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Re: citrus and Adderall - please explain

Posted by Ilene on August 19, 2005, at 19:29:13

In reply to citrus and Adderall - please explain, posted by pseudoname on August 19, 2005, at 17:50:59

> Why can't you take grapefruit or other citrus foods with Adderall or other amphetamines? Something on the web says they'll make your stomach too acidic, but grapefruit juice has a ph of 3 and stomach acid is ph 1, so I don't see how that can be it. Something else says citrus blocks the absorption of amphetamine. Can someone explain it?
>
> Thanks.

I couldn't find anything specific about interactions between Adderall and grapefruit juice, but here's an abstract of an article about grapefruit juice and drug interactions:

Clin Ter. 2005 May-Jun;156(3):97-103.

[Grapefruit juice: potential drug interaction]

[Article in Italian]

Palumbo G, Bacchi S, Palumbo P, Primavera LG, Sponta AM.

Farmacologia Medica, Dipartimento di Medicina Interna e Sanita Pubblica, Universita degli Studi di L'Aquila, Italia. gpalumbo@cc.univaq.it

More than a decade has passed since it was unintentionally discovered that grapefruit juice interacts with certain drugs. The coadministration of these drugs with grapefruit juice can markedly elevate drug bioavailability, and can alter pharmacokinetic and pharmacodynamic parameters of the drug. The predominant mechanism for this interaction is the inhibition of cytochrome P-450 3A4 in the small intestine, resulting in a significant reduction of drug presystemic metabolism. An additional mechanism is the inhibition of P-glycoprotein, a transporter that carries drug from the enterocyte back to the gut lumen, resulting in a further increase in the fraction of drug absorbed. Some calcium channel antagonists, benzodiazepines, HMG-CoA reductase inhibitors and cyclosporine are the most affected drugs. A single exposure to one glass of the grapefruit juice can usually produce the maximal magnitude of the interaction. The data available so far, concerning this interaction and its clinical implications, are reviewed in this article. It is likely that more information regarding this interaction will accumulate in the future, and awareness of such is necessary for achieving optimal drug therapy.

I.


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