Mixing grapefruit and some prescription drugs can be deadly - AmericaNowNews.com

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Eating grapefruit while taking some prescription drugs can be deadly

Grapefruit are a popular choice for dieters, or those trying to get a healthy dose of Vitamin C. Some people who are taking medication should avoid grapefruit altogether.

Consuming grapefruit while also taking some prescription drugs can cause serious harm or death.

"Things that are even healthy for you, may become a problem with certain medications," said Kim DeRhodes who is a clinical staff pharmacist at Carolinas Medical Center-Mercy in Charlotte.

Researchers have identified over a dozen prescription drugs that can become lethal if grapefruit is in your system.

In fact, a total of 85 medications are known to interact with the citrus and, sometimes, they can cause acute kidney failure, gastric bleeding, muscle breakdown, or difficulty breathing.

"There is a substance in grapefruit that interacts with a liver enzyme that's responsible for metabolism of the drugs," DeRhodes said.

"It can actually increase the amount of drug available to the body and some drugs can get to a toxic level."

Some citrus fruits contain compounds called furanocoumarins which interfere with the body's ability to break down prescription drugs before they enter the blood stream.

The mixing of grapefruit and medication – even if consumed hours apart – can cause an overdose since the drug is concentrating in our body.

"Sometimes up to 12-fold what it would normally be, not just a 20 percent or 50 percent increase in blood levels of the drug, it can be many times, which can make you much more likely to have side effects or toxicity," DeRhodes warned.

Whether it's the whole fruit, concentrate, fresh juice or even grapefruit seed extract, the effects on certain drugs are the same, and are able to interfere with medication more than 24 hours after consumption.

Sweet oranges like navels do not contain the active compound. So if you are taking medication, try drinking orange juice instead or find a substitute for your prescription.

"If it does interact, there's a possibility they can use a different medication in that same drug class that would not have that same interaction," DeRhodes said.

Before taking any drug, you should always ask about possible food interactions.

For years, the list of medications affected by grapefruit has been growing as new drugs and new research comes out.

"I always recommend that someone who takes a lot of prescription medications have what's called a medication management therapy session with a pharmacist," and DeRhodes added, "Pharmacists all over the country will do this for little, or no fee."

Mapping out a plan for your prescriptions helps to avoid potential problems.

Your doctor and pharmacist are the best source of advice about prescription drugs, and how they may interact with this mouth-puckering fruit.

While not all medications have a lethal interaction with grapefruit, some can actually have the opposite effect by decreasing the drug's effectiveness.

One way or the other, talk to your health provider about your prescription drugs and your diet.

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Additional Information:  

The following information is from an NBCNews.com article entitled, "Grapefruit may turn more drugs deadly scientists find" (Source: http://vitals.nbcnews.com/_news/2012/11/27/15461503-grapefruit-may-turn-more-drugs-deadly-scientists-find?lite).

  • The total number of drugs that can cause serious harm when mixed with grapefruit has risen annually. More than 85 drugs that interact with whole grapefruit, grapefruit concentrate or fresh grapefruit juice have been identified, though not all have serious consequences.
  • Serious interactions include acute kidney failure, respiratory failure, gastric bleeding and others.
  • 13 drugs may be lethal when mixed with grapefruit.
  • This type of interaction has been known for two decades, when researchers first discovered that ingestion of grapefruit with certain prescriptions can concentrate the medication in the blood stream.
  • For example, drinking less than a cup of grapefruit juice once a day for three days can lead to a 330% concentration of simvastatin, a popular statin drug.
  • The problem is caused by an active ingredient in some citrus fruits (grapefruit, limes, pomelos, Seville oranges), organic chemical compounds called furanocoumarins, which interfere with a digestive enzyme in humans known as CYP3A4.
  • CYP3A4 helps metabolize toxic substances to keep them out of the bloodstream. It usually inactivates the effects of about 50% of all medications and doctors adjust for that when prescribing drugs.
  • When furanocoumarins in citrus inhibit the enzyme the drug will concentrate in the blood leading to triple or quadruple doses of medication.
  • Sweet oranges (navel, Valencia) do not contain the compound. Try drinking orange juice instead of grapefruit if you are taking medication.

Check out this link on MayoClinic.com <www.mayoclinic.com/health/food-and-nutrition/AN00413> for a short list of medications that interact with grapefruit.

The following information is from an ABCNews.go.com article entitled, "Grapefruit medicine interaction warning expanded" (Source: http://abcnews.go.com/blogs/health/2012/11/26/grapefruit-medicine-interaction-warning-expanded/).

  • According to a report by the Canadian Medical Association Journal, researchers at the University of Western Ontario found the list of medications that can interact with grapefruit was far larger than once believed. From 17 in 2008 to 43 in 2012.
  • The frequency of reactions is small but the risks are high, including sudden death
  • Chemicals in grapefruit called furanocoumarins interfere with the body's breakdown of drugs before they hit the bloodstream, essentially causing a drug overdose and severe side effects.
  • Problems include heart rhythm problems, kidney failure, muscle breakdown, difficulty breaking, blood clots.
  • Some medications interact with grapefruit in the opposite effect, decreasing their effectiveness.
  • One grapefruit or one 8-ounce glass of grapefruit juice can cause effects that last more than 24 hours. Seville oranges, limes and pomelos can do the same, but not sweet orange varieties.
  • A list of common drug-grapefruit interactions can be found at this link.

The following information is from a WebMD.com article entitled, "Drugs That Interact With Grapefruit on the Rise" (Source: http://www.webmd.com/news/20121127/grapefruit-some-medications-risky).

  • There are now more than 85 drugs that may interact with grapefruit, including statins, some antibiotics, cancer drugs and heart drugs.
  • Drugs that interact with grapefruit are taken by mouth and the degree of effect can vary. With some drugs, one serving of grapefruit can be the equivalent of taking multiple doses of drug.
  • If there is not an appropriate substitute, you may need to limit your grapefruit consumption. Do not stop taking medication without consulting your doctor.

The following information is from a WashingtonPost.com article entitled, "Medications now interact with grapefruit; Results sometimes dire" (Source: http://www.washingtonpost.com/blogs/the-checkup/post/more-medications-now-interact-with-grapefruit-results-sometimes-dire/2012/11/26/62c6eab2-37ff-11e2-9258-ac7c78d5c680_blog.html).

  • There are about 43 medications whose interactions with grapefruit can cause serious damage. Altogether, more than 85 drugs might interact but not all may cause serious effects.
  • The drugs all have common traits: taken orally, have limited bioavailability (small percentage of active drug makes it into the bloodstream under normal circumstances) and they all interact in the GI tract with enzyme CYP3A4.
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