Though grapefruit and grapefruit juice are a good source of vitamins and minerals that are good for the body, they have very powerful interactions with many commonly used drugs that may have very important implications.

Background

Many drugs are broken down in the body by the enzyme CYP3A4, and grapefruit obstructs this enzyme from working resulting in the reduction of the breakdown of these drugs in the body. This increases the blood levels of the drug which could lead to an increase in side effects or other toxic effects due to very high levels of the drug in the body.

People have different amounts of CYP3A4 in their bodies, which means that grapefruit will affect people differently.

Some other citrus fruits like Seville oranges, pomelos and tangelos tangelos have the same effect as grapefruit. They are used in marmalade. If your medication interacts with grapefruit, you should avoid these fruits as well.

In some cases, it can obstruct proteins that move the drug into the blood decreasing the drug levels which affects the ability of the drug to work properly. This interaction in particular happens with fexofenadine and grapefruit. Avoid taking fexofenadine with fruit juices like grapefruit, apple, and orange because fruit juices reduce the bioavailability of fexofenadine.

Some drugs that interact with grapefruit

The degree of interaction of grapefruit with the drugs below differ. It interacts with some more than others. If you take one of the drugs on this list, you are advised to avoid grapefruit but it is important to speak with your healthcare provider for more specific information.

• Albendazole
• Alfentanil (oral)
• Amiodarone
• Amlodipine
• Apixaban (Eliquis)
• Atorvastatin
• Budesonide (oral)
• Buspirone
• Carbamazepine
• Cilostazol
• Clopidogrel
• Colchicine
• Cyclosporine
• Diazepam
• Eplerenone
• Erythromycin
• Estradiol
• Felodipine
• Fentanyl (oral)
• Fluvoxamine
• Indinavir
• Losartan
• Lovastatin
• Lurasidone (Latuda)
• Methadone
• Methylprednisolone (oral)
• Midazolam (oral)
• Nifedipine
• Oxycodone
• Propafenone
• Quetiapine
• Quinidine
• Quinine
• Repaglinide
• Rivaroxaban (Xarelto)
• Saquinavir
• Saxagliptin (Onglyza)
• Sertraline
• Sildenafil
• Silodosin
• Simvastatin
• Sirolimus
• Solifenacin
• Tacrolimus
• Tadalafil
• Tamsulosin
• Triazolam
• Vardenafil (Levitra)
• Verapamil
• Ziprasidone

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Disclaimer: This is not an exhaustive list and is for information only. This is not medical advice. Please consult your doctor or pharmacist if you need personal treatment options or have any questions that affect you directly.