With citrus season upon us, the Coachella Valley is brimming with plump, juicy fruit that is ripe for the picking and enjoying. Who would have thought this luscious bounty should come with a caution label?
A woman prone to migraines nearly died with five times the safe level of her medication, verapamil in her blood stream. Doctors were baffled but discovered the cause was a reaction between her prescription and grapefruit juice.
Here is a list of approximately 85 drugs that are affected by grapefruit juice:
Anti-cancer drugs: Crizotinib, Cyclophosphamide, Dasatinib, Erlotinib, Everolimus, Imatinib, Lapatinib, Nilotinib, Pazopanib, Sorafenib, Sunitinib, Vandetanib, Venurafenib.
Anti-diabetic drugs: Repaglinide and Saxagliptin.
Anti-Infective drugs: Albendazole, Artemether, Erythromycin, Etravirine, Halofantrine, Maraviroc, Praziquantel, Primaquine, Quinine, Rilpivirine and Saquinivir.
Anti-Inflammatory drugs: Budesonide-oral; Colchicine, Methylprednisolone-oral.
Anti-Lipemic drugs: Atorvastatin, Lovastatin and Simavastatin.
Cardiovasicular drugs: Amidarone, Amlodpine, Apixaban, Cilostazol, Copidogrel, Dronedarone, Eplerenone, Ergotamine, Felodipine, Losartan, Maindipine, Nicardipine, Nifedpine, Nimodipine, Nisoldipine, Nitrendipine, Propafenone, Quinidine, Rivaroxaban, Sibutramine, Sildenafil, Tadalafil, Ticagrelor, Vardenafil and Verapamil.
CNS drugs: Apeppitant, Alfentanil-oral, Buspirone, Carbamazepine, Dextromeethorphan, Disazepam, Fentanyl-oral, Fluvoxamine, Ketamine-oral, Lurasidone, Methadone, Midazolam-oral, Oxycodone, Pimozide, Quazepam, Quetiapine, Sertraline, Triazolam and Ziprasidone.
Estrogens: Estradiol and Ethinylestradiol.
Gastrointestinal drugs: Cisapride and Domperidone.
Immunosuppressant drugs: Cyclosporine, Everolimus, Sirolimus and Tacrolimus.
Urinary Tract drugs: Darifenacin, Festerodine, Solifenacin, Silodosin and Tamsulosin.
Talk to your doctor if you take any of the prescriptions on this list. In general, you may want to avoid grapefruit as well as limes, marmalades and pomelos. In some instances, your doctor will tell you to limit the amount of grapefruit you eat or talk about the timing between when you eat the fruit and when you take the drug. As the potential reactions between these fruits and drugs can range from the reduction of efficacy of the drug to life-threatening reactions and/or permanent irreversible injuries, it may be best to err on the side of safety.