Grapefruit juice with medication

[BertiWooster]

Some one I know is taking the following medications

Doxazosin mesilate
Modified release Verapamil hydrochloride
Lisinopril and hydrochlorothiazide
Aspirin - enteric coated
Calchichew - D3 Forte Chewable tablets
Lansoprazole Gastro - Resistant Capsules
Atorvastatin

I hope i haven't missed any .



He has been told that he shouldn't drink grapefruit juice while he is taking one of the above medication - but he cant remember which medication .

He has also been told to leave a gap of a few hours between taking two of the above medication - again he cant remember which two .

Does anyone know which ?

[anneasquith]

best to read the instructions which should have been given with the medication, if none given discuss with pharmasist.best be safe when taking medication

[Vagrant]

post this in Body & Soul -> Health & Fitness as well

[shaneystar2]

I would think it's the Atorvastatin Bertie .I take Statins and it says on the gumf not to be taken with anything containing grapefruit.

[scotman]

I am on Atorvastatin and the literature says no more than 2 small glasses of Grapefruit juice per day.

[boxtops]

This is a duplicate post, I answered on the other one - it's the statin for cholesterol, I am on a statin and the blurb in the box says that I mustn't take grapefruit juice while I am on it. Shame, because I love grapefruit juice!

[theprof]

It's not just one, While atorvastatin is correct, it also applies to verapamil.

[BertiWooster]

Thanks
I did post here first - and then also in B & S

Just as a matter of interest prof - what exactly happens when grapefruit is taken by someone who is also taking atorvastatin or Verapamil ?

[gina32]

http://cholesterol.ab.../a/grapefruitstat.htm

[theprof]

The link provided by gina32 provides a reasonably good account of what happens BertiWooster.

The bergamotin ( and certain other substances) in grapefruit juice inhibits the CYP3A4 enzyme in the human body. CYP3A4 is very important as it is involved in cholesterol synthesis and drug metabolism amongst other things.

In the case of verapamil, the likelihood of toxicity is greater after drinking grapefruit juice as verapamil itself is an inhibitor of CYP3A4. Drinking grapefruit juice at the same time in this case means that the body really struggles to metabolise the drug leading to raised plasma levels and bioavailability that may show itself as symptoms of toxicity. Despite this though, the clinical significance of raised verapamil levels in this manner is a subject of much debate amongst pharmacologists.