Grapefruit And Meds

[kebaldwin]

Grapefruit And Meds

The Monterey County Herald, Calif.

07-13-07

Our hospital no longer offers grapefruit on our patient menu. Not because grapefruit isn't nutritious. Like other citrus fruits, it is an excellent source of vitamin C, fiber and even contains natural substances that help lower blood cholesterol and triglyceride levels.

Ironically however, some of these same substances that render grapefruit and its juice so healthful have also been found to interfere with the action of some medications ... including several that lower cholesterol levels.

What we have here, say dietitians and pharmacists, is a "food-drug" interaction - an ingredient in food that interferes with the intended action of a medication. Certain active components in grapefruit and its juice hinder certain enzymes in the digestive tract that break down certain medications. As a result, these particular drugs can enter the bloodstream in higher (or lower) amounts than expected, causing serious potential side effects.

Grapefruit and related foods such as Seville oranges, tangelos (a grapefruit hybrid) and lime juice have all been singled out as foods to avoid when taking medications that react with grapefruit juice. Other foods such as lemons, regular oranges, tangerines and grapefruit-flavored sodas are on the "OK to eat" list.

Here is a partial list of common medications that most experts agree should not be taken with grapefruit or its juice, and a few substitute drugs:

-Cholesterol-lowering medications: atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor, Vytorin). Alternate drugs: pravastatin (Pravachol), rosuvastatin (Crestor) and fluvastatin (Lescol).

-Heart and blood pressure medications: cilostazol (Pletal), felopidine (Plendil), nifedipine (Procardia, Adalat). Grapefruit juice does not significantly affect: amlodipine (Norvasc), digoxin (Lanoxin) or diltiazem (Cardizem).

-Sedatives and anti-seizure medications: diazepam (Valium), triazolam (Halcion), carbamazepine (Carbatrol, Tegretol). Drugs in this category that do not react significantly with grapefruit juice: haloperidol (Haldol) and alprazolam (Xanax).

-Antidepressants: buspirone (BuSpar), clomipramine (Anafranil), sertraline (Zoloft).

-Allergy medications: fexofenadine (Allegra). Experts suggest desloratadine (Clarinex) is safe.

-HIV drugs: saquinavir (Fortovase, Invirase), indinavir (Crixivan).

-Immunosuppressant drugs: cyclosporine (Neoral, Sandimmune), tacrolimus (Prograf)

-Other no-no's with grapefruit: sildenafil (Viagra), amiodarone (Cordarone, Pacerone),

Doses and timing matter, too. Less than 1 cup of grapefruit juice can affect the action of some medications for up to three days, according to one study. Yet the blood-thinning medication warfarin (Coumadin) does not interact significantly with grapefruit juice ... unless you drink more than 24 ounces a day.

Bottom line: Always check with your doctor and/or pharmacist to make sure you understand any potential food interactions with any prescribed medication.

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(Barbara Quinn is a registered dietitian at the Community Hospital of the Monterey Peninsula. E-mail her at bquinn~chomp.org.)

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http://www.lef.org/news/LefDailyNews.htm?NewsID=5600&Section=NUTRITION

[kebaldwin]

Eating grapefruit can increase breast cancer risk by a third
By OLINKA KOSTER

Eating grapefruit can increase the risk of breast cancer by almost a third, a study suggests.

It is thought the fruit boosts blood levels of oestrogen, the hormone associated with the risk of the disease.

According to the research, eating as little as a quarter of a grapefruit a day raises the danger by 30 per cent among older women.

Researchers said: "This is the first report of a commonly consumed food that may increase the risk of breast cancer among post-menopausal women.

"Whole grapefruit intake was significantly associated with breast cancer in the present study - generally a 30 per cent increase among women who consume the equivalent of one quarter of a grapefruit or more per day.

"There is evidence that grapefruit increases plasma oestrogen concentrations.

"Since it is well established that oestrogen is associated with breast cancer risk, it is plausible that regular intake of grapefruit would increase a woman's risk of breast cancer."

The study, carried out by the universities of Southern California and Hawaii, was based on more than 50,000 post-menopausal women from five ethnic groups, including 1,657 with breast cancer.

The results, published in the British Journal of Cancer, will further increase fears over the disease, which accounts for more than a quarter of all cancers in women.

More than 40,000 cases are diagnosed and around 12,500 women die from breast cancer in the UK each year.

A number of lifestyle factors have been linked to breast cancer risk.

Earlier this year, it was revealed that a single alcoholic drink daily may increase a woman's risk of developing aggressive forms of breast cancer by 9 per cent.

Dr Shumin Zhang of Harvard Medical School said "moderate alcohol consumption" increased the risk of breast cancer, with beer, spirits and white wine all to blame, but not red wine.

A major European study also recently showed that eating junk food raises women's risk of developing a range of cancers.

And older women with the fattiest diets have a 15 per cent increase in their chances of developing breast cancer, according to a separate U.S. study.
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Find this story at http://www.dailymail.co.uk/pages/live/articles/health/dietfitness.html?in_article_id=468559&in_page_id=1798
©2007 Associated New Media

[lené]

Grapefruit and grapefruit juice, as well as cranberry juice, can also be problematic for people on warfarin/coumadin. I'm on warfarin (blood thinner) due to a genetic clotting mutation, and have to really limit my intake of grapefruit or cranberry. I still have it once in a while (I prefer the fruit to the juice) but not a lot, and I try to have it just a few days before I'm due to be jabbed for blood work to check my clotting, so if the fruit has had an impact, I'll know.

Lene'