A study comparing grapefruit juice with water in patients taking erythromycin showed that the juice increased the drug’s blood levels by 84% ( 11).Įxcess levels of this medication can disrupt heart rhythm ( 11). Primaquine and related antimalarial drugsĮrythromycin is used to treat several types of bacterial infections.Though grapefruit does not interfere with most blood pressure medications, it can cause a few medications to overcorrect blood pressure.Ĭollectively called antimicrobials, these anti-infection medications vary widely in their actions and breakdown in the body.Īlthough antimicrobials are one of the most diverse categories of medications, there are only a few medications with known important grapefruit interactions: Amlodipine (Norvasc) is a calcium channel blocker like felodipine and nifedipine, which also does not interact with grapefruit ( 6, 8). Excessive eplerenone levels can cause too much potassium in the blood, which can interfere with heart rhythm ( 1).Īlternatives: Spironolactone (Aldactone), a similar drug to losartan and eplerenone, does not interact with grapefruit. Losartan is unusual in that grapefruit decreases its effects, potentially limiting its ability to control blood pressure ( 7).Įplerenone works similarly to losartan, but its levels increase when taken with grapefruit. This resulted in a rapid drop in blood pressure, which could be dangerous if unsupervised ( 6). One study found blood levels of nifedipine increased dramatically when taken with about 2 cups (500 mL) of grapefruit juice, compared with no juice. The last two medications in this list work by decreasing the activity of a hormone called angiotensin 2, which naturally increases blood pressure. They work by changing the way your blood vessels use calcium, relaxing the vessels, and relieving blood pressure.
The first two medications in this list are known as calcium channel blockers. However, the following four blood pressure medications should be used cautiously: Most types of blood pressure medicines are not affected by grapefruit.
Grapefruit can increase the side effects of some statin cholesterol medications, causing muscle damage. One study showed that drinking a glass of grapefruit juice with simvastatin or lovastatin increased blood levels of these statins by 260% ( 5).Īlternatives: Pravastatin (Pravachol), rosuvastatin (Crestor), and fluvastatin (Lescol) do not interact with grapefruit ( 1). Grapefruit increases the blood levels of three common statins substantially, increasing the risk of rhabdomyolysis ( 4): This leads to muscle weakness, pain, and occasionally kidney damage ( 3).
Statins can cause rhabdomyolysis, or the breakdown of muscle tissue. This improves the profile of lipoproteins in the blood and decreases deaths from heart disease in patients at risk of it ( 2). Statins work by limiting the natural production of cholesterol. Some cholesterol medications called statins are affected by grapefruit. With that in mind, here is detailed information about 32 common medications that may interact with grapefruit, categorized by use. For a small number of drugs, grapefruit’s effects can be serious. Taking your medication a few hours apart from consuming it isn’t long enough. Grapefruit’s ability to affect medication lasts for 1–3 days. One whole grapefruit or one glass of grapefruit juice is enough to alter how these medications affect you. There are three things to know to understand if and how you can safely consume grapefruit with these medications. In fact, studies show that they increase the blood levels of over 85 medications ( 1).īy slowing the way in which CYPs normally break down medications in your gut and liver, grapefruit can increase the side effects of these drugs ( 1). Grapefruit and a few of its close relatives, such as Seville oranges, tangelos, pomelos, and Minneolas, contain a class of chemicals called furanocoumarins.įuranocoumarins disrupt the normal function of CYPs. Medications are processed in your liver and small intestine by a specialized group of proteins called cytochrome P450 (CYPs).ĬYPs break down medications, reducing the blood levels of many of them.
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