Recently, a list of 85 different drugs – many of them very commonly prescribed – was published. Each one of these drugs can, when mixed with grapefruit or grapefruit juice, cause very serious, even deadly interactions! These drugs include cholesterol-lowering agents, anti-cancer medications, heart disease regulators, drugs to control inflammation, anti-diabetes drugs, meds to treat intestinal complaints, birth control pills, and anti-depressants! The problem lies in the fact that grapefruit juice, if taken in large enough amounts, can interact with certain enzyme processes in the liver, thus increasing (and sometimes decreasing) the amount of the drug in your blood. And, it doesn’t even have to be large amounts of grapefruit! Even in smaller amounts – say, like a glass or two of grapefruit juice – can be a problem. So if you are taking any of the medicines listed below, please be careful and stay away from grapefruits or grapefruit juice. Better to be safe than sorry! I’ve grouped these medicines under different categories to help you find the ones you are taking. This is not a comprehensive list of the drugs that may be dangerous to take with grapefruit; be sure to ask your health care professional or your pharmacist if your medications can be dangerous in combination with any foods or supplements.
If you wish to read more about this, Click here to see the U.S. FDA consumer alert.
- cyclophosphamide (Cytoxan)
- crizotinib (Xalkori)
- everolimus (RAD-001)
- imatinib (Gleevec or Glivec)
- venurafenib (Zelboraf)
The interactions between grapefruit and these drugs can cause deadly heart problems and can damage bone marrow.
- repaglinide (Prandin, GlucoNorm, Surepost, NovoNorm)
- saxagliptin (Onglyza)
Eating or drinking grapefruit can cause a dangerous drop in your blood sugar.
Drugs to fight various infections
- albendazole (Albenza)
- saquinivir (Invirase)
Ingesting grapefruit juice or grapefruits with these drugs can cause a drop in blood pressure plus nausea, headaches, dizziness, skin rashes and heart problems.
- budesonide (Rhinocort, Pulmicort, Entocort, Sinocort)
- methylprednisolone (Solu-Medrol, Medrol, Depo-Medrol, Hybrisil, A-Methapred)
The anti-gout drug colchicine (Colcrys) is also on the list. Using these drugs and eating or drinking grapefruits can cause an increase in blood sugars, blood problems and adrenal gland problem
Cholesterol-lowering agents (statins)
- atorvastatin (Lipitor)
- lovastatin (Mevacor, Altoprev)
- simvastatin (Zocor)
These medications can interact with grapefruit, causing a muscle weakness and breakdown called rhabdomyolysis.
Here the list is long, so please talk to your health care professional to be certain if there are any potential issues for you.
- amiodarone (Cordarone, Pacerone, Nexterone)
- amlodipine (Norvasc)
- clopidogrel (Plavix)
- losartan (Cozaar)
Anti-anxiety and anti-depressant drugs
- buspirone (Buspar)
- diazepam (Diastat, Valium)
- fluvoxamine (Luvox)
Symptoms here can include breathing problems, headaches, nausea, mood changes and sleep issues.
- quetiapine (Seroquel)
- Sertraline (Zoloft)
These medications can interact with grapefruit to cause mood changes, sleepiness and slowed breathing.
Birth control pills can also interact with grapefruit and grapefruit juice. In addition to making them less effective at preventing pregnancy, using grapefruit along with these drugs can also increase the risk of developing breast cancer and blood clots!
Drugs used to treat an enlarged prostate gland such as tamsulosin (Flomax) can interact with grapefruit and cause a blockage of urine flow, constipation, dizziness and a drop in blood pressure.
The pain reliever oxycodone is also on the list. Other names for oxycodone include Roxicodone, Oxycontin, and Oxecta, and it is also in Percocet and other drugs for pain. Dangerously slowed breathing can result from mixing oxycodone and grapefruit!
I mentioned earlier that grapefruit and grapefruit juice can interact with certain enzyme processes in the liver. This is important because the liver is the main organ that deals with medication. The grapefruit blocks this normal liver detoxification process, and you end up with more of the drug in your system. The most important takeaway from this whole story is that knowledge is power. It’s not that grapefruit is bad for you – it’s just that grapefruit has certain properties that can cause problems for anyone on these medications. Knowing if any of the medications that you are taking can interact with grapefruit is important in controlling your health. Related health concerns can range from a mild headache to life-threatening heart problems! It’s important that you make sure you know whether or not it is safe for you to have grapefruits or grapefruit juice. Talk to your prescriber or to a pharmacist! I often suggest that people talk to their pharmacists because they often know these things better than the prescribers! That may sound odd, but it’s true. It’s the pharmacist’s job to know what the risks and complications of medications are, and it’s also their responsibility to know what possible interactions there may be with medicines and foods.
Here’s the link again for the official FDA Warning.
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