Grapefruits?

EMT B

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Is this a real thing? What is the science behind it? Does anyone know?


the word "this" is the link...
 
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NYMedic828

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The grapefruit (Citrus × paradisi) is a subtropical citrus tree known for its bitter fruit, an 18th-century hybrid first bred in Barbados.[1] When found, it was named the "forbidden fruit";[2] and it has also been misidentified with the pomelo or shaddock (C. maxima), one of the parents of this hybrid, the other being sweet orange (C. × sinensis).

These evergreen trees usually grow to around 5–6 meters (16–20 ft) tall, although they can reach 13–15 meters (43–49 ft). The leaves are dark green, long (up to 150 mm, 6 inches) and thin. It produces 5 cm (2 in) white four-petaled flowers. The fruit is yellow-orange skinned and largely an oblate spheroid; it ranges in diameter from 10–15 cm. The flesh is segmented and acidic, varying in color depending on the cultivars, which include white, pink and red pulps of varying sweetness. The 1929 US Ruby Red (of the Redblush variety) has the first grapefruit patent.[3]
???
 

NYMedic828

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click the link?

I don't quite get what the chart is for... Is it suggesting that eating grapefruits causes the interactions listed with the drugs in the chart?
 
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EMT B

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yes


Appendix 1:Grapefruit Interacting Drugs and Associated Oral Bioavailability, Adverse Event(s), Risk Ranking and Potential Alternative Medications
 
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EMT B

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I have a friend out in Oregon that is a medic...he wasn't sure about it and posted it on facebook

really i gotta wonder if i need to take these with a grain of salt...ie:


i have a patient cc of hallucinations. relative states they had a mucinex DM and grapefruit about 45 mins ago...could i say for certain thats what caused it? or are all of these interactions shots in the dark
 
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medicsb

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To put it simply: Something in grapefruit juice inhibits some of the enzymes involved with the cytochrome p450 system in the liver thus allow certain drugs to potentially reach toxic concentrations at normal doses as they are not being broken down as they would be normally.
 

ExpatMedic0

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YES,
Grapefruit effect can vary but with some drugs, only a single serving of grapefruit(as juice or solid form) can dramatically increase the drugs potency, meaning it can be like a person is taking multiple doses of the drug. It should be seriously considered when taking a SAMPLE HX
 

ExpatMedic0

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To put it simply: Something in grapefruit juice inhibits some of the enzymes involved with the cytochrome p450 system in the liver thus allow certain drugs to potentially reach toxic concentrations at normal doses as they are not being broken down as they would be normally.
furanocoumarins ?
 

medichopeful

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Is this a real thing? What is the science behind it? Does anyone know?


the word "this" is the link...

Is it a real thing? Absolutely. Grapefruits and grapefruit juice can affect a lot of medications. During pharmacology it seemed that for every medication it included "don't give with grapefruit juice!"
 
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EMT B

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Is it a real thing? Absolutely. Grapefruits and grapefruit juice can affect a lot of medications. During pharmacology it seemed that for every medication it included "don't give with grapefruit juice!"

well that could just be the same reason why they dont advise taking it with any acidic juice...as it could potentially expedite the breakdown process of the med
 

NYMedic828

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Mind = blown on this being legit.
 

flhtci01

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Pomelos and Seville oranges can have the same effect.

University of Chicago has looked at combining anti-cancer drugs with grapefruit ingestion to reduce the side effects of high-dose cancer drugs. They found some drugs effectiveness is tripled when grapefruit is ingested. That may indicate they can get the same effect with a lower dose of the drug.
 

flhtci01

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It is not all drugs. The drugs are those metabolized by the CYP3A4 enzyme.

Grapefruit suppresses the CYP3A4 enzyme in the digestive tract. With the enzyme suppressed, less drug is metabolized and more is available to enter the bloodstream.
 
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EMT B

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Increases the potency of what classes of drugs? Or all? I'm lost.

my OP has a link to the table of the drugs and the effects



so with all this being said, will grapefruit and grapefruit juice automatically contraindict all the 85 meds on the table, or can you give a lower than normal dose, or is it just something to think about while you are giving those meds?
 

JPINFV

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so with all this being said, will grapefruit and grapefruit juice automatically contraindict all the 85 meds on the table, or can you give a lower than normal dose, or is it just something to think about while you are giving those meds?


Change the doeses... or just don't take grapefruit juice.

Also, it doesn't always increase the effective dose. If the drug is one that requires breakdown by CYP450 to become effective (i.e. a "prodrug"), then you need to increase the dose since the effective dose is less.
 
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