Drug interaction with grapefruit in nasal spray?

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.

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📅︎ Aug 28 2021
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Grapefruits specifically alter many drug interactions
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📅︎ Jun 07 2021
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Grapefruit Is One of the Weirdest Fruits on the Planet (drug interactions) atlasobscura.com/articles…
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📅︎ Oct 11 2020
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What Lyme patients should know about CYP3A4 drug interactions AKA why you shouldn't mix grapefruit seed extract and doxycycline

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

... keep reading on reddit ➡

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📅︎ Nov 18 2020
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PSA: Don’t eat/drink grapefruit - dangerous drug interactions

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 💖

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📅︎ Oct 10 2020
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TIL that grapefruit has a number of adverse drug interactions, and when eaten with certain drugs, can lead to accidental overdoses en.wikipedia.org/wiki/Gra…
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👤︎ u/_shredder
📅︎ Mar 27 2018
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Grapefruit drug interaction

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.

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👤︎ u/hkins504
📅︎ Oct 27 2020
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From its name to its drug interactions, there’s a lot going on with grapefruit atlasobscura.com/articles…
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👤︎ u/qznc_bot2
📅︎ Oct 07 2020
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Grapefruit can cause potentially harmful interactions with common drugs atlasobscura.com/articles…
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📅︎ Oct 11 2020
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"What CBD And Grapefruit Have In Common When It Comes To Drug Interactions: Risks You Should Know"

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

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📅︎ Jul 01 2019
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Grapefruit Is One of the Weirdest Fruits on the Planet (drug interactions) atlasobscura.com/articles…
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📅︎ Oct 11 2020
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From its name, to its hazy origins, to its drug interactions, grapefruit is one of the weirdest fruits on the planet atlasobscura.com/articles…
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📅︎ Oct 07 2020
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Grapefruit can cause potentially harmful interactions with common drug interactions atlasobscura.com/articles…
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📅︎ Oct 11 2020
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Interesting Article: Grapefruit's History & Drug Interactions atlasobscura.com/articles…
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👤︎ u/MsMargo
📅︎ Oct 09 2020
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TIL drinking grapefruit juice while on meds may cause serious interactions with your drugs or even kill you fda.gov/downloads/ForCons…
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📅︎ Feb 28 2015
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Grapefruit and drug interactions

#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

... keep reading on reddit ➡

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👤︎ u/-CultriX-
📅︎ Apr 29 2019
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"What CBD And Grapefruit Have In Common When It Comes To Drug Interactions: Risks You Should Know" reddit.com/r/CBD/comments…
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📅︎ Jul 01 2019
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CBD-Drug Interactions: Role of Cytochrome P450. Same as Grapefruit. Effects metabolism of some blood pressure, statins and others. cbdschool.com/cbd-and-dru…
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📅︎ Nov 20 2018
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Grapefruit and drug interactions reddit.com/r/FADQ/comment…
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👤︎ u/-CultriX-
📅︎ May 01 2019
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TIL according to the Canadian Medical Association, more than 85 drugs have the possibility of interacting with grapefruit; of these drugs, 43 have interactions that can result in serious adverse effects. archive.wusa9.com/assetpo…
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📅︎ Jun 15 2015
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Grapefruit juice and drug interaction, just check it out cuz I know you've heard of it

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.

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Grapefruit and drug interactions reddit.com/r/FADQ/comment…
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👤︎ u/-CultriX-
📅︎ Apr 30 2019
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About grapefruit drug interaction: avoid not just grapefruit, but also pomelo and sour orange, and some more

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?)

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👤︎ u/0ju3wb2zvk
📅︎ Jan 16 2017
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What is the result of the drug interaction of Percocet with grapefruit juice?

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

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📅︎ Jun 23 2016
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Grapefruit–drug interactions en.wikipedia.org/wiki/Gra…
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👤︎ u/combuchan
📅︎ Aug 30 2015
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TIL that grapefruit has a number of adverse drug interactions, and when eaten with certain drugs, can lead to accidental overdoses - todayilearned reddit.com/r/todayilearne…
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📅︎ Mar 28 2018
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Grapefruit seed extract drug interactions (Birth control & Zoloft)

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?

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📅︎ Oct 21 2018
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What are some grapefruit and illegal/illicit drug interactions that could be deadly or harmful?
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👤︎ u/Lurker_IV
📅︎ Feb 06 2017
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Grapefruit–drug interactions en.wikipedia.org/wiki/Gra…
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📅︎ Nov 11 2016
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I understand that grapefruit causes major and moderate drug interactions, but my question is why. Why is grapefruit so toxic with drugs, but lemons or limes aren't?
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📅︎ Feb 21 2016
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Mechanism of Grapefruit–Drug Interaction en.wikipedia.org/wiki/Gra…
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📅︎ Jun 04 2015
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Grapefruit interactions

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.

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📅︎ Dec 27 2021
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Grapefruit–drug interactions en.wikipedia.org/wiki/Gra…
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👤︎ u/Pigeoncow
📅︎ Nov 04 2016
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ELI5: why does grapefruit cause adverse interactions with so many prescription drugs?

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

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📅︎ Aug 23 2014
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Interactions between metformin and grapefruit

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

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👤︎ u/c1nunya
📅︎ Jan 01 2022
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CBD-Drug Interactions: The Role of Cytochrome P450 - CBD, in turns out, is a more potent inhibitor...than the grapefruit compound Bergapten (the strongest of several grapefruit components that inhibit CYPs projectcbd.org/article/cb…
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👤︎ u/shallah
📅︎ Nov 09 2015
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THC and Grapefruit juice interaction?

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.

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📅︎ Nov 27 2021
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Grapefruit–drug interactions: Grapefruit has been found to interact with numerous drugs, in many cases resulting in adverse effects en.wikipedia.org/wiki/Gra…
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👤︎ u/reuben_
📅︎ Dec 08 2014
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TIL drinking grapefruit juice while on meds may cause serious interactions with your drugs or even kill you - todayilearned reddit.com/r/todayilearne…
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📅︎ Mar 01 2015
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Like grapefruit juice’s impact on prescription drugs, software testing involves critical interactions between different parts of the system. And risks exist when these different parts interact with one another. blog.hexawise.com/2014/02…
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👤︎ u/curiouscat
📅︎ Apr 07 2014
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YSK that grapefruit juice can make Allegra ineffective (and interacts with several other drugs)

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.

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📅︎ Jun 29 2020
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Gorilla Mode any interactions with Grapefruit juice?

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

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📅︎ Oct 08 2021
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If grapefruit compounds interact with so many drug pathways, why aren’t they normally toxic?

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?

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📅︎ Oct 27 2020
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