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David Mittleman
David Mittleman
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The Odd, Yet Dangerous Connection Between Grapefruit Juice and Prescription Drugs

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If you enjoy a glass of grapefruit juice with your breakfast, you should check to make sure that it doesn’t interact with your prescription medications. Unfortunately, many Americans learn this lesson the hard way. Take, for example, Lucas King, a 59-year-old retiree who suffers from heart disease and is on prescription heart medication to treat his condition.

King’s heart disease is attributable to many factors: he is obese, inactive, and has a family history of the health condition. In addition, his LDL or "bad" cholesterol level was too high: 225 mg/dL. However, even after following his doctor’s advice to get more exercise and change his unhealthy diet, his numbers just wouldn’t budge. So, to help King, his doctor prescribed the drug Lipitor, along with continued diet and exercise. Over time, King’s doctor raised the dosage to the maximum, which helped him to lose over 36 pounds and bring his LDL cholesterol down to 104.

Feeling much healthier, King decided to travel to his winter home in Florida. Naturally, he took advantage of the grapefruit tree growing in his yard and drank at least 2 glasses of juice each day from the fruit. But just two months after receiving the good news about his health, King was rushed to a Florida emergency room with muscle pain, fever, and fatigue. Subsequently, King was diagnosed with rhabdomyolysis, a severe muscle reaction that can cause death.

While King’s diagnosis might seem bizarre and unusual, it is actually more common for individuals who take prescription cholesterol-lowering medications than you might think. Prescription statins can already cause rhabdomyolysis, which is indicated on the warning label and the fact sheet that patients receive with the medication. What most patients don’t realize, however, is that grapefruit juice slows the activity of the liver enzyme responsible for metabolizing the drugs. In fact, the Florida Department of Citrus acknowledges that grapefruit juice interacts with some cholesterol-lowering drugs. Thankfully, not all prescription statins interact with the fruit juice, so if you enjoy a glass or two with your morning meal, there are other statins that you could take instead. King did just that: he switched to Pravachol and is doing much better. Read below for a list of prescription drugs that interact with grapefruit juice, including some for other health problems:

  • Anxiety: Xanax, Buspar, Versed, Halcion
  • Depression: Luvox, Zoloft
  • Allergies: Allegra
  • Abnormal heart rhythm: Cordarone, quinidine
  • Heart disease/stroke/blood clots: Coumadin
  • Epilepsy: Tegretol
  • Cancer: Cyclophosphamide, etoposide, ifosfamide,
    tamoxifen, vinblastine, vincristine

  • Cough: Dextromethorphan (found in many over-the-counter cold
    medicines)

  • HIV: Agenerase, Crixivan, Viracept, Norvir, Fortovase
  • Prostate enlargement: Proscar
  • Heart disease/High blood pressure: Coreg, Cardizem, Plendil, Cardene, Adalat, Procardia, Nimotop, Sular, Covera, Calan, Verelan
  • Erectile dysfunction: Viagra, Cialis
  • Asthma/Emphysema: Theophylline
  • High cholesterol: Lipitor, Lescol, Mevacor, Zocor
  • Pain: Alfenta, Duragesic, Actiq, Sufenta
  • Infection: Biaxin, Sporanox, erythromycin, troleandomycin

Most importantly, check with your doctor about specific interactions between grapefruit juice and medication to ensure your health and safety.