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GrapefruitAka: Grapefruit Drug Interaction

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  1. Metabolism
    1. Decreases intestinal cytochrome P450 3A4
    2. Effect onset: Within 4 hours of Grapefruit intake
    3. Effect duration: May persist 24-72 hours
    4. Increases level of drugs metabolized by CYP 3A4
  2. Drug Interactions: Increased serum concentrations
    1. Antiarrhythmics
      1. Agents affected
        1. Amiodarone
        2. Disopyramide
        3. Quinidine
      2. Alternative agents not affected by grapefruit
        1. Digoxin
        2. Diltiazem
        3. Verapamil
        4. Beta Blockers
    2. Calcium Channel Blockers
      1. Agents affected
        1. Felodipine
        2. Nicardipine
        3. Nifedipine (Procardia)
        4. Nimodipine
        5. Nisoldipine
      2. Alternative agents not affected by grapefruit
        1. Diltiazem
        2. Verapamil
        3. Beta Blockers
    3. Statins
      1. Agents affected
        1. Atorvastatin (Lipitor)
        2. Lovastatin (Mevacor)
        3. Simvastatin (Zocor)
      2. Alternative agents not affected by grapefruit
        1. Fluvastatin (Lescol)
        2. Pravastatin (Pravachol)
        3. Rosuvastatin (Crestor)
        4. Fibric Acids
        5. Niacin
        6. Bile acid sequestrants
    4. Immunosuppressants
      1. Agents affected
        1. Cyclosporine
        2. Tacrolimus
    5. Protease Inhibitors
      1. Agents affected
        1. Saquinavir
      2. Alternative agents not affected by grapefruit
        1. Amprenavir
        2. Atazanavir
        3. Fosamprenavir
        4. Indinavir
        5. Lopinavir with Ritonavir
        6. Ritonavir
        7. Nelfinavir
  3. References
    1. Stump (2006) Am Fam Physician :
    2. Dahan (2004) Eur J Clin Nutr 58:1
    3. Kane (2000) Mayo Clin Proc 75:933

Citrus paradisi (C0947567)

Definition (MSH)A plant species of the genus CITRUS, family RUTACEAE that provides the familiar grapefruit. There is evidence that grapefruit juice inhibits CYTOCHROME P-450 isoform 3A4, resulting in delayed metabolism and higher blood levels of a variety of drugs.
ConceptsPlant (T002)
MSHD032083
EnglishCitrus paradisi, Citrus sinensis x Citrus grandis, Citrus sinensis x Citrus maxima, Citrus x paradisi, Citrus x paradisi Macfad., grapefruit
Parent ConceptsCitrus (C0008865)
SourcesMSH, MTH, NCBI
Derived from the NIH UMLS (Unified Medical Language System)



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