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An easy way to tell if a medication may be affected by grapefruit juice is by researching whether another known CYP3A4 inhibitor drug is already contraindicated with the active drug of the medication in question. Examples of such known CYP3A4 inhibitors include cisapride (Propulsid), [46] erythromycin, itraconazole (Sporanox), ketoconazole ...
For example, when the blood pressure drug felodipine is taken with grapefruit juice rather than water, levels of the medication in the blood can more than double and result in headache, irregular ...
Grapefruit and grapefruit juice have been found to interact with numerous drugs, in many cases resulting in adverse effects. [4] This happens in two ways: one is that grapefruit can block an enzyme which metabolizes medication, [5] and if the drug is not metabolized, then the level of the drug in the blood can become too high, leading to an adverse effect. [5]
The effects of grapefruit last from 3–7 days, with the greatest effects when juice is taken an hour previous to administration of the drug. [25] In addition to grapefruit, other fruits have similar effects. Noni (Morinda citrifolia), for example, is a dietary supplement typically consumed as a juice and also inhibits CYP3A4. [26]
Enzyme Inhibitors Inducers; CYP1A1: Certain foods (e.g., cumin, turmeric) Certain herbs/herbal teas (e.g., peppermint, German chamomile, dandelion, Kava) Amiodarone ...
Grapefruit–drug interactions are common, as the juice contains furanocoumarins that interfere with the metabolism of many drugs. This can prolong and intensify the effects of those drugs, leading to multiple side-effects such as abnormal heart rhythms, bleeding inside the stomach, low blood pressure, difficulty breathing, and dizziness.
[5] [6] It is metabolized in the liver by the cytochrome P450 enzyme CYP3A4, [7] thereby making the medication susceptible to grapefruit-drug interactions. The drug has an elimination half-life of approximately 12 hours, allowing for once-daily administration. [7] Levomilnacipran is excreted in urine. [7]
1] Numerous medications listed in the Harvard article as non-reactive alternatives are shown in this Wikipedia page as reactive. For example this wikipedia page shows Clonazepam (Klonopin), with citations from 1999 and 2019, as reacting with Grapefruit. The Hardvard article list Clonazepam as a non-reactive anti-anxiety medication alternative.