A cold glass of grapefruit juice is part of the morning routine for a lot of people. What you may not realize, however, is that this same juice might interact with drugs you are taking. The interaction between grapefruit and some medications was discovered by accident when researchers were looking for an interaction between a particular blood pressure medicine and alcohol. Grapefruit juice was used as a vehicle to mask the taste of the alcohol. While the alcohol did not affect the amount of the drug circulating in the body, the grapefruit juice greatly increased the levels of the medication.
Some medications which may be affected by grapefruit juice include: midazolam (Versed), cyclosporin (Sandimmune, Neoral), lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), and Thyroid medications.
Certain prescription antihistamines, such as Astemizole which is in Hismanal and terfenadine which is in Seldane and Seldane-D, could also be affected by grapefruit juice. With these particular medications, increased drug levels could be associated with arrhythmias which could be fatal.
If you are taking a medication that should not be taken with one of these drugs, Erythromycin, itraconazole (Sporanox), ketoconazole (Nizoral), mibefradil or (Posicor), the safest course of action is to assume that it would interact with grapefruit juice. An example of this is cisapride (Propulsid), which is used to treat certain gastrointestinal problems.
If you drink grapefruit juice regularly, it would be a good idea to inquire about its possible interaction with any medications you may be taking or any new drugs that are added. Some sources recommend not drinking grapefruit juice within 2 hours before and 5 hours after a drug that may interact with it. A safer approach would be to substitute another citrus juice, such as orange juice, which has the same vitamins but has not demonstrated the drug interactions.
Remember that eating grapefruit or taking grapefruit supplements may also interact with the same medications. Some drinks that are flavored with fruit juice could be flavored with grapefruit juice. Check the label, if you are not sure.