grapefruit juice

[Guest guest]

At least 5 years ago this was published in newspapers and on the

internet. The message was " don't take grapefruit in any form if you

are taking any medication as it increases and prolongs/increases the

medicines concentration in the blood stream " .

The guilty components are the flavonids. The flavonids in other

citrus fruits (oranges, lemons, limes. tangerines etc) are said to

be harmless. If the citrus fruit is a cross breed you should get

some medical advice or simply avoid it.

You did the right thing to remind us of this. Some doctors are still

unware of this.

> Prescription for Disaster: Grapefruits Unappealing Consequences

>

> New research shows that a component in grapefruits appears to

interfere with

> the liver’s ability to eliminate some heart medicines and

other

drugs from the

> body. As a result, they can build up in the blood to toxic levels.

>

> The list of affected drugs includes medications to treat high

blood pressure,

> heart failure arrhythmias and high cholesterol. Some of the brand

names are:

> Procardia, Plendil, Adalat, Nimotop, Calan, Verelan and Isoptin,

Lipitor,

> Zocor, Mevacor, Quinidine, Pletal and Norvasc, Toprol XL , and

most beta blockers.

>

> Although the science behind this interaction is complex, the

solution is

> simple.

>

> If you are taking medications which may be affected by grapefruit

or

> grapefruit juice, then do not drink grapefruit juice. Studies

still vary on how much

> juice a patient can drink and when. Our advice is to play it safe

and avoid

> grapefruits in any form.

>

> Should you have questions about your medications and drinking

grapefruit

> juice, we advise you to ask your Midwest Heart Specialists

physician about

> interactions.

> Drug and Food Interactions: Do not take Grapefruit Juice without

talking to

> your doctor first if you are taking:

> High blood pressure medicine (also called antihypertensives,

examples: Adalat

> ® nifedipine, Hytrin® terazosin, Tenormin® atenolol, Toprol

®

> Lopressor® metoprolol, Cardizem® Dilacor® diltiazem, Calan

® Isoptin®

> verapamil, Zestril® lisinopril) (3-10)

> Medicine to help you relax or sleep (also called benzodiazepines,

examples:

> Xanax® alprazolam, Ativan® lorazepam, Valium® diazepam,

Halcion®

> triazolam) (3-10)

> Transplant medicine (also called immunosuppressants, example:

Neoral®

> Sandimmune® cyclosporine) (3-10)

> Invirase® saquinavir (3-10)

> Tegretol ® carbamazepine (3-10)

> Quinidex® Quinidine (3-10)

> High cholesterol medicine (also called HMG-CoA reductase

inhibitors,

> examples: Mevacor® lovastatin, Zocor® simvastatin, Lipitor®

atorvastatin) (3-10)

> Estrogen (examples: Premarin® conjugated estrogens, birth

control pills)

> (3-10)

> Medicine for allergies or colds (also called antihistamines,

examples:

> Claritin® loratadine, Allegra® fexofenadine, Benadryl®

diphenhydramine) (3-10)

>

>

>

[Guest guest]

Thanks, Lionel! Kathleen Stept

> At least 5 years ago this was published in newspapers and on the

> internet. The message was " don't take grapefruit in any form if you

> are taking any medication as it increases and prolongs/increases the

> medicines concentration in the blood stream " .

>

[Guest guest]

> At least 5 years ago this was published in newspapers and on the

> internet. The message was " don't take grapefruit in any form if you

> are taking any medication as it increases and prolongs/increases

the

> medicines concentration in the blood stream " .

Lionel:

Increasing the concentration of a medicine in the bloodstream is not

ALWAYS A BAD THING. After reading a recent study where hign dose

statins (approximately 4 times the normal dose) dramatically reduced

cardiovascular events ---- I asked my cardio about the

Lipitor/grapefruit interaction. Specifically I asked him, " If

grapefruit increases the amount of Lipitor in my bloodstream, in

light of the new study is that a bad thing, or a good thing " . He said

it was a good thing --- and that in fact some oncologists are using

the grapefruit interaction to intensify the effects of some very

expensive cancer drugs.

So yes there is an interaction. Yes it could be dangerous. But with

the advice and consent of your doctor, it also can be beneficial.

With my doctors consent, I intend to continue taking my lipitor with

my morning grapefruit.

H, Charlotte NC

[Guest guest]

> At least 5 years ago this was published in newspapers and on the

> internet. The message was " don't take grapefruit in any form if you

> are taking any medication as it increases and prolongs/increases

the

> medicines concentration in the blood stream " .

Lionel:

Increasing the concentration of a medicine in the bloodstream is not

ALWAYS A BAD THING. After reading a recent study where hign dose

statins (approximately 4 times the normal dose) dramatically reduced

cardiovascular events ---- I asked my cardio about the

Lipitor/grapefruit interaction. Specifically I asked him, " If

grapefruit increases the amount of Lipitor in my bloodstream, in

light of the new study is that a bad thing, or a good thing " . He said

it was a good thing --- and that in fact some oncologists are using

the grapefruit interaction to intensify the effects of some very

expensive cancer drugs.

So yes there is an interaction. Yes it could be dangerous. But with

the advice and consent of your doctor, it also can be beneficial.

With my doctors consent, I intend to continue taking my lipitor with

my morning grapefruit.

H, Charlotte NC

[Guest guest]

> At least 5 years ago this was published in newspapers and on the

> internet. The message was " don't take grapefruit in any form if you

> are taking any medication as it increases and prolongs/increases

the

> medicines concentration in the blood stream " .

Lionel:

Increasing the concentration of a medicine in the bloodstream is not

ALWAYS A BAD THING. After reading a recent study where hign dose

statins (approximately 4 times the normal dose) dramatically reduced

cardiovascular events ---- I asked my cardio about the

Lipitor/grapefruit interaction. Specifically I asked him, " If

grapefruit increases the amount of Lipitor in my bloodstream, in

light of the new study is that a bad thing, or a good thing " . He said

it was a good thing --- and that in fact some oncologists are using

the grapefruit interaction to intensify the effects of some very

expensive cancer drugs.

So yes there is an interaction. Yes it could be dangerous. But with

the advice and consent of your doctor, it also can be beneficial.

With my doctors consent, I intend to continue taking my lipitor with

my morning grapefruit.

H, Charlotte NC

[Guest guest]

> > At least 5 years ago this was published in newspapers and on the

> > internet. The message was " don't take grapefruit in any form if

> Lionel:

> Increasing the concentration of a medicine in the bloodstream is

not

> ALWAYS A BAD THING. .......................snip

Lionel and :

No one knows for sure whether grapefruit juice potentiates or makes

a drug ineffective. So, I wouldn't really want to take a chance

either way.

Taking cranberry juice on the other hand has been documented and

proven to potentiate the effect of Coumadin in about 5

persons.....and has caused some deaths when the INR went way out of

range.

Isabelle

[Guest guest]

> > At least 5 years ago this was published in newspapers and on the

> > internet. The message was " don't take grapefruit in any form if

> Lionel:

> Increasing the concentration of a medicine in the bloodstream is

not

> ALWAYS A BAD THING. .......................snip

Lionel and :

No one knows for sure whether grapefruit juice potentiates or makes

a drug ineffective. So, I wouldn't really want to take a chance

either way.

Taking cranberry juice on the other hand has been documented and

proven to potentiate the effect of Coumadin in about 5

persons.....and has caused some deaths when the INR went way out of

range.

Isabelle

[Guest guest]

> > At least 5 years ago this was published in newspapers and on the

> > internet. The message was " don't take grapefruit in any form if

> Lionel:

> Increasing the concentration of a medicine in the bloodstream is

not

> ALWAYS A BAD THING. .......................snip

Lionel and :

No one knows for sure whether grapefruit juice potentiates or makes

a drug ineffective. So, I wouldn't really want to take a chance

either way.

Taking cranberry juice on the other hand has been documented and

proven to potentiate the effect of Coumadin in about 5

persons.....and has caused some deaths when the INR went way out of

range.

Isabelle

[Guest guest]

From: jerrynmn1@...

Date: Sat Dec 13, 2003 Subject: grapefruit juice

Jerry previously wrote:

(snip) New research shows that a component in grapefruits appears to

interfere with the liver's ability to eliminate some heart medicines

and other drugs from the body. As a result, they can build up in the

blood to toxic levels. (snip)

[Guest guest]

From: jerrynmn1@...

Date: Sat Dec 13, 2003 Subject: grapefruit juice

Jerry previously wrote:

(snip) New research shows that a component in grapefruits appears to

interfere with the liver's ability to eliminate some heart medicines

and other drugs from the body. As a result, they can build up in the

blood to toxic levels. (snip)

[Guest guest]

From: jerrynmn1@...

Date: Sat Dec 13, 2003 Subject: grapefruit juice

Jerry previously wrote:

(snip) New research shows that a component in grapefruits appears to

interfere with the liver's ability to eliminate some heart medicines

and other drugs from the body. As a result, they can build up in the

blood to toxic levels. (snip)

[Guest guest]

> Lionel and :

>

> No one knows for sure whether grapefruit juice potentiates or makes

> a drug ineffective. So, I wouldn't really want to take a chance

> either way.

> (snip)

> Isabelle

Isabelle:

Grapefruits action to increase the bio-availability of certain drugs

seems to be well understood and well documented. The below is

excerpted from the Merck manual:

" A drug interaction results in an increase or decrease in the effects

of one drug or both drugs. Drug interactions may be desired, as in

combination therapy (eg, for hypertension, asthma, certain

infections, or malignancy), in which two or more drugs are used to

increase therapeutic effects or reduce toxicity, or they may be

unwanted, causing adverse drug effects or therapeutic failure

(snip)

Inhibited metabolism: One drug may inhibit the metabolism of another,

possibly prolonging and increasing the action of the latter.

(Snip)

Grapefruit juice inhibits CYP3A4, a cytochrome P-450 enzyme, and

thereby increases the bioavailability of certain drugs (eg,

felodipine) and increases their effect. "

So I stand by my previous post --- the grapefruit drug interaction is

NOT ALWAYS A BAD THING. But make sure your doctor is aware and agrees!

H, Charlotte NC

[Guest guest]

> Lionel and :

>

> No one knows for sure whether grapefruit juice potentiates or makes

> a drug ineffective. So, I wouldn't really want to take a chance

> either way.

> (snip)

> Isabelle

Isabelle:

Grapefruits action to increase the bio-availability of certain drugs

seems to be well understood and well documented. The below is

excerpted from the Merck manual:

" A drug interaction results in an increase or decrease in the effects

of one drug or both drugs. Drug interactions may be desired, as in

combination therapy (eg, for hypertension, asthma, certain

infections, or malignancy), in which two or more drugs are used to

increase therapeutic effects or reduce toxicity, or they may be

unwanted, causing adverse drug effects or therapeutic failure

(snip)

Inhibited metabolism: One drug may inhibit the metabolism of another,

possibly prolonging and increasing the action of the latter.

(Snip)

Grapefruit juice inhibits CYP3A4, a cytochrome P-450 enzyme, and

thereby increases the bioavailability of certain drugs (eg,

felodipine) and increases their effect. "

So I stand by my previous post --- the grapefruit drug interaction is

NOT ALWAYS A BAD THING. But make sure your doctor is aware and agrees!

H, Charlotte NC

[Guest guest]

> Lionel and :

>

> No one knows for sure whether grapefruit juice potentiates or makes

> a drug ineffective. So, I wouldn't really want to take a chance

> either way.

> (snip)

> Isabelle

Isabelle:

Grapefruits action to increase the bio-availability of certain drugs

seems to be well understood and well documented. The below is

excerpted from the Merck manual:

" A drug interaction results in an increase or decrease in the effects

of one drug or both drugs. Drug interactions may be desired, as in

combination therapy (eg, for hypertension, asthma, certain

infections, or malignancy), in which two or more drugs are used to

increase therapeutic effects or reduce toxicity, or they may be

unwanted, causing adverse drug effects or therapeutic failure

(snip)

Inhibited metabolism: One drug may inhibit the metabolism of another,

possibly prolonging and increasing the action of the latter.

(Snip)

Grapefruit juice inhibits CYP3A4, a cytochrome P-450 enzyme, and

thereby increases the bioavailability of certain drugs (eg,

felodipine) and increases their effect. "

So I stand by my previous post --- the grapefruit drug interaction is

NOT ALWAYS A BAD THING. But make sure your doctor is aware and agrees!

H, Charlotte NC

[Guest guest]

Grapefruit juice is contra-indicated for many psychotropic meds, too.

Usually it says not to have grapefruit juice within a few hours of

taking the meds.

Lindsey