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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by jsarirose on February 13, 2003, at 15:38:58
Isn't grapefruit & grapefruit juice bad to have when you're taking certain drugs? Does anyone know what those drugs are? I can't remember if it pertained to anti-depressants or other meds I take.
Posted by SBOATRN on February 13, 2003, at 15:50:12
In reply to Grapefruit Meds, posted by jsarirose on February 13, 2003, at 15:38:58
Klonopin is one that contraindicates grapefruit juice. Not sure if it increase or decreases drug level, but it's advised not to use it.
Posted by Eddie Sylvano on February 13, 2003, at 16:20:05
In reply to Grapefruit Meds, posted by jsarirose on February 13, 2003, at 15:38:58
> Isn't grapefruit & grapefruit juice bad to have when you're taking certain drugs? Does anyone know what those drugs are? I can't remember if it pertained to anti-depressants or other meds I take.
--------------------This has to do with the fact that something in the juice inhibits the action of certain enzymes in the intestine. If those enzymes were necessary to break down the drug you were taking, the net effect is that more of the drug gets into your bloodstream than would ordinarily (you get more effect from the drug). This should only be an issue if you're taking the drug at roughly (~2 hrs) the same time as the juice. The enzymes affected by grapefruit juice are CYP3A4 and CYP1A2. Some psychiatric drugs that are broken down by these enzymes include:
Buspirone
Alprazolam
Triazolam
Midazolam
Carbamazepine
Trazodone
Nefazodone
Quetiapine
Clozapine
HaloperidolYour particular drug insert may tell you which CYP450 enzymes are responsible for the drug's breakdown. This is also roughly the same process by which drugs interact with each other, since each drug (just like the grapefruit juice) inhibits or enables their own particular set of enzymes. Some drugs can even inhibit the enzymes responsible for their own metabolism. Craziness.
Posted by jsarirose on February 13, 2003, at 16:26:55
In reply to Re: Grapefruit Meds » jsarirose, posted by Eddie Sylvano on February 13, 2003, at 16:20:05
> > Isn't grapefruit & grapefruit juice bad to have when you're taking certain drugs? Does anyone know what those drugs are? I can't remember if it pertained to anti-depressants or other meds I take.
> --------------------
>
> This has to do with the fact that something in the juice inhibits the action of certain enzymes in the intestine. If those enzymes were necessary to break down the drug you were taking, the net effect is that more of the drug gets into your bloodstream than would ordinarily (you get more effect from the drug). This should only be an issue if you're taking the drug at roughly (~2 hrs) the same time as the juice. The enzymes affected by grapefruit juice are CYP3A4 and CYP1A2. Some psychiatric drugs that are broken down by these enzymes include:
>
> Buspirone
> Alprazolam
> Triazolam
> Midazolam
> Carbamazepine
> Trazodone
> Nefazodone
> Quetiapine
> Clozapine
> Haloperidol
>
> Your particular drug insert may tell you which CYP450 enzymes are responsible for the drug's breakdown. This is also roughly the same process by which drugs interact with each other, since each drug (just like the grapefruit juice) inhibits or enables their own particular set of enzymes. Some drugs can even inhibit the enzymes responsible for their own metabolism. Craziness.
>
>Thanks to both messages. I used to be on Klonopin, and now I take Trazadone. I take it at night though, so I guess it would be just fine. I have had grapefruit, but I just remembered I wasn't sure if I was supposed to.
Thanks for the info!
-Jessica
Posted by noa on February 13, 2003, at 19:02:08
In reply to Re: Grapefruit Meds, posted by jsarirose on February 13, 2003, at 16:26:55
Thanks for reminding me of this, cuz Mom just sent me grapefruits from her trip to Florida, so now I know not to eat 'em at night.
Posted by viridis on February 13, 2003, at 22:54:33
In reply to Re: Grapefruit Meds, posted by SBOATRN on February 13, 2003, at 15:50:12
I knew about the Xanax/grapefruit juice thing, but I didn't think Klonopin was a problem -- I generally take it first thing in the morning, often with grapefruit juice! I'll have to check that out.
Posted by mattdds on February 14, 2003, at 0:42:34
In reply to Re: Grapefruit Meds » SBOATRN, posted by viridis on February 13, 2003, at 22:54:33
Viridis,
Perhaps the grapefruit juice is why you do so well on 1mg Klonopin / day? Sounds like a possible "augmentation" strategy, lol.
Matt - out buying grapefruit juice
Posted by viridis on February 14, 2003, at 3:16:17
In reply to Re: Grapefruit Meds » viridis, posted by mattdds on February 14, 2003, at 0:42:34
Good point Matt -- maybe "inadvertent augmentation"? (But really, K seems to work well even with orange or tomato juice -- maybe it's just a juice thing???).
Anyway, no complaints, and no side effects!
Posted by JohnL on February 15, 2003, at 8:28:35
In reply to Grapefruit Meds, posted by jsarirose on February 13, 2003, at 15:38:58
> Isn't grapefruit & grapefruit juice bad to have when you're taking certain drugs? Does anyone know what those drugs are? I can't remember if it pertained to anti-depressants or other meds I take.
You can safely enjoy grapefruit juice. BUT, you don't want to take your meds and grapefruit juice at the same time. You want the drug to have some time to break down and get absorbed into your system before introducing the grapefruit.
Grapefruit may or may not affect the particular med you are taking. But it does actually affect a lot of meds.
Grapefruit juice can slow down the metabolism of the drug and increase the drug level in your blood. But this is only a concern when the grapefruit and the drug are taken at the same time.
For example, let's say you take your med dose at 8:00 am. Wait a few hours and enjoy your grapefruit juice then.
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