The Fruit That Messes With Your Meds

Read this before your next snack

By Leah Zerbe

If you pop a prescription pill every morning, be careful when you're washing it down: A refreshing glass of grapefruit juice can have serious consequences when mixed with common meds, finds a new analysis.

The review of 161 earlier studies, published in the Canadian Medical Association Journal, warns that the number of drugs known to interact with grapefruit is higher than previous estimates suggest: A total of 43 medications—many of them quite common—can cause severe side effects like blood clots, breathing problems, kidney damage, and even death, when mixed with grapefruit.

 

"Dietary intake of grapefruit and certain other citrus fruits can inhibit a key liver enzyme involved in drug metabolism," explains cardiologist Gregg Fonarow, MD, director of the Ahmanson-UCLA Cardiomyopathy Center at the University of California, Los Angeles. The inhibition of that enzyme, Dr. Fonarow says, can impact how certain drugs are metabolized, leading to increased concentrations of medication in the bloodstream. And it doesn’t take much to trigger a reaction: One small glass of grapefruit juice, or a single grapefruit, is often enough.

 

Among the drugs that shouldn't be mixed with grapefruit: Common cholesterol meds, including simvastatin (Zocor), the pain medication methadone, sildenafil (Viagra), sertaline (Zoloft), and even certain antibiotics like ciprofloxacin (Cipro) and levafloxacin (Levaquin).

Even if your prescription wasn’t on that list, consider the following tips to stay safe from risky interactions:

Check your Rx Medications accompanied by serious interaction risks will have those hazards printed on the label, so give that info a careful once-over. If you spot a warning that concerns you, talk to your doctor. (For more drinks that shouldn't be combined with certain meds, read up on 

 

Rethink your juice routine Grapefruit isn’t the only type of juice to take note of, says pharmacist Suzy Cohen, author of Drug Muggers. Some research suggests that pomegranate juice might trigger drug interactions, and the same could be true for tangerines and oranges. If you do take a drug accompanied by a grapefruit warning, ask your doctor whether other fruits are safe.

 

Be skeptical of supplements, too Certain supplements contain grapefruit compounds, which Cohen points out might also interact with medication. If you take a supplement to combat candida (yeast), be especially careful—they often contain grapefruit seed extract.