Hello everyone,
I have been reading the posts and had to respond to this one. I take
meds that must not have grapefruit in my diet, read lables, sometimes
it is part of a 'mix'.

Google grapefruit and medicines and it will bring up many things.

Here is one, not sure of proper posting.

http://www.azstarnet.com/dailystar/dailystar/114761

Grapefruit may sabotage meds

Many unaware of wide-ranging, serious interactions

By Carla McClain
Arizona Daily Star
Tucson, Arizona | Published: 02.07.2006

Like so many Tucsonans, John Duncan had a grapefruit tree in his back
yard and grew up eating the fruit, or drinking its juice, just about
every day.

With one of the Earth's most healthful foods always there for the
picking, Duncan never had an inkling that this habit might one day pose
a grave threat to his well-being.
But it did. That daily grapefruit has been blamed for the eventual
ruining of the healthy kidney given to him for transplant by his sister
when his own kidneys failed.

Along with many millions of Americans taking potent prescription
medicines, Duncan, 39, simply did not know that grapefruit and
grapefruit juice - long touted as being a great source of vitamin C,
good for the heart and helpful in weight control - can dramatically
change the effectiveness of many drugs.

In Duncan's case, the drug was cyclosporine - the vital
anti-rejection drug he had to take every morning to keep his body from
kicking out the donor kidney.

But the "grapefruit effect" goes way beyond transplant drugs. All of
the many millions of aging baby boomers taking drugs to control
cholesterol or high blood pressure could be harmed by that seemingly
innocent glass of grapefruit juice at breakfast.
So, too, are those taking medications for anxiety, insomnia or
depression, as well as for pain control, organ transplants and HIV
treatment. Even Viagra, the widely used impotence drug, is affected.
More than 30 commonly prescribed drugs now carry a warning against
ingesting grapefruit in any form. Although life-threatening effects are
rare, and the reaction varies widely with every individual, the danger
remains real - and too often unknown - scientists, doctors and
pharmacists warn.

"The effect in some of these drugs is quite profound," said Jude
McNally, managing director of the Arizona Poison Control and Drug
Information Center. "And there are a lot of medicines that have not
been tested that may be affected that we don't yet know about.

"You know a lot of prescriptions carry warnings against drinking
alcohol, yet people do it all the time," McNally continued. "But
grapefruit is different. People often call here, wondering if the
grapefruit warning is real. It is. This is not one of the
take-it-lightly warnings."

McNally himself stopped drinking grapefruit juice completely once he
started taking Zocor, a cholesterol-lowering drug known to be affected
by the fruit.

Zocor, along with Lipitor and Mevacor, are among the hugely popular
statin drugs that can zoom to high levels in the blood if taken with a
glass of grapefruit juice or a few grapefruit wedges, studies have
shown.

In some sensitive patients, this sudden and unexpected boost can
trigger a painful muscle disorder and possible effects on the heart and
kidneys.

What grapefruit does - unlike any other citrus fruit - is inhibit
an enzyme in the small intestine that slows down the metabolism of
certain drugs. With that enzyme turned off, unexpectedly high levels of
these drugs will flood into the bloodstream.

Some drugs, like some patients, react more strongly than others to the
grapefruit effect. The levels of the statin drug Mevacor, for example,
can jump twelvefold if taken around the same time as a glass of
grapefruit juice, while Lipitor gets a much lower spike.
Fortunately, the cholesterol-lowering drug Pravachol is not at all
affected by grapefruit, and doctors can prescribe it instead for
patients who refuse to give up their daily enjoyment of the citrus.

"Oh boy, do they ever resist it - they beg you. So many seem almost
addicted to the stuff," said Dr. Gordon Ewy, director of the University
of Arizona's Sarver Heart Center. As a cardiologist, Ewy constantly
warns patients about the potentially toxic effects of grapefruit
combined with many of the drugs he prescribes - including some blood
pressure and anti-arrhythmia drugs, as well as the statins.

"I think it's a bigger problem here than in other parts of the
country," he said. "So many of us have grapefruit trees right out the
back door."

Although most of these drugs carry printed warnings telling patients to
avoid eating grapefruit entirely, Ewy says he allows half a grapefruit
"once in a while."

"But daily? No. That's out. I certainly wouldn't do it," he said.
Although the most common effect of grapefruit is to intensify a drug's
side effects, such as headaches and dizziness, sometimes the result can
be life-threatening. Taken with some widely used blood pressure drugs
known as calcium channel blockers, the citrus can lower pressure below
safe levels and trigger tachycardia - a dangerously fast heartbeat.

One of the deadliest interactions occurred with Seldane, an allergy
drug. That medicine was taken off the U.S. market after a 29-year-old
man died just hours after taking Seldane with two glasses of grapefruit
juice. The drug hit toxic levels in his blood, fatally destabilizing
the rhythm of his heart.

Several years ago, as the mechanism of this effect was becoming better
understood, the Mayo Clinic warned: "Interaction between grapefruit
juice and certain drugs can be unpredictable and potentially dangerous.
... (This) is particularly worrisome for the elderly, who are more
likely to take medications."

Grapefruit's action on Viagra - an impotence drug that's so popular
with older men - is slightly different. Although it does boost the
drug's blood levels, this somehow tends to slow down the drug's
intended result - quite the opposite of what its users want.

Although "the grapefruit effect" has been known to scientists for more
than a decade, many people taking affected drugs today remain unaware
of it.

"Too many people just don't see it as a big deal, the way they do, say,
a peanut allergy, which they know can kill so quickly," said John
Belobraydic, pharmacy manager at a Walgreens drugstore on Campbell
Avenue.

When Duncan received his sister's kidney, in 1988, doctors didn't know
his daily glass of grapefruit juice would boost the level of his
rejection drug so high that it would damage that fragile kidney.

But they - and he - are well aware of it now. With a new donor
kidney functioning perfectly, Duncan has sworn off his beloved
grapefruit for good.

"You could say I've developed an aversion to it," he said. "But I do
miss it."