questionsdid you know grapefruit juice can cause massive…

vote-for57vote-against
vote-for1vote-against

Neat! I always just thought grapefruit juice was something you took to trip harder with your DOC ^_^.

vote-for15vote-against

You must not have seen this Zyrtec commercial http://www.youtube.com/watch?v=kq3W6TvCB74

I remember the shock and confusion when I told my girlfriend she couldn't have Fresca anymore because the natural grapefruit flavoring had a high chance of interacting with a lot of her medicines. She knew she wasn't supposed to have grapefruit because she reads side-effect lists like they are to-do lists, but she had no idea Fresca was grapefruit flavored.

vote-for12vote-against

@scmtim: You should also warn her about Squirt, if it's sold in your area. Unfortunately named, but nothing's more refreshing on a hot summer day.

I very rarely take prescription meds, and the last time I was sick enough to do I forgot about the grapefruit/drug interaction possibility. Fortunately I mentioned to my doctor on a follow-up visit that I was drinking lots of grapefruit juice and he reminded me and told me not to drink it till I was off the prescription.

vote-for7vote-against

I knew grapefruit interfered with drug absorption but I never put it together and realized that time-release drugs could be releasing over time while not getting absorbed - so when the grapefruit effect wears off you get a huge overdose. Now that almost any daily prescription drug is in a time-release formula, that list is long.

vote-for6vote-against

@omnichad: My understanding is grapefruit juice has the opposite effect from what you're describing, i.e. it greatly enhances absorption.

vote-for7vote-against

One of the first things I was told before getting my liver transplant was that I could no longer have grapefruit because it would inhibit the absorption, not increase. That said, I didn't realize until recently it also means that I can no longer have Squirt soda.

vote-for14vote-against

@omnichad's description was fairly accurate: grapefruit juice (and certain other citric juices) reduce the body's ability to metabolize certain drugs (so you get less effect from the medication), but because the drug isn't being broken down, levels of the drug can build up to very dangerous levels (so there will eventually be too much of a medication in the bloodstream).

It's not all medications; a medication should be labelled VERY CLEARLY if there's a potential interaction - but do take it seriously if you see that warning.

vote-for5vote-against

@neuropsychosocial: Yeah - replace "absorbed" with broken down in my comment. I definitely said it wrong there.

vote-for4vote-against

Yes - I knew about it because my father can no longer eat it due to his medications.

What is new to me is that there is a soda called "Squirt"

vote-for4vote-against

@mml666: It is bottled by the same company that does RC, Diet Rite and A&W, AFAIK. They are sold together here on the "buy three get one free" sales.

vote-for4vote-against

Yes. Partly because I already knew and also because every year, during the making of Rum Balls, everyone is reminded to please not bring grapefruit or grapefruit juice as it interferes with the old timer's meds.

vote-for5vote-against

Yup. I take a HMGCoA Reductase inhibitor (aka a statin) and they are all metabolized by the same pathway inhibited by grapefruit.

vote-for4vote-against

Yes, it intereferes with my daughter's Anti-Rejection meds (post-transplant). I always found it odd though. Grapefruit and Starfruit.

vote-for4vote-against

Squirt belongs to the Dr. Pepper/7-Up brand.

A can of Squirt has roughly 1% grapefruit juice. You would need to pound back like 10 to have the effect of a slice of grapefruit.

Although because it tastes so good, I end up drinking 4 without even knowing it.

vote-for2vote-against

I love Fresca but rarely find it around here on the shelves, and when I do it is more than I want to spend. Thanks for the heads-up on the meds...I'll go check mine now.

vote-for2vote-against

Yeah, I haven't had a grapefruit in years, and I love grapefruit.

vote-for3vote-against

Yes, I did know that because there are warning labels on all of the drugs that are affected.

vote-for4vote-against

Grapefruit juice is a flavoring in Squirt and Fresca, it is not a major ingredient. There is such an infinitesimal amount of grapefruit juice in them that they will not interfere with the elimination of those drugs that can be affected.

Only drugs that are eliminated in the intestines by the CYP3A4 enzyme are affected by grapefruit juice consumption. Most drugs are eliminated by the kidneys or the liver, so those drugs aren't affected. If the prescription drug you are taking can be, there should be a warning label on the bottle.

In most cases, all you have to do is take a smaller dose of the drug...grapefruit juice inhibits the elimination of the affected drugs, so you will have a higher dose in your system for a longer period of time. Just make sure that your doctor knows that you drink grapefruit juice regularly, and they should adjust your medication appropriately. Of course, that's assuming that they aren't the worst doctor in the world (and you know there is one somewhere).

vote-for2vote-against

My understanding is that hormonal birth control is effected as well. So, no grapefruit if you want to remain child-free.

vote-for1vote-against

Learn something new everyday...what would I do without you guys?!?

vote-for1vote-against

For a while before I had heart surgery, I was on meds (beta blockers) with which grapefruit would have interfered. The doctor and pharmacist were very clear on the subject of not eating grapefruit or drinking grapefruit juice, as was the printed information with the prescription.

Regarding hormonal birth control: I had never heard that, but I feel like I should have if it's the case. I'll have to look into it.

vote-for4vote-against

@sunnyx0r, @starryc84: Check with your pharmacist, but I believe the efficacy of combined oral contraceptive pills (those that contain both estrogen and progestrogen) is only slightly affected by consumption of grapefruit juice, but the possibility of serious side effects is increased. P450 CYP3A4 isn't involved in the metabolism of progestrogen, which is the linchpin in preventing the release of hormones-that-cause-ovulation. However, the metabolism of estrogen is affected by P450 CYP3A4, so taking a combined oral contraceptive pill with grapefruit juice might result in extremely high levels of estrogen in the body, which can increase the risk of breast cancer, blood clots, etc.

I am not a medical doctor nor a pharmacist, and this is not medical advice. Always check with your doctor - or better yet, pharmacist!