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Grapefruit Is a Culprit in More Drug Reactions
NY Times ^ | DECEMBER 17, 2012 | RONI CARYN RABIN

Posted on 12/18/2012 8:13:07 PM PST by neverdem

The patient didn’t overdose on medication. She overdosed on grapefruit juice.

The 42-year-old was barely responding when her husband brought her to the emergency room. Her heart rate was slowing, and her blood pressure was falling. Doctors had to insert a breathing tube, and then a pacemaker, to revive her.

They were mystified: The patient’s husband said she suffered from migraines and was taking a blood pressure drug called verapamil to help prevent the headaches. But blood tests showed she had an alarming amount of the drug in her system, five times the safe level.

Did she overdose? Was she trying to commit suicide? It was only after she recovered that doctors were able to piece the story together.

“The culprit was grapefruit juice,” said Dr. Unni Pillai, a nephrologist in St....

--snip--

The interaction also can be caused by other citrus fruits, including Seville oranges, limes and pomelos; one published case report has suggested that pomegranate may increase the potency of certain drugs.

Older people may be more vulnerable, because they are more likely to be both taking medications and drinking more grapefruit juice. The body’s ability to cope with drugs also weakens with age, experts say.

Under normal circumstances, the drugs are metabolized in the gastrointestinal tract, and relatively little is absorbed, because an enzyme in the gut called CYP3A4 deactivates them. But grapefruit contains natural chemicals called furanocoumarins, that inhibit the enzyme, and without it the gut absorbs much more of a drug and blood levels rise dramatically.

For example, someone taking simvastatin (brand name Zocor) who also drinks a small 200-milliliter, or 6.7 ounces, glass of grapefruit juice once a day for three days could see blood levels of the drug triple, increasing the risk for rhabdomyolysis, a breakdown of muscle that can cause kidney damage...

(Excerpt) Read more at well.blogs.nytimes.com ...


TOPICS: Culture/Society; News/Current Events
KEYWORDS: cyp3a4; fooddrugreactions; furanocoumarins; grapefruit; medicine
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Grapefruit Interacting Drugs and Associated Oral Bioavailability, Adverse Event(s), Risk Ranking and Potential Alternative Medications(PDF)

Type 2 diabetics taking repaglinide, aka Prandin, and saxagliptin, aka Onglyza, beware of the mentioned foods.

1 posted on 12/18/2012 8:13:19 PM PST by neverdem
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To: neverdem

Maybe John Boenher will suggest we have a frank discussion about citrus.


2 posted on 12/18/2012 8:19:22 PM PST by SpaceBar
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To: neverdem

I’m not sure if suggesting a smaller amount of medication plus grapefruit juice, as a cost saver, would be a joke or not. I’d guess that the grapefruit juice would have to be pretty well calibrated as well, not just something from the grocery store.


3 posted on 12/18/2012 8:22:03 PM PST by jiggyboy (Ten percent of poll respondents are either lying or insane)
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To: neverdem
Grapefruit Is a Culprit in More Drug Reactions

That's why it is a good idea to read the pamphlets included with your medications.

4 posted on 12/18/2012 8:24:01 PM PST by Alaska Wolf (Carry a Gun, It's a Lighter Burden Than Regret)
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To: neverdem

I don’t eat or drink grapefruit, but I do drink a bit of orange juice at breakfast. I’ll have to check that out, I guess, since I take atorvastatin.


5 posted on 12/18/2012 8:30:18 PM PST by Cicero (Marcus Tullius)
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To: neverdem

Thank you for this. I had known that grapefruit juice and other citrus interferes with some drugs, but didn’t know about the statins.


6 posted on 12/18/2012 8:33:08 PM PST by MestaMachine (It's the !!!!TREASON!!!!, stupid!)
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To: neverdem
I'm on Lipitor and the instructions say not to have grapefruit juice. I really miss grapefruit juice - I don't have a sweet tooth - I have an anti-sweet tooth. I was also on verapamil for a while.



Keep Faith with the Fallen of Benghazi! Let the Obama Regime, for once, tell the Truth!

Fiat Justitia, Ruat Coelum!

Genuflectimus non ad principem sed ad Principem Pacis!

Listen, O isles, unto me; and hearken, ye people, from far; The LORD hath called me from the womb; from the bowels of my mother hath he made mention of my name. (Isaiah 49:1 KJV)

7 posted on 12/18/2012 8:41:14 PM PST by ConorMacNessa (HM/2 USN, 3/5 Marines RVN 1969 - St. Michael the Archangel defend us in Battle!)
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To: neverdem

It is interesting since Grapefruit juice is my least favorite type of juice and I’ve very rarely had it. Grapefruit sparkling water, on the other hand I’ve indulged in that more.


8 posted on 12/18/2012 8:48:16 PM PST by Merta (I blame Adam)
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To: neverdem
From MedicineNet.com: Large quantities of grape fruit juice (>1 quart daily) also will increase blood levels of simvastatin and should be avoided.
9 posted on 12/18/2012 8:51:05 PM PST by Brandonmark (OWCM is The new American Minority!)
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To: Judith Anne; 2ndreconmarine; Fitzcarraldo; Covenantor; rejoicing; Rushmore Rocks; ...

Health & science stories like this one is one of the few reasons I check out the NY Times. Most patients are unaware of adverse food and drug interactions, unless it’s printed on the label of the drug container.

This one of those rare everybody on my lists gets pinged, including some medical docs who have identified themselves as such that are not on any list. Comment# 1 has a link to the list of these drugs. From its URL it looks like it was in the Journal of the Canadian Medical Association.

Happy Chanukah, Merry Christmas and Happy New Year!


10 posted on 12/18/2012 8:53:59 PM PST by neverdem ( Xin loi min oi)
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To: Judith Anne; 2ndreconmarine; Fitzcarraldo; Covenantor; rejoicing; Rushmore Rocks; ...

Health & science stories like this one is one of the few reasons I check out the NY Times. Most patients are unaware of adverse food and drug interactions, unless it’s printed on the label of the drug container.

This one of those rare everybody on my lists gets pinged, including some medical docs who have identified themselves as such that are not on any list. Comment# 1 has a link to the list of these drugs. From its URL it looks like it was in the Journal of the Canadian Medical Association.

Happy Chanukah, Merry Christmas and Happy New Year!


11 posted on 12/18/2012 8:54:59 PM PST by neverdem ( Xin loi min oi)
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To: neverdem

A while back, someone who was a medical transcriber told me, that, grapefruit juice was a trick older folks used with their meds to save money. They’d take half the dose prescribed with a glass of grapefruit juice. The medical establishment would frown on that because they would lose money... and it would mess up their statistics.

I don’t know how much of that is true.


12 posted on 12/18/2012 8:59:33 PM PST by 1_Rain_Drop
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To: neverdem

13 posted on 12/18/2012 9:00:01 PM PST by Revolting cat! (Bad things are wrong! Ice cream is delicious!)
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To: neverdem; a fool in paradise; Slings and Arrows

14 posted on 12/18/2012 9:01:02 PM PST by Revolting cat! (Bad things are wrong! Ice cream is delicious!)
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To: neverdem

Thanks for the ping!


15 posted on 12/18/2012 9:02:20 PM PST by Alamo-Girl
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To: neverdem

Neverdem: JA, first on your ping list, is dearly departed. I still think of her frequently.


16 posted on 12/18/2012 9:02:34 PM PST by steve86 (Acerbic by Nature, not NurtureĀ™)
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To: neverdem
Since grapefruit juice is cheaper than prescription drugs - maybe a smaller dose and a glass of juice would be a better idea...
17 posted on 12/18/2012 9:07:52 PM PST by GOPJ (Detroit should be renamed 'Michael Mooresville'...)
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To: neverdem

Thanks for the info. Now, how do I stop these darn kidney stones? Yeah, I drink lots of lemonade.


18 posted on 12/18/2012 9:11:38 PM PST by doug from upland (Obama and the leftists - destroying our country one day at a time)
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To: neverdem

Already gnu about the adjuvant properties of grapefruit, but thanks, more quantitative information is always desirable. I’d heard about it effectively doubling the dose, but never a multiple of five.


19 posted on 12/18/2012 9:12:22 PM PST by Carry_Okie (The Slave Party: advancing indenture since 1787.)
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To: steve86

I miss her, too. :(


20 posted on 12/18/2012 9:13:02 PM PST by Politicalmom (Liberalism. Ideas so great they have to be mandatory.-FReeper Osage Orange)
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