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 ...
Type 2 diabetics taking repaglinide, aka Prandin, and saxagliptin, aka Onglyza, beware of the mentioned foods.
Maybe John Boenher will suggest we have a frank discussion about citrus.
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.
That's why it is a good idea to read the pamphlets included with your medications.
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.
Thank you for this. I had known that grapefruit juice and other citrus interferes with some drugs, but didn’t know about the statins.
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.
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!
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!
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.
Thanks for the ping!
Neverdem: JA, first on your ping list, is dearly departed. I still think of her frequently.
Thanks for the info. Now, how do I stop these darn kidney stones? Yeah, I drink lots of lemonade.
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.
I miss her, too. :(
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.