levels of the test medication. The peel

> had the biggest effect. The evidence for grapefruit juice affecting

> drug metabolism is much stronger, but it seems that grapefruit

> itself might also be a problem.

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