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Wed Nov 28, 2012, 08:52 PM

Researchers warn mixing grapefruit with drugs can kill you

The number of drugs when mixed with grapefruit that can lead to serious health problems, including sudden death, has skyrocketed, warns a Canadian researcher who first discovered the toxic link.

In an article in the Canadian Medical Association Journal, David Bailey, a scientist at the Lawson Health Research Institute in London, Ontario, said more than 85 drugs, many of them highly prescribed for common medical conditions, are known to interact with the pink fruit.He first made the link 20 years ago.But the number of medications with the potential to interact with grapefruit and cause serious adverse health effects has jumped from 17 to 43 in the last four years, as new drugs have been rolled out, Bailey said.

Grapefruit poses a risk when mixed with certain drugs because it inhibits an enzyme that metabolizes ingested drugs, resulting in the drugs entering the bloodstream at full force, which can lead to overdosing.Some of the drugs known to interact with grapefruit include anti-cancer agents, heart drugs, pain medications and drugs to treat schizophrenia. All of them are administered orally.It doesn’t take much grapefruit to have an effect. Drinking a single glass of grapefruit juice with medication can lead to serious side effects, including gastrointestinal bleeding, kidney failure, breathing problems and sudden death.

Other citrus fruits such as Seville oranges and limes can have similar effects. But they have been studied less.

http://www.rawstory.com/rs/2012/11/27/researchers-warn-mixing-grapefruit-with-drugs-can-kill-you/

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 08:56 PM

1. The label on my prescription Simvastin, says

"AVOID GRAPEFRUIT JUICE." Not a big fan of grapefruit so no problem for me!

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 08:59 PM

2. That would explain all the grapefruit rolling around on the back seat of the Red Shark.

Grapefruit poses a risk when mixed with certain drugs because it inhibits an enzyme that metabolizes ingested drugs, resulting in the drugs entering the bloodstream at full force . . .

Thanks, I always wondered about that particular choice of road food by Hunter Thompson and his Samoan attorney.





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Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:00 PM

3. Wow. Now there's something that totally surprises me. nt

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:00 PM

4. 1. True. 2. Very old news (at least, I knew of this decades ago). GRAPEFRUIT JUICE CAN BE

DEADLY WITH CERTAIN MEDICINES!

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:10 PM

5. Old news but good to be repeated every year

People like citrus juice during cold and flu season. Orange is benign, grapefruit potentially lethal.

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Response to jmowreader (Reply #5)

Wed Nov 28, 2012, 09:21 PM

8. Not necessarily.

The article points out that Seville oranges and lime (and according to Wikipedia, even apple), may cause similar effects, but they haven't studied them much yet.

Best to avoid citrus and take vitamin C tablets if in doubt, until there's some reliable clarification.

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Response to silverweb (Reply #8)

Thu Nov 29, 2012, 07:25 PM

15. They don't make OJ from Seville oranges, at least not in US

Sevilles are the bitter oranges marmalade comes from. Orange juice is from Valencias.

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:12 PM

6. My Mom died pretty young and loved both grapefruit and the juice. She also took pain pills

My Dad always suspected her regular diet of grapefruit mixed with the drugs was part of the reason she died so early. Guess we will never know for sure.

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:17 PM

7. And possibly other citrus.

But they aren't even sure how severe the effects may be at this point because they haven't actually studied this problem much. According to Wikipedia, even apple reacts with some medications.

Even over-the-counter cough syrup (dextromethorphan/DM) and antihistamines (Benadryl/diphenhydramine) react.

Well, gee, Big Pharma Moneybags... maybe you should invest just a little bit of those obscene profits into some actual research to see what might kill off your customers who also happen to like citrus?



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Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:22 PM

9. Here's alist of drugs that have a bad interaction (some pretty common ones)

The following drugs are affected by CYP3A4 inhibition with grapefruit compounds:

The benzodiazepines triazolam (Halcion), orally administered midazolam (Versed), orally administered triazepam (Mogodon), diazepam (Valium), alprazolam (Xanax) and quazepam
ritonavir (Norvir) inhibits CYP3A4 preventing the metabolism of protease inhibitors
sertraline (Zoloft and Lustral)

Additional drugs found to be affected by grapefruit juice include, but are not limited to:

Some statins such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor, Simlup, Simcor, Simvacor) but not Pravastatin (Pravachol), fluvastatin (Lescol) or rosuvastatin (Crestor) which are unaffected by grapefruit.
Dihydropyridines including felodipine (Plendil), nicardipine (Cardene), nifedipine, nisoldipine (Sular), nitrendipine (Bayotensin)
losartan (Cozaar)
The cough suppressant dextromethorphan
modafinil (Provigil, Alertec, Modavigil, Modalert, Modiodal, Modafinilo, Carim, Vigia)
repaglinide (Prandin)
verapamil (Calan SR, Covera HS, Isoptin SR, Verelan)
buspirone (Buspar) Grapefruit juice increased peak and AUC plasma concentrations of buspirone 4.3- and 9.2-fold, respectively, in a randomized, 2-phase, ten-subject crossover study!Lilja JJ, Kivistö KT, Backman JT, Lamberg TS, Neuvonen PJ (1998). "Grapefruit juice substantially increases plasma concentrations of buspirone*". Clinical Pharmacology & Therapeutics 64 (6): 655–660. doi:10.1016/S0009-9236(98)90056-X. PMID 9871430. edit
levothyroxine (Eltroxin, Levoxyl, Synthroid) Effects of grapefruit juice on the absorption of levothyroxine.
Antiarrhythmics including amiodarone (Cordarone), dronedarone (Multaq), quinidine (Quinidex, Cardioquin, Quinora), disopyramide (Norpace), propafenone (Rhythmol), and carvedilol (Coreg)
Antihistamines astemizole (Hismanal) and terfenadine (Seldane) - now removed from the US and Canadian markets
cisapride (Prepuslid, Propulsid) (which treats GERD) - now removed from the US and Canadian markets
Erectile dysfunction drugs sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
The anti-migraine drugs ergotamine (Cafergot, Ergomar), amitryptiline (Elavil, Endep, Vanatrip) and nimodipine (Nimotop)
Fluvoxamine (Luvox, Faverin, Fevarin and Dumyrox)
Codeine and Tramadol. It reduces the amount of codeine converted by CYP3A4 into norcodeine thus increasing the amount metabolized into morphine. Morphine itself, however, is not affected by grapefruit juice, as it is not metabolized by the cytochrome P450 system.
Cyclosporine (Neoral). Blood levels of cyclosporine are increased if taken with grapefruit juice. A plausible mechanism involves the combined inhibition of enteric CYP3A4 and P-glycoprotein, which potentially leads to serious adverse events (e.g., nephrotoxicity).Blood levels of tacrolimus (Prograf) can also be equally affected for the same reason as with cyclosporine.
omeprazole (Losec, Prilosec)
zolpidem (Ambien) Little or no interaction with grapefruit juice.
oxycodone (Oxycodone is metabolized by the cytochrome P450 system, specifically CYP3A4, of which the bergamottin flavonoid is a strong inhibitor)
hydrocodone (The hepatic cytochrome P450 enzyme CYP2D6 converts it into hydromorphone, a more potent opioid.)
dihydrocodeine
quetiapine (Seroquel)
methadone Inhibits the metabolism of methadone and raises serum levels.
buprenorphine Metabolized into norbuprenorphine by cytochrome-P450 isoenzyme 3A4
Tyrosine kinase inhibitors, including imatinib (Gleevec) and nilotinib (Tasigna), used to treat chronic myelogenous leukemia and gastrointestinal stromal tumors.
trazodone (Desyrel) Little or no interaction with grapefruit juice.
Anthelmintics (Used for treating certain parasitic infections, includes praziquantel albendazole and mebendazole)
carbamazepine (Tegretol) Grapefruit or grapefruit juice slows the breakdown of this drug, increasing the level of it in blood
imatinib (Gleevec) Although no formal studies with imatinib and grapefruit juice have been conducted, the fact that grapefruit juice is a known inhibitor of the CYP 3A4, suggests that co-administration may lead to increased imatinib plasma concentrations. Likewise, although no formal studies were conducted, co-administration of imatinib with another specific type of citrus juice called Seville orange juice (SOJ) may lead to increased imatinib plasma concentrations via inhibition of the CYP3A isoenzymes. Seville orange juice is not usually consumed as a juice because of its sour taste, but it is found in marmalade and other jams. Seville orange juice has been reported to be a possible inhibitor of CYP3A enzymes without affecting P-glycoprotein when taken concomitantly with cyclosporine.
Loperamide (Imodium)
colchicine (Colcrys)
erlotinib (Tarceva)
In a mouse study, blood concentrations of acetaminophen/paracetamol (Tylenol) were found to be increased by white and pink grapefruit juice, with the white juice acting faster.

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Response to upi402 (Reply #9)

Wed Nov 28, 2012, 11:13 PM

13. And many over-the-counter (so-called) supplements.

Like herbs, etc. which are just unregulated drugs, sold by the same drug conglomerates which the natural medicine crowd trumpet so loudly.

Sorry, for hijacking the thread, but grapefruit acts on many drugs, including the unregulated ones.

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Response to octoberlib (Original post)


Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:27 PM

11. I haven't been able to eat grapefruit or drink grapefruit juice for almost a decade

 

High blood pressure.

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 09:30 PM

12. Yeah, but it's REALLY great

with vodka. It's called a Salty Dog and it's my favorite drink.

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Response to octoberlib (Original post)

Wed Nov 28, 2012, 11:27 PM

14. Shroomers have known this for years

Mushrooms + citric acid = Quicker more intense trip. Or so I've heard.

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