When taking medications it is essential to know what risks exist in combination with the intake of food and beverages . Generally, the package inserts refer to the dangerous effects of drinking alcohol with a prescription medication running, but there are also risks with other products that do not contain alcohol. One of the most striking cases is that of grapefruit , which in both fruit and juice formats (the most common), is associated with harmful consequences for health if combined with certain medications.
Grapefruit is a fruit that stands out in the field of nutrition for its healthy properties . In this sense, it is a source of fiber, key to the proper functioning of the digestive tract; it has a lot of potassium, an essential mineral for proper body function; and provides a large amount of vitamin C, necessary for the normal growth and development of the human body. However, the US Food and Drug Administration (FDA) warns about its dangers with certain drugs.
According to this US government agency, these are the drugs that can cause problems if they interact with grapefruit or grapefruit juice in our body (the generic name is included in parentheses):
Cholesterol-lowering drugs such as Zocor (simvatastine) and Lipitor (atorvastatin).
Medications that treat hypertension such as Procardia (nifedipine) and Adalat CC (nifedipine).
Medicines to prevent rejection in organ transplants such as Neoral (cyclosporine) and Sandimmun (cyclosporine).
Anti-anxiety medications such as Buspar (buspirone).
Medicines that treat Crohn’s disease or ulcerative colitis such as Entocort EC (budesonide).
Medicines that treat abnormal rhythm of the heartbeat such as Pacerone (amiodarone) and Cordarone (amiodarone).
Antihistamine medications such as Allegra (fexofenadine).
Grapefruit juice does not affect all of the above generic drugs. The severity of the interaction may be different depending on the person, the medicine, and the amount of juice taken .
The dangers of grapefruit with these medications
Grapefruit juice allows too much of the medicine, or in other cases too little, to get into the blood. “When there is too much medicine in the blood, you can have more side effects , ” explains Shiew Mei Huang, a physician at the FDA.
For example, if you drink too much grapefruit juice with cholesterol-lowering medications, too much of it could stay in the body, increasing the risk of liver and muscle damage , and even leading to kidney failure .
Also, many drugs are broken down ( metabolized ) in the small intestine with the help of the CYP3A4 enzyme. Grapefruit juice can block the intestinal action of CYP3A4, so instead of being metabolized, more of the drug enters the blood and spends more time in the body.
The amount of CYP3A4 in the intestine varies between people. Some have a lot and others little. Therefore, grapefruit juice can affect differently, even in people taking the same medicine.
On the other hand, antihistamine drugs such as fexofenadine have their amount in the blood reduced by grapefruit juice. This can cause the medicine not to work as it should.