Eating grapefruit or drinking grapefruit juice can mean danger when you are under popular medications for high blood pressure, high cholesterol and depression. In most cases, it increases the level of the medicine in your blood.
This can increase the risk of side effects or alter the effect the drug has. According to a Center for Disease Control survey from 2015-2018, nearly 50% of people surveyed had used at least one prescription drug in the past 30 days. Avoid consuming grapefruit when taking medications such as blood pressure medication, heart medications, prostate medications (Vigra, flomax) and psychiatric drugs.
There are potential medication interactions that can make a drug less effective and even cause negative side effects.
One of the most common food-drug interactions pertains to grapefruit and grapefruit juice. Grapefruit and medications can interact, so it’s important to be cautious about consuming grapefruit while taking certain drugs.
How and why do drugs interact with grapefruit products, and why is it a concern? Keep reading to learn more about grapefruit drug interactions.
Why does grapefruit interfere with medication?
Grapefruit and grapefruit juice contain chemicals called furanocoumarins. Furanocoumarins disrupt an enzyme called CYP (cytochrome P450) in the small intestine which helps metabolize and clear medications from your bloodstream.
When the action of this type of enzyme is impacted medication is broken down more slowly, increasing the blood levels of the medication. This means that the side effects of certain prescription medications can be enhanced.
What medications should not be taken with grapefruit?
A review on grapefruit and drug interactions found that over 85 medications interact with grapefruit. Here is a list of some of the more common medications that interact with grapefruit and grapefruit juice as we take a closer look at why cant you have grapefruit with certain medications.
Cholesterol-lowering medication
Statins are a type of cholesterol-lowering drug. Statins work by blocking an enzyme that helps your liver make cholesterol.
Some of the affected drugs that interact with grapefruit and grapefruit juice are:
- Atorvastatin (brand name Lipitor)
- Lovastatin (brand name Mevacor)
- Simvastatin (brand name Zocor)
A study on grapefruit and drug interactions found that drinking a glass of grapefruit juice daily increases the blood level of simvastatin and lovastatin by 260%.
Blood pressure medication
Nearly half of American adults have high blood pressure, so blood pressure medication is commonly prescribed. Grapefruit and blood pressure medication do not tend to mix.
Certain types of blood pressure medication interact with grapefruit and grapefruit juice including:
- Felodipine
- Nifedipine (brand name Procardia)
- Losartan (brand name Cozaar)
- Eplerenone (brand name Inspra)
Drinking grapefruit juice with blood pressure-lowering medications can cause a drop in blood pressure by increasing the blood levels of the medication.
Other blood pressure medications that don’t interact with grapefruit include Spironolactone and Amlodipine. Taking amlodipine with grapefruit can result in interactions that impact the medication’s effectiveness.
Medications for abnormal heart rhythm
While not as common as blood pressure medication, people with abnormal heart rhythms taking Amiodarone or Dronedarone should be aware that those medications can interact with grapefruit and grapefruit juice.
Antimicrobial medication
Several medications fight infections by killing bacteria and viruses.
Fortunately only a few interact with grapefruit and grapefruit juice including:
- Erythromycin – a type of antibiotic
- Rilpivirine – a type of drug used to treat HIV
- Primaquine – a type of antimalarial drug
- Albendazole – an anti-parasitic drug that fights infections from tapeworms
Medications for mood disorders
Medications used to treat mental health disorders like depression, anxiety, and panic attacks are known to interact with grapefruit and grapefruit juice.
- Quetiapine (brand name Seroquel) – used to treat schizophrenia, bipolar disorder, and depression
- Lurasidone (brand name Latuda) – used to treat schizophrenia
- Ziprasidone (brand name Geodon) – used to treat schizophrenia and bipolar disorder
- Buspirone (brand name Buspar) – used to treat anxiety
- Diazepam (brand name Valium) – used to treat anxiety, muscle spasms, and seizures
- Midazolam (brand name Versed) – a type of anesthesia for sedation
- Triazolam (brand Halcion) – a type of sedative used for insomnia
Some pain medications
Over-the-counter pain medications don’t interact with grapefruit. Certain prescription pain meds do interact with grapefruit and include:
- Fentanyl: It’s important to be aware that certain components in grapefruit can potentially affect the way fentanyl is metabolized. This can lead to changes in how the medication is absorbed, distributed, and eliminated,
- Oxycodone: Combining grapefruit with oxycodone can result in interactions that may affect how the medication works in your body.
- Colchicine: When colchicine and grapefruit are combined, there’s a possibility of interactions occurring that could potentially alter how the medication behaves within your body.
Medications for prostate issues and erectile dysfunction
Medications for erectile dysfunction help relax blood vessels to improve blood flow, which can potentially cause low blood pressure. Increasing the bioavailability of the drug by consuming grapefruit could be potentially dangerous.
- Sildenafil (brand name Viagra)
- Silodosin (brand name Rapaflo)
Possible side effects
Grapefruit juice and medications can have interactions that may affect how the drugs work in your body. This means that the medication’s bioavailability is enhanced and may cause more serious side effects.
For example, drinking grapefruit juice with a blood pressure medication might cause your blood pressure to fall too low, resulting in dizziness and possible falls.
If you take statins and consume grapefruit products there is a risk of developing rhabdomyolysis. Rhabdomyolysis is a rare syndrome when muscle fibers break down and damaging proteins enter the bloodstream. Rhabdomyolysis can result in kidney failure and extreme cases, death.
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Should you cut grapefruit out of your diet?
You should speak with your healthcare provider or pharmacist about whether or not you can safely include small amounts of grapefruit in your diet. It is also worth noting that beverages containing grapefruit, such as grapefruit sparkling water may interact with certain medications due to the presence of grapefruit components. It’s advisable to consult a healthcare professional if you have concerns about potential interactions with your specific medications.
The consensus is to err on the side of caution and avoid grapefruit and grapefruit juice consumption if you’re taking a medication it might interact with.
Alternatives to grapefruit
Most kinds of fruit and fruit juices don’t interact with medications, so it’s fine to eat other types of citrus fruits, berries, apples, bananas, melon, and more. The exception is if you’re taking warfarin (a type of blood thinner) which might interact with cranberry juice.
When in doubt, ask your pharmacist if there are any potential food/drug interactions when you start a new medication.
What other food and drinks can interact with my medication?
Drugs in the class called monoamine oxidase inhibitors (MAOIs) help to treat depression. Monoamine oxidase is an enzyme that breaks down tyramine, an amino acid byproduct that helps regulate blood pressure. Eating foods high in tyramine while taking MAOIs might result in high tyramine levels and cause dangerous blood pressure spikes.
Foods high in tyramine include strong/aged cheeses like gorgonzola and Camembert, cured meats like summer sausage, pickled and fermented foods, and soybeans.
There are thousands of drugs available so it’s impossible to summarize all of the potential food and drug interactions. Your pharmacist will instruct you on any potential interactions when you start a new medication. You can also refer to the safety pamphlet that comes with your prescription medication.
Conclusion
You may have find yourself asking ‘why is grapefruit dangerous?’ Grapefruit on its own is not an issues, however, grapefruit and grapefruit juice are known to interact with several medications. If you’re taking a medication known to interact with grapefruit or are concerned about grapefruit and medication interactions, it’s best to avoid grapefruit or ask your healthcare provider if there is a medication with a similar effect that doesn’t interact with grapefruit.
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