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Grapefruit and medication: A cautionary note

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Harvard Health Ad Watch: Got side effects? There's a medicine for that. Packing your hurricane go bag? Make provisions for your health. Evoking calm: Practicing mindfulness in daily life helps. Grapefruit and grapefruit juice are healthful, providing enough vitamin C, potassium, dietary fiber, and other nutrients to earn the American Heart Association's 'heart-check' mark. That's the good news. The bad news is that grapefruit juice can interact with dozens of medications, sometimes dangerously. Doctors are not sure which of the hundreds of chemicals in grapefruit are responsible. The leading candidate is furanocoumarin. It is also found in Seville sour oranges and tangelos; although these fruits have not been studied in detail, the guidelines for grapefruit should apply to them as well. Grapefruit's culprit chemical does not interact directly with your pills. Instead, it binds to an enzyme in your intestinal tract known as CYP3A4 , which reduces the absorption of certain medications. When grapefruit juice blocks the enzyme, it's easier for the medication to pass from your gut to your bloodstream. Blood levels will rise faster and higher than normal, and in some cases the abnormally high levels can be dangerous. A variety of medications can be boosted by grapefruit juice; the table below lists some of the most important along with related drugs that are less likely to be influenced. Statins high cholesterol. It doesn't take much grapefruit juice to boost the levels of drugs that are susceptible. And because this effect of the juice wears off slowly, a third of its impact is still evident after 24 hours. What are the practical implications of this interaction? If you take one of the affected medications, the simplest solution is to switch to orange juice. If you are really hooked on grapefruit juice, though, you can ask your doctor whether you can switch to a related drug that's less vulnerable to the boosting effect. And if that's not possible, you should certainly avoid taking your pills and your juice simultaneously; the more time between the two, the better, and the smaller your glass of juice, the better. If you are on a low or moderate dose of the medication, you can probably get away with an occasional glass of grapefruit juice, but if you are on a high dose, it could be dangerous. That's especially true in the case of calcium channel blockers, which can lower your blood pressure or slow your heart rate excessively. Sildenafil Viagra is of special interest to men. The clinical information is incomplete, but men who take Viagra should be aware that grapefruit juice might boost blood levels of the drug. That could be a good thing for some men with erectile dysfunction, but it could trigger headaches, flushing, or low blood pressure. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Get the latest in health news delivered to your inbox! Thanks for visiting. Don't miss your FREE gift. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health , plus the latest advances in preventative medicine, diet and exercise , pain relief, blood pressure and cholesterol management, and more. Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss Stay on top of latest health news from Harvard Medical School. Recent Blog Articles. Ever hear of tonsil stones? Midlife ADHD? Coping strategies that can help. Ever worry about your gambling? Color-changing eye drops: Are they safe? Does your child need to bathe every day? How well do you worry about your health? Do parasocial relationships fill a loneliness gap? March 30, Grapefruit can mean danger when combined with some popular drugs used for high blood pressure, high cholesterol and depression Grapefruit and grapefruit juice are healthful, providing enough vitamin C, potassium, dietary fiber, and other nutrients to earn the American Heart Association's 'heart-check' mark. Why do grapefruit and medications interact? That's especially true in the case of calcium channel blockers, which can lower your blood pressure or slow your heart rate excessively Sildenafil Viagra is of special interest to men. Print This Page Click to Print. Related Content. Staying Healthy. Free Healthbeat Signup Get the latest in health news delivered to your inbox! Sign Up. Close Thanks for visiting. The Best Diets for Cognitive Fitness , is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health , plus the latest advances in preventative medicine, diet and exercise , pain relief, blood pressure and cholesterol management, and more. I want to get healthier. Close Health Alerts from Harvard Medical School Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss Close Stay on top of latest health news from Harvard Medical School. Sign me up. Medications substantially boosted by grapefruit juice Generic name Brand name. Medications that have little or no interaction with grapefruit juice Generic name Brand name. Felodipine Plendil Nifedipine Procardia, Adalat. Immunosuppressants to prevent rejection of transplanted organs.

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