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WARNING! - Grapefruit and meds (heart and others)
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billh99 posted:
This will probably show up in a day or two, but I felt that it should be posted now.

For a long time there has been a warning about the consumption of grapefruit juice and a few meds. The package insert for simvastatin warns against a quart or more.

But new study indicates that many more drugs are affected and it can happen with a small glass of juice and probably a 1/2 of whole grapefruit. And the affect can last over 24 hrs.

Also some meds for cancer, inflammation, diabetic, and several other conditions are also affected.

From a blog on theheart.com here is a list of the heart related meds.
http://blogs.theheart.org/melissa-walton-shirley-blog/2012/11/27/grapefruit-forbidden-fruit-or-juice-or-both

For now, there are enough data to support the recommendation for banning grapefruit and grapefruit juice altogether from the diets of those on certain cardiovascular medications. For laypersons who read my blog, I'll add the names under which these compounds are marketed. (For a more complete list, check abcnews.com.) They include:

Rhythm agents:

Amiodarone (Pacerone).
Dronedarone (Multaq).
Quinidine (not commonly prescribed).



Cholesterol agents:

Atorvastatin (Lipitor).
Lovastatin (Mevacor).
Simvastatin (Zocor).



The new anticoagulant rivaroxaban (Xarelto), prescribed in placed of warfarin in some.



High-blood-pressure meds:

Nifedipine (Procardia).
Verapamil (Verelan).
Felodipine (Plendil).



Antiplatelet agents:

Ticagrelor (Brilinta).
Clopidogrel (Plavix)—in this case, it completely nullifies the effect of Plavix instead of exaggerating it, as in the other meds listed above.



In addition, there is an interaction with the heart-failure diuretic eplerenone (Inspra).

I note that sirolimus is also listed here, and I'm curious about patients with stents coated with sirolimus (the older Cypher stents), but I don't know of any data or case reports that directly address this issue.


Here is a news story about this. http://abcnews.go.com/blogs/health/2012/11/26/grapefruit-medicine-interaction-warning-expanded/

And here is a list of the meds, the effect, and possible alternates from the Canadian Medical Journal.
http://www.cmaj.ca/content/suppl/2012/11/26/cmaj.120951.DC1/grape-bailey-1-at.pdf
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