Grapefruit

[DogAgilityObsessed]

Husband just said he bought a grapefruit for breakfast tomorrow. But can I have grapefruit with our usual meds?

[MrsNails]

What Meds are you on? If you’re on Methotrexate the answer is NO.....

Here’s a list of Meds where you should NOT eat Grapefruit......

healthline.com/nutrition/gr...

[DogAgilityObsessed in reply to MrsNails]

That’s a really helpful list. Thanks

[MrsNails in reply to DogAgilityObsessed]

No Problem 😉 Every so often l re-read the Patient Information Leaflet that with my Meds just to keep myself up to date.

Actually, when they stopped my MTX for Surgery l bought a carton of grapefruit juice as a treat! It didn’t last long as l was soon on something else that excluded grapefruit!

[Blackcatlover in reply to MrsNails]

Thank you for this list.

[MrsNails in reply to Blackcatlover]

No Probs 😉

[Maryis80 in reply to MrsNails]

I have been taking Alendronic Acid for a couple of years and read here a while ago that I should not eat grapefruit whilst taking it. I cut down my consumption of grapefruit to one a week, rather than every day. Saw my rheumy yesterday who said I can stop takingAA (hurrah). My question is, how soon can I restart my almost daily half a grapefruit habit. Does it take a while for the AA to get out of the system. Couldnt find the answer on the list given in this post.

[MrsNails in reply to Maryis80]

Hi Mary, l can’t find anything out about this, you’d may have to ask a Pharmacist. I actually wasn’t aware of the AA/Grapefruit Connection but l wasn’t eating/drinking Grapefruit anyway due to the MTX

If l come across something l’ll let you know.

MrsN

[Suffererc in reply to MrsNails]

I drink a lot of grapefruit. Drank it when I was taking AA.

[PMRpro Ambassador in reply to Maryis80]

AA remains in the body in the bones forever - but most interactions are that grapefruit juice increases the blood levels so adverse events are more likely or reduces the blood level so they don't work as well. Once you are off the tablets there shouldn't be a problem.

[Maryis80 in reply to PMRpro]

Thank you, I will enjoy my breakfast grapefruit. Now hoping to come off Leflunomide so can have more units of alcohol than 4 per week!

[DogAgilityObsessed]

Not Methotrexate. Just prednisolone, omeprazole, magnesium, K2, theiCal. AA in a week or two

[piglette]

You cannot have grapefruit with statins either.

[Bcol in reply to piglette]

Not all statins, some are ok

[alvertta]

Best to avoid.

[prunus]

I found when I was on predisolone that I just could not eat grapefruit although it was not on the official list. So if you are on pred I would say keep off.

[Suffererc in reply to prunus]

I drink grapefruit all the time. Whoops. Just bought load more cartons

[prunus in reply to Suffererc]

We're all different - good luck to you.

[Theziggy]

A bit more info here DogAgilityObsessed

nhs.uk/news/medication/pres...

[DogAgilityObsessed]

Thanks to everyone. I really enjoyed my half grapefruit this morning. But what a minefield and so confusing. No wonder even the expert pharmacists are sometimes contradictory. I see even limes may work like grapefruit. Fortunately I’m not on statins at the moment (despite high cholesterol) or MTX but I will probably avoid in general anyway.

[Hildalew]

Some months ago - maybe even last year - I've lost any sense of time quantities of time passing since the lockdowns and such kicked in - I asked on here whether anybody had experienced a problem related to eating grapefruit while on prednisolone. I had had a sudden problem - of diarrhoea - and the only thing that had been different in my diet was grapefruit.

The initial reply from the long-standing members of this forum was that it was not something they had ever heard of as a side-effect of Pred - but a handful of more recent PMR patients mentioned that they had had a problem.

I haven't eaten grapefuit since then and have pretty much stayed away from oranges because I remembered tha,t just occasionally, before I started taking Pred, I had had some brief discomfort after eating an orange or a satsuma etc. I do drink a lot of lemon juice (with hot water, honey and usually some of the flesh of the lemon in there too) and have had absolutely no problem.

It may just be an individual intolerance thing as far as Pred is concerned.

[YuliK]

Dear Folks

I cp the medicines which don’t mix with grapefruit, and in some cases with citrus fruit in general.

Drugs that interact with grapefruit are:

taken orally (by mouth)

inactivated by the enzyme P450 3A4

usually given in a dose which accounts for inactivation by P450 3A4

The researchers provide a list of drugs that are predicted to interact with grapefruit, including:

Drugs used to treat cancer (crizotinib, dasatinib, erlotinib,everolimus, lapatinib, nilotinib, pazopanib, sunitinib, vandetanib, vemurafenib)

Drugs used to treat or prevent infections (erythromycin, halofantrine, maraviroc, primaquine, quinine, rilpivirine)

Drugs used to treat high cholesterol (atorvastatin, lovastatin, simvastatin)

Drugs used to treat heart and blood vessel conditions (amiodarone, apixaban, clopidogrel, dronedarone, eplerenone, felodipine, nifedipine, quinidine, rivaroxaban, ticagrelor)

Drugs affecting the central nervous system (oral alfentanil, buspirone, dextromethorphan, oral fentanyl, oral ketamine, lurasidone, oxycodone, pimozide, quetiapine, triazolam, ziprasidone)

Drugs used to treat nausea (domperidone)

Immunosuppressants (cyclosporine, everolimus, sirolimus, tacrolimus)

Drugs used to treat urinary tract conditions (darifenacin, fesoterodine, solifenain, silodosin, tamsulosin)

Yulik 😷

Source nhs.U.K./news/medication/pres.

The link which Theziggy kindly posted earlier.