![]() ![]() ![]() Article titled "Drug interactions due to cytochrome P450" by CC Ogu and JL Maxa published in the Baylor University Medical Center Proceedings in 2000.Katzung & Trevor's Pharmacology: Examination & Board Review, 11e. In: Trevor AJ, Katzung BG, Kruidering-Hall M. Trevor AJ, Katzung BG, Kruidering-Hall M.Grapefruit-medication interactions: forbidden fruit or avoidable consequences?. CMAJ. Medicinal importance of grapefruit juice and its interaction with various drugs. Nutr J. Intersection of the Roles of Cytochrome P450 Enzymes with Xenobiotic and Endogenous Substrates: Relevance to Toxicity and Drug Interactions. Chem Res Toxicol. Science Daily Grapefruit Juice and Medication Can Be a Dangerous Mix January 2005.An attack of gout occurs when uric acid causes inflammation (pain, redness. eMedTV Crestor and Grapefruit Kristi Monson, PharmD and Dr. gastritis (swelling of the stomach lining) Can occur with Lipitor: diarrhea joint pain Can occur with both Zocor and Lipitor: muscle pain nausea. Potential Side Effects Diarrhea nausea nerve pain vomiting stomach pain.Having set myself up as someone with (rusty) familiarity with the area, feel free to ask me questions (but steel yourself against disappointment). I have it in my mind (but no cite) that the reason juices are emphasized is that it’s much easier to chug a liter of grapefruit juice (for example) than it is to eat the equivalent amount of fruit. This paper also was useful, particularly as it concentrates on fruit juices (Tables 2, 3, 4). Grapefruit is definitely a problem, and some other items are definitely potential problems. The development and use of the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor (statin) class of drugs, which, according to the prescribing information, reduce low-density lipoprotein cholesterol (LDL-C) on average by 55 to 60 at the maximal doses of the most potent statins, has had a major impact in reducing the incidence of cardiovascular diseases (CVD), including stroke. I think this is one of those situations where you can over-react, so I like Table 6 as a summary. Table 6 is the most useful, as it concentrates on clinically relevant interactions with 3A4. The color coding relates to the evidence available and is explained in Table 1. This can help lower your risk of heart-related complications, like heart attacks or strokes. So “AUC increased 2.6 fold” means you have 2.6 times the expected exposure to the drug. Rosuvastatin (Crestor) is a common statin medication used to treat high cholesterol.It works in the liver to lower the amount of low-density lipoprotein (LDL, or bad cholesterol). Table 2 is all about AUC (= Area Under the Curve, the curve being a graph of blood levels of drug over time) - the bigger the AUC, the larger the exposure to the drug. Breast cancer: There is concern about the safety of drinking excessive amounts of grapefruit juice. This is probably the most comprehensive listing I found (note: recent but pre-proof). Pregnancy and breast-feeding: Not enough is known about the use of grapefruit during pregnancy and breast-feeding. Some things act as inhibitors of the enzymes (so they don’t metabolize as well, resulting in higher than intended drug levels) some act as inducers, increasing levels of the enzymes and thus reducing drug levels. Hmmm - having done this sort of thing for a living (but long retired), I thought to myself, “I’ll just google up some review or other with a list of foods…” Much more difficult than I was expecting.Ĭytochrome P450 exists in a whole bunch of isoforms (variations) many of which are involved in the metabolism of drugs and foodstuffs (isoform 3A4 being the most problematic). How Well Do You Know the Grapefruit Drug Interaction? ![]() cyclosporine).4 The impact of other bergamottin sources is unclear. Repeated consumption has a greater effect than one exposure but certain medications’ effects are sensitive to consistent drug levels (e.g. containing Seville orange peels), and bergamot-flavored products (including pharmaceuticals) are often overlooked sources of bergamot oil.Įating a whole grapefruit or drinking a cup of grapefruit juice can cause a clinically significant interaction with a host of medications. Oil of bergamot contains a litany of phototoxic and carcinogenic compounds, including bergamottin and psoralen, which cause redness and increase skin cancer risk after sun exposure.2īergamot oil contains anti-cholesterol compounds these compounds worsen bergamottin’s statin-boosting effects.3 Earl Grey tea, certain fruit jams (e.g. Skincare products, perfumes, and food flavorings use its namesake the bergamot orange but consumers rarely eat the whole fruit. You may encounter bergamot oil.īergamottin is in more than just grapefruit. I don’t think bergamot oranges are something you often encounter as a fresh fruit, certainly not to eat in any substantial quantity because they are sour. ![]()
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