Grapefruit and drug interactions

The action of a substance in the body depends on the pharmacodynamics, while the effect of the body essentially determines the pharmacokinetics. In a substance ingested by a person, there are many body systems, intestine, liver, kidneys etc., that intervene and modify, to exert the final action of the specific target cell.

The Grapefruit is a fruit that interacts with many drugs and medicines received from patient for various diseases. A recent study from Canada showed that at least 85 drugs react negatively with Grapefruit and cause varying different effects, while 43 drugs still can, if administered simultaneously with Grapefruit, cause severe and dangerous side effects.

The researchers analyzed 161 studies, many of these were controlled and randomized, 29 drug monographs like many medicines leaflets and concluded that the most common side effects due to interactions of Grapefruit with various medications are: myelotoxicity, rhabdomyolysis, gastrointestinal bleeding, urinary retention, dizziness, orthostatic hypotension, nephrotoxicity, respiratory depression, torsade de pointes and other.

Another significant problem arises when a drug is administered with Grapefruit, it is the gradual loss of activity. The Grapefruit affects the liver, activates the enzyme cytochrome P450 3A4 (CYP3A4), accelerates the metabolism of the drug and eliminates rapidly, reducing its levels in the body. The doctor knows that the patient consumes Grapefruit, increasing the dose of the drug while trying to achieve the desired pharmacological effect. Eventually, however, the patient stops taking Grapefruit, for various reasons, the drug is released from the suppressive effect of Grapefruit and since administered in larger doses cause significant and often serious side effects.The Grapefruit can exert a harmful influence of and in small doses, for example 200-250 ml juice is liable to cause a problem.

The drugs with which can interact the Grapefruit are many and include antibiotics, cardiovascular, anti-cholesterol drugs for diseases of the nervous, gastrointestinal and genitourinary, other immunosuppressants.The authors state further that two tasks than those analyzed, they found an increased risk of breast cancer by 30% (95% CI 1.06 to 1.58) in postmenopausal women receiving estrogens and drank at least 1 cup Grapefruit a day compared to others who did not drink .In conclusion both patients and doctors should know that some healthy foods which are recommended for dietary reasons and mainly for weight loss can be especially dangerous if combined with some common drugs.

Source : Bailey DG, et al "Grapefruit-medication interactions

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