STONE: Grapefruit, some meds don’t mix well

High in fiber, chalked full of vitamins, and abundant in essential minerals, the grapefruit has long been recognized for its nutritional benefits. From its reputation as a weight loss wonder to a familiar accompaniment at the breakfast table, this ruby-red fruit has been consumed by Americans for years. But, did you know this citrus powerhouse might pose considerable health risks if taken with certain prescription medications?

The main reason believed to be responsible for this interaction involves organic compounds formed within the grapefruit. These compounds, known as a furanocoumarins, interfere with liver and intestinal enzymes altering the effects of certain medications. For some medications, grapefruit can augment their potency or in other cases decrease it. In either case, this can lead to significant injury, up to and including death if proper precautions aren’t followed. Unfortunately, the list of medications adversely affected by grapefruit continues to grow. Between 2008 to 2012, researchers have found the number of medications that have serious adverse effects from an interaction with grapefruit has grown from 17 to 43 medications. To date, there are 85 known medications where grapefruit has been linked to altering absorption.

As new medications and varied formulations of existing drugs continue to enter the pharmaceutical market, the likelihood of grapefruit-medication interactions will increase. Among the current drugs known to have interactions with grapefruit include many that are commonly prescribed, and possibly some you take on a routine basis. These include medications to treat high cholesterol, anxiety, abnormal heart rhythms, oral contraceptives, and blood pressure to name a few. Men, take note…also among the medications is a certain blue pill known as sildenafil (more likely recognized by its brand name Viagra). So, before you slug down that glass of grapefruit juice, think twice.

Interestingly, people aged 45 years and older tend to consume the most grapefruit. Ironically, this same age demographic is also the largest consumer of prescription medications in the United States. Considering these facts, precautions should be considered to avoid potentially life-threatening drug interactions. Unlike similar interactions between medications and food, where medicine might be taken hours before or after consuming certain foods, grapefruit is different. Drinking a single, 8-ounce serving of grapefruit juice can have lasting effects on medications for up to 24 hours. Therefore, susceptible drugs should be separated from grapefruit consumption by at least 24 hours. Unfortunately, if you take a daily medication with a known interaction, avoiding anything and everything grapefruit is your best bet.

Another safeguard is listing all medications you currently take, both daily and as needed, and ask your pharmacist if any foods, including grapefruit, might affect them. Pharmacists are the “go-to” experts when it comes to identifying known and potential drug-food interactions which can not only save your life, but time and money as well. A prime example is cholesterol-lowering agents, also known as “statins” which include brand names such as Lipitor, Zocor, and Mevacor. Grapefruit can significantly increase the effects of these medications, creating harmful levels in the body, leading to liver toxicity, breakdown of muscle tissues, and in worse possible cases…death. This is why it is vitally important to follow the directions and advice of your pharmacist and healthcare providers when being instructed on the proper use of medications.

Also, be cognizant of other foods you may need to avoid since grapefruit can be hidden within the ingredients. Grapefruit can be found in products such as fruit juice mixes (both fresh and concentrated), some juice blends (look for words like “citrus blend”), and dietary supplements containing grapefruit bioflavonoids. You can still, however, enjoy the perks and benefit of citrus from oranges, tangerines, limes, and lemons which are safe to eat and drink. These fruits and their juices do not interfere with medications like grapefruit does. Know your medications, seek proper medical guidance, and if in doubt…pass on the grapefruit.