It is indeed hard to predict the drugs that will not work well with grapefruit but you can still be guided by several clues.ĭrugs with harmful interactions with grapefruit have three common features:ġ. Furanocoumarins may have a stronger effect than naringin. 15 Grapefruit, Seville oranges, 16 and bergamot 17 contain naringin. It is difficult to predict grapefruit incompatibility since dangerous drug interactions depend on the actual drug and not on the drug’s class. Polyphenols Citrus fruits may contain various polyphenols, including naringin and furanocoumarins, such as bergamottin, dihydroxybergamottin, and bergapten. How would you know if a drug is incompatible with grapefruits?Īlthough the list above summarizes the most common drugs affected by grapefruit, there are many other drugs that may not work well with grapefruit. Triazolam, Diazepam, Alprazolam, Midazolam, Quazepam, NitrazepamĬarvedilol, Dronedarone, Propafenone, DisopyramideĪlso Read: Essential Guide to Medications for Nurses 7. Nifedipine, Felodipine, Amlodipine, Nicardipine Other drugs classified as “intermediate risk” for adverse drug interactions with grapefruit include the following: Drug Non-nucleoside Reverse Transcriptase InhibitorsĬyclosporin, Everolimus, Tacrolimus, Sirolimus Tachycardia, bone marrow or kidney damage Possible Adverse Reaction with Grapefruitĭasatinib, Erlotinib, Everolimus, Lapatinib, Nilotinib, Pazopanib, Sunitinib Here is a list of drugs with major risks for harmful grapefruit interactions: Nurses should be aware of dangerous grapefruit and medication interactions to properly guide patients upon intake of prescribed medicines. What are the common drugs that do not interact well with grapefruit? Consumption of any of these fruits is known to decrease Fexofenadine’s potency.Ħ. Aside from grapefruit, apple and orange are also contraindicated. However, there are additional fruit restrictions for Fexofenadine (Allegra). Other citrus fruits not mentioned are safe to take with medicines. Seville orange, pomelo, tangelo and limes should be avoided since they also contain furanocoumarins. Are there other citrus fruits that produce similar drug interactions as with grapefruit? For this reason, it is best to avoid grapefruits for the whole duration of drug therapy.
Once grapefruit is ingested and furanocoumarins already affecting the CYP3A4 enzyme, it will take 72 hours for the enzyme to completely return to its normal activity. Can grapefruit just be taken at a different time, far from the drug intake schedule? As mentioned above, a little trace of grapefruit can already have a significant effect to CYP3A4 enzymes and may cause adverse drug interactions. This can lead to more statin side effects, like muscle pain and possible muscle breakdown ( rhabdomyolysis ). But grapefruit and grapefruit juice can increase the levels of certain statin medications. All possible products that can come from grapefruits should be avoided like the actual fresh fruit, juice, concentrate, extract, jam, candy and many more. Some statins Statins are first-choice options for treating high cholesterol.
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