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The Potential Risk of Grapefruit Juice

Citrus fruits are considered to be very healthy, thanks to their high vitamin C content as well as the many minerals and other nutrients they contain. However, ingesting grapefruit juice can lead to severe poisoning when mixed with certain substances. A variety of medical studies in recent years found that combining grapefruit juice with certain medications can lead to an overdose. This article will discuss the reasons for these results, and list the medications you absolutely cannot mix with grapefruit.

The Risk of Drinking Grapefruit Juice
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The Grapefruit/Medication Connection

The human body produces an enzyme called CYO3A4 that, amongst other things, helps break down certain chemicals before they are absorbed into the bloodstream. Grapefruits contain a chemical that inhibits the CYO3A4 enzyme’s functions, which leads to more of the medication being absorbed into the bloodstream. When the level of medication in the blood is too high, you enter a state of overdose, which can lead to exacerbated side-effects and even poisoning.

Other Citrus Fruits

The inhibiting chemical in grapefruit can also be found in other citrus fruits, such as pomelo, limes, and bitter oranges (a type of orange that is very bitter and is mainly used in jams). It’s important to mention that other species of oranges, as well as lemons - are safe to ingest, as they don’t contain the aforementioned chemical.

Potential Severity of Reactions

It’s difficult to predict the severity of reaction grapefruit juice will have on one's body, as it can be affected by many variables. Different juices contain different levels of the inhibiting chemical, meaning that each type of juice can have a different level of effect. Additionally, the quantity of juice consumed can have a drastically varied effect according to one's weight.

The Risk of Drinking Grapefruit Juice
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Medications that Should Not Be Taken with Grapefruit Juice:

There are currently more than 85 different medications that should not be taken with grapefruit juice, and new drugs join the list every year. The following list shows the drugs that pose the most danger when taken with Grapefruit:

Heart Rate and Blood Pressure Medication

Generic name Commercial names

Amlodipine 

Norvasc

Amiodarone

Procor, Amiodacore, Amiocor

Felodipine 

Logimax, Penedil
Nifedipine  Osmo-Adalat, Nifedipine-Teva, Pressolat, Megalat

Nimodipine 

Nimotop

Quinidin 

Quiniduran

Verapamil

Verapress, Apoacor, Ikacor, Ikapress, Veracor

Lipid Lowering Medication

Generic name Commercial names

Atorvastatin

Lipitor

Lovastatin

Lovalip

Simvastatin

Simovil, Simvacor,

Simvastatin-Teva

Tranquilizers and Psychiatric Medication

Generic name Commercial names

Buspirone

Buspirol, Sorbon

Clomipramine

Anafranil, Maronil

Diazepam

Assival, Diaz, Valium

Midazolam

Dormicum, Midazol, Midazolam

Pimozide

Orap Forte

Sertraline

Lustral

Other (Immunosuppressants, antihistamines, etc.)

Generic name Commercial names

Carbamazepine

Carbi, Tegretol, Teril, Timonil

Cisapride

Prepulsid

Cyclosporine

Sangcya, Sandimmun, Deximune

Itraconazole

Sporanox

Saquinavir

Invirase, Fortovase

Sirolimus

Rapamune

Tacrolimus

Prograf
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