Can You Take Apriso With Grapefruit Juice?

In our latest question and answer, the pharmacist discusses whether or not Apriso can be taken with grapefruit juice.

Mar 19, 2018

Lew asked

Is it okay to take Apriso with grapefruit juice? I also take the following supplements. Do any of them react negatively with grapefruit juice? Vitamin K2, Probiotic 10, Krill oil Qunol,  Vitamin D3, Vitamin B12, folate, B6 & biotin.

Answer

Grapefruit juice is documented to have mild to severe drug interactions with a wide variety of medications. Other citrus fruits may have similar interactions (including limes). However, grapefruit has been by far the most studied and documented.

The mechanism by which grapefruit juice interacts with medication varies but the most common is that it interferes with an enzyme that metabolizes the drug (CYP3A4).This can lead to a much greater amount of the medication entering your bloodstream and causing effects of an overdose at normal therapeutic dosing levels.

The extent that grapefruit juice affects certain medications varies from person to person as individuals can have varying levels of CYP3A4. The amount of juice or fruit ingested and when its ingested also can greatly effect the extent of the interaction. With some medications even a small amount of juice or fruit ingested many hours before or after can end up becoming a hazardous interaction. 

Apriso With Grapefruit Juice

Apriso does not interact with grapefruit juice or other fruit juices.  Drugs that are effected by grapefruit juice or other fruit juices include but are not limited to:

  • Multaq  (dronedarone)
  • Cordarone(amiodarone)
  • Certain statins (simvastain,lovastatin, and atorvastatin)
  • Dextromethorphan
  • Benadryl (diphenhydramine)
  • Buspar (buspirone)
  • Tegretol (carbamazepine)
  • Trazodone
  • Seroquel (qeutiapine)
  • Immunosuppressants (ciclosporin, tacrolimus, sirolimus, mercaptopurine)
  • Procardia (nifedipine)
  • Plendil (felodipine)
  • Protease Inhibitors (Norvir, Viracept)
  • Erectile dysfunction (Viagra, Cialis, Levitra)

Over the counter medications and supplements can have varying composition and potency. Any over the counter supplement may have "do not take with grapefruit" in some manner on the packaging to let you know when it may be an issue. 

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