Nexplanon (Etonogestrel) With Grapefruit

In our latest question and answer, the pharmacist discusses whether or not grapefruit interacts with Nexplanon (Etonogestrel).

Nexplanon (Etonogestrel) With Grapefruit
Jun 15, 2018

Purplesocks asked

Does grapefruit interact with the contraceptive implant 'Nexplanon?

Answer

GrapefruitNexplanon (Etonogestrel) is an implantable contraceptive device.  It is indicated for the prevention of pregnancy.  While a large number of drugs do have an interaction with grapefruit juice, Nexplanon (Etonogestrel) is not one of these drugs.  So it is fine to drink grapefruit juice while using Nexplanon (Etonogestrel). See below for a discussion on grapefruit juice drug interactions.

When Grapefruit Juice Can Cause Drug Interactions

Grapefruit juice is known to cause drug interactions with certain drugs.  Grapefruit juice is known to interfere with the action of an enzyme found in the small intestine called CYP3A4.  This enzyme helps in the metabolization or breaking down of many drugs.  When grapefruit juice interferes with the enzyme CYP3A4, the drug levels can increase in the blood and can potentially cause side effects to toxic levels of the drugs to occur.  

It should be noted that not all patients will respond the same to this type of potential drug interaction.  The amount of enzymes in every person can vary greatly.  Hence, the reaction a particular patient has may not be the same as other patients. However, it is still important to be aware of the drug interaction that grapefruit juice can cause and to avoid using grapefruit juice when a drug interaction is known.  

Some known drugs that grapefruit juice can react with include:

  • Cholesterol lowering statin drugs such as Mevacor (lovastatin) and Lipitor (atorvastatin)
  • Antihistamine: Allegra (fexofenadine)
  • Immunosuppressants: Neoral (cyclosporine) and Program (tacrolimus)
  • Antiarrhythmic: Cordarone (amiodarone)

The above list is just an example of some of the types of drugs that can interact with grapefruit juice.  Patients should discuss possible drug interactions with their pharmacist and prescriber.  Often, the prescription may be labeled not to take the drug with grapefruit juice.  This warning can also be found in the patient drug information that the pharmacy dispenses with each prescription.

Conclusion

Grapefruit juice is know to cause drug interactions with a number of medications.  Patients should be aware of this type of potential drug interaction and discuss with their pharmacist or prescriber.  In the case of Nexplanon (Etonogestrel), there is no interaction with grapefruit juice and it is fine to drink while on this drug.

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