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It is therefore challenging to predict the extent of grapefruit product-drug interactions and to compare available in vitro and in vivo data. The mechanisms and magnitudes of the interactions can be influenced by the concentrations of furanocoumarins and flavonoids in the grapefruit product, the volume of juice consumed, and the inherent variability of specific enzymes and transporter components in humans. Polyphenolic compounds such as flavonoids have been proposed as the causative agents of the P-gp and OATP interactions. organic anion-transporting polypeptides ). Grapefruit products have also been associated with interactions with P-glycoprotein (P-gp) and uptake transporters (e.g. The primary mechanism through which interactions are mediated is mechanism-based intestinal cytochrome P450 3A4 inhibition by furanocoumarins resulting in increased bioavailability of administered medications that are substrates. 2013 March 5 185(4).Abstract : Grapefruit juice and grapefruit product consumption have potential health benefits however, their intake is also associated with interactions with certain drugs, including calcium channel blockers, immunosuppressants and antihistamines. Grapefruit–medication interactions: forbidden fruit or avoidable consequences? Canadian Medical Association Journal.This includes herbs, vitamins, homeopathic products, supplements and over-the-counter medicines. Tell your doctor and other health professionals about all the medicines you are taking.Tell your doctor if you are having unusual or uncomfortable side effects from your medicine.If you have questions, ask your doctor or pharmacist. Always read the labels for any medicine you are taking.Read the labels on foods and natural health products to make sure they do not contain grapefruit, grapefruit juice or grapefruit extract.For some medicines you may need to limit the quantity of grapefruit you have, while with others you may need to avoid it completely. Before you take any medicine, ask your doctor or pharmacist if you can safely drink grapefruit juice.You can take steps to avoid problems with grapefruit juice and your medicine. How can you avoid problems with grapefruit juice and your medicine? Seville oranges (which are sometimes used in marmalade but not in orange juice), pomelos and tangelos may also cause problems.

Some problems are mild, while others are more serious. The risk of experiencing the effect of an interaction from grapefruit can vary a lot from person to person. The interaction can be different depending on the person, the medicine and the amount of grapefruit you eat or grapefruit juice you drink. To find out if you can drink grapefruit juice while taking your medicine, talk to your doctor or pharmacist. Sandimmune and Neoral (both cyclosporine).Here are some medicines that grapefruit and grapefruit juice can interact with (cause problems with), although there may be others that are not on this list: Examples of medicines affected by grapefruit Having too much medicine in your blood increases your chances of having side effects. When a medicine doesn't get broken down properly, you can have too much medicine in your blood. Grapefruit juice contains chemicals that can cause problems with enzymes that break down certain types of medicines in your body. How does grapefruit affect some medicines? Do not stop taking your medicines without advice. If your usual diet includes grapefruit or grapefruit juice and you've been prescribed a medicine that's affected by grapefruit, speak to your GP or pharmacist. How can you avoid problems with grapefruit juice and your medicine?.Examples of medicines affected by grapefruit.How does grapefruit affect some medicines?.On this page, you can find the following information: This can increase the risk of side effects or change the effect the medicine has. In most cases, it increases the level of the medicine in your blood. Eating grapefruit or drinking grapefruit juice can affect some medicines.