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Grapefruit and Medicine – A Deadly Mix

We have known for a long time that grapefruit juice can be a dangerous, and sometimes deadly, when mixed with certain medications. Now, the experts warn that the medication list that can result in these dangerous interactions is much longer that many have known.

Researchers at the University of Western Ontario said in a new report released Monday in the Canadian Medical Association Journal that while 17 drugs were identified in 2008 as having potential to cause serious problems when taken with grapefruit, this number at present has grown to 43.

“The frequency of these reactions may be small, but the risks are not worth it, especially for drugs which could cause sudden death,” said lead study author David Bailey, a professor of pharmacology. “Physicians need to know that this affects a number of new drugs and apply this information to their practice and patients.”

Who would think that something as common as grapefruit, known to dieters and the like as a healthy fruit, would pose such dangerous risks? So, how does it cause these problems? Grapefruits contain chemicals called furanocoumarins that interfere with how your body breaks down drugs before they enter the bloodstream. While preventing the normal breakdown of a drug, these chemicals in grapefruit can cause severe side effects and even go as far as to cause a drug overdose.

The side effects commonly seen with grapefruit-induced overdoses are heart rhythm problems, kidney failure, muscle breakdown, difficulty with breathing and blood clots. Atorvastatin, commonly known by the brand name Lipitor and popular with millions, is one of the drugs that have been linked to serious cases of drug toxicity when combined with grapefruit products. Other common heart medications, including verapamil and amiodarone, have also led to severe interactions with grapefruit.

Just one grapefruit or one 8 ounce glass of grapefruit juice can produce an effect that may last more than 24 hours. Other fruits can have the same effect including Seville oranges, limes and pomelos, but sweet orange varieties do not cause any interaction.

Most of us are weary of drug-to-drug reactions and commonly ask a doctor or pharmacist advice about such. But, fewer people are aware of drug-food interactions. Ask your pharmacist or doctor about medicines AND foods you should avoid when prescribed a new drug.

Here is a list of known medications that produce severe effects when mixed with grapefruit and grapefruit products:

A-C
Alfentanil (oral)
Amiodarone
Apixaban
Atorvastatin
Buspirone
Clopidogrel
Crizotinib
Cyclosporine

D-F
Darifenacin
Dasatinib
Dextromethorphan
Domperidone
Dronedarone
Eplerenone
Erlotinib
Erythromycin
Everolimus
Felodipine
Fentanyl (oral)
Fesoterodine

H-P
Halofantrine
Ketamine (oral)
Latatinib
Lovastatin
Lurasidone
Maraviroc
Nifedipine
Nilotinib
Oxycodone

P-Z
Pazopanib
Pimozide
Primaquine
Quinine
Quetiapine
Quinidine
Rilpivirine
Rivaroxaban
Silodosin
Simvastatin
Sirolimus
Solifenacin
Sunitinib
Tacrolimus
Tamsulosin
Ticagrelor
Triazolam
Vandetanib
Venurafenib

Verapamil
Ziprasidone

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