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grapefruit and drug interactions

Source: National Institutes of Health (NIH)

Chemicals in grapefruit interfere with the enzymes that break down (metabolize) certain drugs in your digestive system. This can result in excessively high levels of these drugs in your blood and an increased risk of serious side effects.

The exact chemicals in grapefruit juice that cause this interaction are not known. But these chemicals are present in the pulp and peel of grapefruit as well as in the juice. For this reason, any grapefruit product - including dietary supplements that contain grapefruit bioflavonoids - can interact with certain medications. If you avoid grapefruit, you may also want to avoid tangelos, a hybrid grapefruit, and Seville oranges, a type of bitter orange often used to make marmalade and compotes.

These drugs are known to have potentially serious interactions with grapefruit products, tangelos and Seville oranges.
drug nametype of drug
alprazolam (Xanax)benzodiazepines (tranquilizers)
amiodarone (Cordarone)to treat and prevent abnormal heart rhythms (arrhythmias)
amlodipine-atorvastatin (Caduet)to lower both high cholesterol and high blood pressure
atorvastatin (Lipitor)HMG-CoA reductase inhibitors used to treat high cholesterol
budesonide capsules (Entocort EC)corticosteroid to treat Crohn's disease
buspirone (BuSpar)anti-anxiety
carbamazepine (Carbatrol, Tegretol)an anti-seizure medication
cilostazol (Pletal)to reduce the symptoms of intermittent claudication
clomipramine (Anafranil)antidepressants
cyclosporine (Neoral, Sandimmune)immunosuppressant drugs
diazepam (Valium)benzodiazepines (tranquilizers)
felodipine (Plendil)calcium channel blockers used to treat high blood pressure
indinavir (Crixivan)HIV medications
lovastatin (Mevacor, Altoprev)HMG-CoA reductase inhibitors used to treat high cholesterol
lovastatin-niacin (Advicor)to lower cholesterol and triglyceride levels
methadone (Methadose)pain relief medication (C-II drug)
nifedipine (Adalat, Nifediac, Procardia)calcium channel blockers used to treat high blood pressure
nimodipine (Nimotop)subarachnoid hemorrhage (bleeding in the brain)
nisoldipine (Sular)calcium channel blockers used to treat high blood pressure
saquinavir (Invirase)HIV medications
simvastatin (Zocor)HMG-CoA reductase inhibitors used to treat high cholesterol
simvastatin-ezetimibe (Vytorin)to lower LDL cholesterol and to raise HDL cholesterol
sirolimus (Rapamune)immunosuppressant drugs
tacrolimus (Prograf)immunosuppressant drugs
triazolam (Halcion)benzodiazepines (tranquilizers)
verapamil (Verelan)calcium channel blockers used to treat high blood pressure
If you take any of these drugs, you should completely avoid grapefruit products, tangelos and Seville oranges, unless otherwise directed by your doctor.
Talk to your doctor or pharmacist if you have concerns about the effect of grapefruit products on any of the medications you take.





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2006