What is a common side effect from taking certain prescription drugs and consuming grapefruit juice?
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Eating grapefruit or drinking grapefruit juice can affect some medicines. In most cases, it increases the level of the medicine in your blood. This can increase the risk of side effects or change the effect the medicine has. Show
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If your usual diet includes grapefruit or grapefruit juice and you've been prescribed a medicine that's affected by grapefruit, speak to your GP or pharmacist. Do not stop taking your medicines without advice. How does grapefruit affect some medicines?Grapefruit juice contains chemicals that can cause problems with enzymes that break down certain types of medicines in your body. When a medicine doesn't get broken down properly, you can have too much medicine in your blood. Having too much medicine in your blood increases your chances of having side effects. Examples of medicines affected by grapefruitHere are some medicines that grapefruit and grapefruit juice can interact with (cause problems with), although there may be others that are not on this list:
To find out if you can drink grapefruit juice while taking your medicine, talk to your doctor or pharmacist. Different people may react differentlyThe risk of experiencing the effect of an interaction from grapefruit can vary a lot from person to person. The interaction can be different depending on the person, the medicine and the amount of grapefruit you eat or grapefruit juice you drink. Some problems are mild, while others are more serious. For some medicines you may need to limit the quantity of grapefruit you have, while with others you may need to avoid it completely. If you have grapefruit or grapefruit juice in your diet, talk to your pharmacist about any prescription medicine or over-the-counter medicine to find out:
What about other citrus fruits?Seville oranges (which are sometimes used in marmalade but not in orange juice), pomelos and tangelos may also cause problems. How can you avoid problems with grapefruit juice and your medicine?You can take steps to avoid problems with grapefruit juice and your medicine.
References
ResourcesTe reo resourcesThe Māori Pharmacists’ Association Ngā Kaitiaki o Te Puna Rongoā has a free phone line to answer questions whānau have about their medicines. Call 0800 664 688. Note: This is a non-urgent service and they will get back to you within 24 hours. Brochures
Related topicsCommon questions to ask about the medicines you are takingMedicines – when problems occurYes. Sadly, grapefruit juice and actual grapefruit can interfere with the way your body deals with dozens of medications—even if you don’t drink the juice and take the pills at the same time. Just having grapefruit or grapefruit juice in your body can affect how well the medications work, and the effect can last up to a few days! In some cases, the combination can cause dangerous side effects ranging from drowsiness to serious problems with your heart and blood pressure. We’re not talking about rare drugs either: The medications to watch out for include common blood pressure drugs, erectile dysfunction medications, anti-infections drugs, antihistamines, steroids, opioid painkillers, and even birth control pills. Here is a list of some common medications affected by grapefruit juice:
A more complete list is available here, but the list of affected medications is always changing so it’s best to check with your doctor or pharmacist if you are a grapefruit-lover. If you really want to know… Why does grapefruit interact with certain medications?Grapefruit juice blocks enzymes responsible for breaking down medications in the body. The main enzyme affected is one called cytochrome p450 (or CYP450, for short). This can make the medication last longer in the blood and cause unwanted side effects. Grapefruit can also interfere with medications in other ways: Sometimes it stops the medication from being converted in the body into a more “active” form. This can make the medication less effective. Either way, grapefruit only has an effect on medications that you take as pills. It doesn’t affect intravenous medications. How does this affect me? This is where it gets complicated. The effect of mixing medications with grapefruit juice depends on so many factors—like which medications you take and how much grapefruit you consume—that we can’t give you a straight-up answer. That said, we’ll take a look at some common scenarios below. Some meds can be taken carefully with grapefruit juiceStatinsStatins can be taken with moderate grapefruit intake: A daily 8 oz glass of grapefruit juice, or half a grapefruit, did not lower the effect of statins on cholesterol levels and did not cause worse side effects in this study. Sildenafil (Viagra)Grapefruit juice can affect blood levels of sildenafil (Viagra), but this seems to vary from person to person. Mixing grapefruit juice with Viagra could (in theory) drop your blood pressure pretty significantly, so you should be careful and talk to your doctor before doing it—until you know how it affects you. Some medications are less effective when taken with grapefruit juiceFexofenadine (Allegra)Grapefruit juice has a strange effect on some antihistamines, especially fexofenadine (Allegra), as it actually makes it less effective. Clopidogrel (Plavix)Clopidogrel (Plavix) normally prevents blood clots in those at high risk of having a stroke or heart attack, but grapefruit juice can make it less effective. If you are taking Plavix, you should definitely avoid grapefruit or grapefruit juice. Levothyroxine (Synthroid)Grapefruit juice can lower the effectiveness of the levothyroxine (Synthroid) you take, meaning you may need to take a higher dose to get the same effect. Tamoxifen (Nolvadex)Grapefruit juice may make tamoxifen (Nolvadex), a drug used to treat and prevent breast cancer, less effective. If you need to take tamoxifen, you should definitely avoid grapefruit juice. Some medications can reach toxic levels when taken with grapefruit juiceSome medications can reach toxic levels if taken with grapefruit juice. Taking a chance with these is not worth it, as the risks can be potentially serious. If you are on the following medications, you should change your morning drink or cocktail mixer to something other than grapefruit juice. Blood pressure drugsMixing some blood pressure medications such as nifedipine (Procardia), amlodipine (Norvasc), and felodipine (Plendil) with grapefruit, can drop your blood pressure and make you feel quite unwell. AntiarrhythmicsSome antiarrhythmics such as verapamil (Calan) or amiodarone (Cordarone) can cause fatal heart rhythms when taken with grapefruit. Blood thinnersGrapefruit can cause new blood thinners like Eliquis and Xarelto to reach higher levels in the blood. A common side effect of this can be bleeding anywhere in the body, but this often happens first in your gut. If you are on these medications and drink grapefruit juice, you will need to keep an eye out for blood in your poop. Anti-anxiety medicationsAnti-anxiety medications such as sertraline (Zoloft), buspirone (Buspar), and diazepam (Valium) can cause drowsiness or dizziness when taken with grapefruit juice. Opioid painkillersIf you take opioid painkillers such as fentanyl (Duragesic), oxycodone (Roxicodone), or methadone (Dolophine), drinking grapefruit juice can cause an unexpected overdose and stop your breathing. ImmunosuppressantsIf you have ever had a transplant or take medications like Prograf, sirolimus (Rapamune), Afinitor, or cyclosporine (Neoral, Sandimmune) for another reason, you should avoid grapefruit juice as it can cause serious problems with your bone marrow and kidneys. SteroidsSome steroids like budesonide (Pulmicort) and methylprednisolone (Medrol) can reach higher blood levels if taken with grapefruit juice. This can dangerously raise your blood sugar levels and blood pressure, and cause other serious and sometimes long-lasting effects of too much steroids in the body. But I LOVE grapefruit juice…Unfortunately, even a glass of the tart tangy nectar is enough to have a significant and lasting effect on the way your body handles your medication (anywhere from a few hours to a few days). So, if you are a committed grapefruit-lover, we recommend talking to your doctor about your medications and how they might interact with grapefruit. You might be able to change to another medication that is not affected by grapefruit. Or you might have to switch allegiance to orange, apple, or pomegranate juice instead. Was this page helpful?Subscribe and save.Get prescription saving tips and more from GoodRx Health. Enter your email to sign up. By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx. |
