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Grapefruit Kills

Adverse side effects include ‘sudden death’.

Which was always a calculated risk on River Phoenix-inspired speedball binges, or a quiet night in with a box of Bath Salts and a sharp-toothed friend. It’s not quite what you might have prepared yourself for before sitting down to a healthy breakfast though.

Grapefruit, already considered by many to be the most evil of the citrus family, turns out to have powers far greater than its well-known ability to shoot a defensive spray of concentrated acid into the eye of its prey on spoon-entry.

‘acute kidney failure, respiratory failure, gastrointestinal bleeding, bone marrow suppression in immunocompromised people, renal toxicity and other serious side effects’

All possible when grapefruit is combined with certain prescription drugs. Which is an even more compelling reason to give the Roseanne Barr of the citric world (corpulent, sour) a miss than that they leave your esophagal tract feeling like you’ve eaten a car battery chased with the toenail-flecked dregs of a Oaxacan campesino’s mescal bottle.

Stick to eggs.


Grapefruit–medication interactions increasing

The number of prescription drugs that can have serious adverse effects from interactions with grapefruit are markedly increasing, yet many physicians may be unaware of these effects, states an article published in CMAJ (Canadian Medical Association Journal). The article, a review by the researchers who discovered the interactions more than 20 years ago, summarizes evidence to help clinicians better understand the serious effects this common food can have when consumed with certain prescription drugs.

“Many of the drugs that interact with grapefruit are highly prescribed and are essential for the treatment of important or common medical conditions,”

writes Dr. David Bailey, Lawson Health Research Institute, London, Ont., with coauthors.

“Recently, however, a disturbing trend has been seen. Between 2008 and 2012, the number of medications with the potential to interact with grapefruit and cause serious adverse effects…has increased from 17 to 43, representing an average rate of increase exceeding 6 drugs per year. This increase is a result of the introduction of new chemical entities and formulations.”

Adverse effects include sudden death, acute kidney failure, respiratory failure, gastrointestinal bleeding, bone marrow suppression in immunocompromised people, renal toxicity and other serious side effects.

“Unless health care professionals are aware of the possibility that the adverse event they are seeing might have an origin in the recent addition of grapefruit to the patient’s diet, it is very unlikely that they will investigate it,” write the authors. “In addition, the patient may not volunteer this information. Thus, we contend that there remains a lack of knowledge about this interaction in the general healthcare community.”

There are more than 85 drugs that may interact with grapefruit, and 43 can have serious side effects. Other citrus fruits such as Seville oranges, often used in marmalade, limes and pomelos also contain the active ingredients (furanocoumarins).

These chemicals are innate to the fruit and cause the interaction by irreversible inhibition of the drug metabolizing CYP3A4 enzyme that normally inactivates the effects of an estimated 50% of all medication. Drugs that interact with these chemicals have three characteristics: they are administered orally, they have very low to intermediate bioavailability (percentage of the oral dose of drug absorbed into the blood circulation unchanged) and they undergo drug metabolism in the gastrointestinal tract by CYP3A4. For drugs with very low bioavailability, ingestion of a single normal amount of grapefruit can be analogous to consuming multiple doses of the drug alone.

“The current trend of increasing numbers of newly marketed grapefruit-affected drugs possessing substantial adverse clinical effects necessitates an understanding of this interaction and the application of this knowledge for the safe and effective use of drugs in general practice,” conclude the authors.

The drugs?

Alfentanil (oral)
Amiodarone
Apixaban
Atorvastatin
Buspirone
Clopidogrel
Crizotinib
Cyclosporine
Darifenacin
Dasatinib
Dextromethorphan
Domperidone
Dronedarone
Eplerenone
Erlotinib
Erythromycin
Everolimus
Felodipine
Fentanyl (oral)
Fesoterodine
Halofantrine
Ketamine (oral)
Latatinib
Lovastatin
Lurasidone
Maraviroc
Nifedipine
Nilotinib
Oxycodone
Pazopanib
Pimozide
Primaquine
Quinine
Quetiapine
Quinidine
Rilpivirine
Rivaroxaban
Silodosin
Simvastatin
Sirolimus
Solifenacin
Sunitinib
Tacrolimus
Tamsulosin
Ticagrelor
Triazolam
Vandetanib
Venurafenib
Verapamil
Ziprasidone

Source: Canadian Medical Association Journal
With thanks to Fark.com user ‘Snarfangel’ for the drug list (not included in original press release).
Photo: FreeDigitalPhotos.com
Next scary medical story? ‘zipper detachment strategies for penile skin entrapment’ are a real thing. USCF study lists the most common genital injuries’

About Trebuchet (1296 Articles)
Lay on, Macduff, And damn'd be him that first cries, 'Hold, enough!'

5 Comments on Grapefruit Kills

  1. Rocky Seelig // 27/04/2013 at 08:21 // Reply

    The 1929 Ruby Red patent was associated with real commercial success, which came after the discovery of a red grapefruit growing on a pink variety. Only with the introduction of the Ruby Red did the grapefruit transform into a real agricultural success.;

    Our very own web site
    <http://www.caramoan.ph/

  2. Carl Byron Batson // 27/04/2013 at 10:19 // Reply

    Grapefruit interaction is fairly old news but this article brought back some memories.

    As a former bodybuilder I remember buying G juice by the gallon, as did many of my gym buddies. Quite simply (listen up you fatties), naringin (responsible for giving grapefruit its bitter flavour) was also well known to have the power to slow down the breakdown of certain drugs in the intestines and importantly for us gym rats, caffeine. Forget your fancy schmancy highly priced diet pills.

    Basic science tells us that a nice strong shot of caffeine will not only give us that kick to work a little harder, it will also give us a little increase in thermogenesis (how the body burns calories to create heat and energy) and when the body heats up it starts burning that nasty fat way better. The prolonged digestion time given by our friend grapefuit juice means that substances such as caffeine are not cleared out of the body as quickly as usual, leading to obvious increased levels of the chemicals in the body, a good thing for those burning off in the gym.

    There was also the belief that grapefruit can block the enzyme function that is responsible for carbs and fat storage. When the enzyme function is being blocked, the body won’t store up the additional calories and fat and will burn them instead. That’s why grapefruit was adopted as part of many a weight loss program.There are also other elements one could add to make the fat burn process even more effective but you can probably work that out for yourselves.

    So beware if you are taking any medication with grapefruit juice unless the specific drug interactions are known.

    • Indeed. Grapefruit – the killer fruit.
      Nature tried to warn us with its foul taste, but would we listen?

  3. Erin Waldenberg // 21/06/2013 at 08:39 // Reply

    Massive bleeding from the GI tract can be dangerous. However, even very small amounts of bleeding that occur over a long period of time can lead to problems such as anemia or low blood counts.Once a bleeding site is found, many therapies are available to stop the bleeding or treat the cause.’,*’

  4. Handy information. Blessed my family I uncovered your web site unintentionally, exactly what pleasantly surprised why this particular car accident decided not to came about before! My spouse and i saved the item.

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