![]() ![]() "One of the questions I get a lot as a pharmacist is: I was just placed on this medication – can I drink alcohol?" Leonard says. "My sense is we would have to be talking about somebody who primarily drinks grapefruit juice, as opposed to other liquids," Woodall says.Īlcohol is a beverage that can interact with a wide variety of drugs. It's more likely that drinking grapefruit juice in large quantities, rather than eating a single grapefruit in the morning, would cause systemic side effects. Allergy medications with fexofenadine like Allegra.Immune-suppressing drugs like cyclosporine for transplant patients.Calcium channel blockers to treat high blood pressure.Chemotherapies such as vincristine and docetaxel.Erectile dysfunction drugs like Viagra (sildenafil).Statin drugs to manage cholesterol including Lipitor (atorvastatin), Zocor (simvastatin) and Mevacor (lovastatin).Grapefruit can interact with these drugs or drug classes: "This can potentially result in fluctuating levels of that medication in the body." "If somebody likes to eat grapefruit or drink grapefruit juice, there are certain substances that may affect the way the body handles the medication," says Mandy Leonard, senior director of pharmacy at Cleveland Clinic. Grapefruit can impact how digestive enzymes break down and how the body absorbs a number of medications. "The problem comes when somebody eats a spinach salad every day for a few weeks until the bag of spinach runs out, and then goes the next week without eating any." Instead, predictable consumption allows medication to be adjusted accordingly. "I've certainly taken care of people on warfarin who've been stable for a long time and they eat spinach, kale, collard greens, every meal of the day," says Woodall, who is also an associate professor of clinical education at UNC Eshelman School of Pharmacy. Patients taking warfarin regularly have their blood levels monitored. "I tell people frequently: You really don't need to avoid eating green leafy vegetables. Tasha Woodall, associate director of pharmacotherapy in geriatrics with the Mountain Area Health Education Center in Asheville, North Carolina, often talks about workarounds for patients on drugs like warfarin. Vitamin K is used by the body to make some blood-clotting factors, whereas warfarin reduces the action of vitamin K. Green leafy veggies are rich in vitamin K, which interacts with the common blood-thinning drug warfarin (Coumadin). Some other citrus fruits, such as pomelos and Seville oranges (a bitter orange used in marmalades and compotes) can have similar effects.Spinach, kale, collard greens and broccoli are super-healthy but they can make medications to prevent blood clots less effective. As little as eight ounces (237 milliliters) can have an effect on the metabolism of some drugs. ![]() These interactions have been observed within a few hours after consuming grapefruit and may last for up to three days. If a drug is not adequately metabolized, higher levels of the drug may enter the bloodstream, which can lead to a potentially dangerous situation. When grapefruit or grapefruit juice is consumed, a compound within the grapefruit disrupts the CYP3A4 enzyme’s ability to metabolize a drug. It is responsible for breaking down approximately 60% of the drugs we take. CYP3A4 is the most abundant member of the enzyme family. This family of enzymes is responsible for making chemical reactions needed to breakdown many different compounds, from food to drugs. Cytochrome P-450 is a group of enzymes located throughout the body, with the largest amount found in the liver and the intestinal walls.
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