Grapefruit–drug interactions Puns

I (33M, white, 6’2”, 210lbs, no medical conditions other than depression, non smoker, casual drinker) have heard rave reviews of this nasal spray for allergy discomfort: https://www.target.com/p/xlear-saline-nasal-spray-1-5-fl-oz/-/A-50097279#lnk=sametab

It contains grapefruit seed extract. I take Celexa 20mg (only med I’m on), and know I’m not supposed to drink grapefruit juice because of potential interactions. Is that same risk present with a nasal spray? I can’t find any useful info online.

Hi! I've been very active in the comments but I don't post much. I have a PhD in biochemistry and I do a lot of reading about Lyme. I'm not a medical doctor and can't give out medical advice, but I'd like to start doing some informational posts to share some of the concepts that I think are important for Lyme patients to understand.

I've encountered two redditors in the past two days who were both having terrible gastrointestinal side effects from doxycycline, and who were also taking grapefruit seed extract. The GSE is likely causing doxycycline to build up in the body, resulting in digestive misery. This isn't the only combination that Lyme patients need to be aware of.

But I tend to write a lot, so:

TL;DR - Use a drug interaction checker whenever your protocol changes to look for drug interactions. If you use herbs, the online tools won't necessarily have information on them, so it's good to be aware of which herbs can cause problems.

#Cytochrome P450 3A4 aka CYP3A4 CYP3A4 is a liver enzyme that is responsible for breaking down many different drugs, roughly 30% to 50% of drugs (sources vary). Most of the time, it's fine to have one enzyme responsible for breaking down multiple drugs that you're taking.

However, a few drugs can change the speed that CYP3A4 works at. Some can even totally deactivate the enzyme, and your body needs to produce more.

#Slowing down CYP3A4 (aka inhibiting it)

If a drug or herb slows down CYP3A4, that means that the other drugs that are usually broken down by CYP3A4 won't be broken down as quickly. If you only took one dose of the other drug, like when you take Tylenol for a headache, this might not be a big deal. The Tylenol would stay in your system for longer, and you would get pain relief for longer. It would only be a problem if you wanted the Tylenol to be short-acting for some reason.

However, that's not how we take drugs to treat chronic diseases. We take them every day. So imagine if instead of tylenol, we're talking about doxycycline. Something else has slowed down (or deactivated) the CYP3A4 and you still have too much doxycycline in your system from yesterday when you take your next dose. And then the same thing happens the next day, and the next.

What happens is that you have a higher blood level in your body than you would normally. All of the bad side effects from taking too much doxycycline start popping up, but you don't know why. You just kn

Grapefruit has been proven to dangerously interact with many medications... including estradiol and ethinylestradiol! (There is an increased risk of breast cancer and thrombosis for both)

You can read more about how it happens on Wikipedia

Here is a more detailed list of medications and associated risks (list isn’t complete and they are always adding more to the list.. probably safer to avoid grapefruit in general if you can)

I’m ftm so I don’t know much about mtf transition (I think y’all take these for HRT???) but saw this on the grapefruit interaction list and figured I’d post since better safe than sorry Sending love from the other side 💖

I just watched S2: E4 that shows Walter pouring his son and himself grapefruit juice. I know grapefruit has many harmful drug interactions, but I was wondering/speculating if the writers thought about that since Walt is taking many different drugs.

Like grapefruit, CBD is thought to inhibit certain gut enzymes that process drugs and eliminate them from the body. Without the proper function of these enzymes, "a low dose of a med could become a high dose" and a "high dose of a med could become a dangerously high dose, or even an overdose." This does not apply to all medications, but it may apply to "many common drugs, including antihistamines, benzodiazepines, certain antidepressants and statins."

Full article

#Edit 27/06/2019 or 06/27/2019:

1. Basic Review of the Cytochrome P450 System
2. Coumarines and P450s studies reported-to-date
3. Coumarin and Furanocoumarin Quantitation in Citrus Peel via Ultraperformance Liquid Chromatography Coupled with MassSpectrometry (UPLC-MS)
4. Coumarins - An Important Class of Phytochemicals

Lists of Inhibitors, Inducers and Substrates of CYP450 Isoenzymes

Some Common Substrates, Inhibitors and Inducers of CYP450 Isoenzymes

Inhibitors, Inducers and Substrates of CYP-450 Isozymes (TABLE)

Flockhart-Table on Drug Interactions

Quote from link number 3:

>Furanocoumarins can also inhibit cytochrome P450s of the3A4 family through mechanism-based inactivation16,17or theCYP73A family.18Moreover, for patients submitted tomedication, this inhibition of cytochrome P450s by furanocou-marins can lead to an increased drug concentration in theblood,19which can cause deleterious side effects.20Thisphenomenon wasfirst demonstrated with grapefruit juice19and is often referred to as the“grapefruit juice effect”byphysicians. This CYP3A4 inhibition process is primarilyattributed to bergaptol and its derivatives (bergapten,isoimperatorin, bergamottin, 6′,7′-dihydroxybergamottin, andparadisins A, B, and C).21,22However, these compounds do nothave the same inhibitory potential, and furanocoumarin dimers(spiroesters) such as paradisins are considered strongerCYP3A4 inhibitors than the monomers.21,23

Concentration of Coumarins and Furanocoumarins in the Citrus Peel Extracts

#End of edit

Note: a lot of the BOLD drugs/substances are clickable for more information!

Hi all!

Some of us like to enjoy a delicious grapefruit with their substance of choice or prescribed medications.

F

Found the interaction in a thread earlier... Scroll down to "Inhibition through fruit ingestion" in this link. Then "food and juices" in this link.

Basically we have an enzyme that breaks down drugs in us, CYP3A4. It can be blocked by consuming certain fruits and other various substances therefore increasing the bioavailability of the drug in your system. But be careful, increasing bioavailability could lead to overdose. Fruits are in the second link.

Edit: just wanna give a big thank you to everyone and my mother and their mother and /u/awall621 and so on for this being my first post with no negative comments! I also wanna add you can eat these fruits (which can be found in the second link) before, during, or after ingestion of a drug.

Grapefruit-drug interactions

Check out The Distribution of Coumarins and Furanocoumarins in Citrus Species Closely Matches Citrus Phylogeny and Reflects the Organization of Biosynthetic Pathways especially Figure 3

Basically, the taller the bar is on Figure 3, the more the fruit interacts with medications.

I kind of felt like some of the oranges interfered with my Strattera, so I looked up some papers and read up on oranges, and found that blood oranges possibly come from pomelos. Oooohh... None of my favorites (blood orange and cara cara orange) are directly tested in this paper, so if anybody have any sources on it, please let me know!

Anyways, check out Figure 3 before you try any new citrus fruit.

List of citrus fruits that cause grapefruit-drug interactions:

• Pomelos (also called Citrus Maxima or Pumello)

• Grapefruits

• Sour oranges (also called bitter orange, Seville orange, bigarade orange, or marmalade orange)

• Bergamots

• Nasnaran mandarin (Although most other mandarins don't cause this problem)

• Some limes including Mexican lime, Giant key lime... check out Figure 3 for limes

• Tangelo (hybrid between tangerine and grapefruit)

List of citrus fruits that are free of such interactions:

• Navel orange and most of sweet oranges

• Most of mandarin, satsuma, clementine, tangerine (aren't they all same though?)

• Most lemons

• Yuzu

List of citrus fruits I'm not sure about yet:

• Blood oranges (possibly a hybrid between tangerine and pomelo?)

• Cara Cara oranges (possibly a hybrid between oranges and grapefruits?)

I read it increases the plasma concentration of oxycodone. How does this effect the body?

I'm on birth control and 25mg of sertraline/Zoloft (just started) and recently started a daily probiotic pill that includes GSE in the mix. I'm not sure the actual amount of GSE in each pill (emailed the company, but haven't gotten a response yet). I know grapefruit should be avoided when on certain medications and I figured the same extended to GSE, but I wasn't sure. I don't want to fuck up my BC or my Zoloft (especially since I just started), but this probiotic has been working wonders for a number of problems I've been having. I can't make it into the doctor for a few days to ask my primary. Should I stop the probiotic or am I okay to continue all 3 together?

My family has delayed the holidays, and they really like grapefruit. I looked up the interactions online, I could only find interactions pertaining to Midazolam. Is it safe to drink grapefruit juice? I don't want to confront my family about this if I don't have to. My doctor isn't answering their emails. Thanks, and sorry if this is an out-of-place question.

I never see warnings about other citrus fruits, what does grapefruit have that other fruits don't that causes so many problems?

Hi, I’m wondering if anyone knows if it’s safe to drink grapefruit juice or take grapefruit seed extract while on metformin. Thanks

I have some Grapefruit juice. If I smoke some weed from my bong and drink some juice, would the effects affect me in a noticeable amount? I’m a daily medicinal smoker.

While it's fairly common knowledge that grapefruit juice can interfere with statin class drugs and many prescription medications - it can also alter the effects of many common OTCs, such as Allegra.

https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix

I didn't know this, and now I'm suffering mightily from pollen.

Does anybody know? Some of the ingredients E.g. kanna may interact weirdly with grapefruit’s metabolism blocking effect in the gut. But can’t find anything solid

I often see that you shouldn’t eat grapefruits if you are taking certain medications. If the grapefruit components are inhibiting drug pathways, wouldn’t they also inhibit important endogenous pathways?