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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]
The Grapefruit-drug interaction article lists Levothyroxine as one of the drugs whose absorption is affected by grapefruit, but the only readily available research online, which is the one cited, ([1]), concluded that "Grapefruit juice may slightly delay the absorption of levothyroxine, but it seems to have only a minor effect on its ...
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.
"Indiana University Department of Medicine Clinical Pharmacology Drug Interactions Flockhart Table ™". "INHIBITORS, INDUCERS AND SUBSTRATES OF CYTOCHROME P450 ISOZYMES". "The Life Raft Group: Long List of Inhibitors and Inducers of CYP3A4 and CYP2D6". "DRUGBANK Online: Cytochrome P-450 Enzyme Inhibitors".
Grapefruit decreased drug metabolism in humans, which likely represented the first clinical example of a food producing such an effect. Clinically, the concern is that a single judicious amount of grapefruit ingested even many hours beforehand would noticeably boost oral drug bioavailability and cause overdose toxicity.