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Day in Health
by Lisa Collier Cool
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The number of common prescription drugs that can interact with grapefruitwith potentially serious or even fatal resultsis climbing sharply, according to a new
comprehensive review published in Canadian Medical Association Journal. Researchers from Western University report that grapefruit juice can interact with more than 85 oral medications, including certain cholesterol-lowering statins, cancer medications, antibiotics, anti-depressants, pain medications, heart drugs and other widely used pills. "What I've noticed over the last four years is really quite a disturbing trend, and that is the increase in the number of drugs that can produce not only adverse reactions but extraordinarily serious adverse drug reactions," lead researcher David Bailey, a clinical pharmacologist at the Lawson Health Research Institute, told CBC News. Learn About More Dangerous Drug and Food Interactions
That means more of the drug stays in your body, which could cause it to build up to toxic or even lethal levels. The same compounds are also found in other citrus fruits, including Seville oranges (the kind used in marmalade), limes and pomelos, the study reports, but not in regular oranges. These adverse reactions can occur many hours after someone consumes grapefruit or its juiceand as little as one glass of grapefruit juice can be enough to trigger dangerous interactions, the researchers report.
interaction can trigger a rare type of ventricular tachycardia, an extremely rapid heart arrhythmia, the researchers report. Mixing the citrus fruit with the prescription painkiller oxycodone can lead to severe breathing problems, while combining grapefruit and the statin medication Zocor (simvastatin) may spark a potentially life-threatening complication called rhabdomyolysis, in which breakdown of muscle fibers can result in kidney damage of failure. For a complete list of drugs that react with grapefruitand which adverse events can occur, click here.
Drugs these foods can interact with: Warfarin (Coumadin). If you take this drug, its not necessary to avoid leafy greensinstead doctors advise eating a consistent amount week to week, so your dose of warfarin can be calibrated accordingly. Milk. Milk and calcium supplements can interfere with absorption of certain infection-fighting drugs, if taken together. The best solution is to wait a few hours after taking these drugs before drinking milk, popping a calcium supplement, or taking antacids (which can also contain calcium). Drugs it can interact with: Tetracycline and fluoroquinolones (a class of antibiotics that includes Cipro, Levaquin and Avelox). Alcohol. Mixing alcohol with certain medicationsincluding both prescription and over-the-counter drugscan have a wide range of harmful effects, from nausea and vomiting to drowsiness (increasing risk for car accidents), internal bleeding, liver damage, sudden changes in blood pressure, impaired breathing, and loss of coordination, warns National Institute on Alcohol Abuse and Alcoholism (NIAAA). Drugs it can interact with: Painkillers, OTC cold, cough, flu and allergy remedies statins, drugs for angina (Isodil), anxiety and epilepsy (Ativan, Klonopin, Xanax,), arthritis (Celebrex, Voltaren), depression (Celexa, Effexor, Lexapro), diabetes (Glucophage, Orinase), enlarged prostate, high blood pressure, infections and other conditions. NIAAA offers a detailed list of drugs that dont mix with alcohol. Aged, cured or pickled foods. Aged cheeses like cheddar or Swiss, cured meats, and sauerkraut contain tyramine, an amino acid that sparks one of the most feared drug-food interactions when combined with certain antidepressants. The mixture can cause facial flushing, sweating, sudden rise in blood pressure, irregular heartbeats and brain hemorrhage. Tyramine is also found in certain types of wine, such as Chianti, sherry and Riesling. Drugs it can interact with: Monoamine oxidase inhibitors (MAOI) for depression,
and the antibiotics Zyvox and isoniazid. Chocolate. The caffeine in chocolate (and other caffeinated foods) can trigger severe jitters or tremors when combined with certain meds, and packs a double whammy by irritating the stomach lining, amplifying the side effects of drugs likely to cause nausea. Chocolate also contains some tryamine, the culprit in a fooddrug interaction that killed a University of Wisconsin Hospital and Clinics patient. Drugs it can interact with: MAO inhibitors for depression, some antibiotics, narcotic painkillers like Vicodin and Percoset, asthma medications, and stimulants, such as Ritalin.