Is it ok to eat grapefruit with blood pressure medicine

Grapefruit and grapefruit juice can interact with Amlodipine. Amlodipine is broken down by enzymes (CYP3A4) in the lower intestine. People have varying levels of these enzymes in their body, so eating grapefruit can affect people differently, even when they both take Amlodipine. Eating grapefruit can block the action of these essential enzymes. Blocking these enzymes causes the drug to stay around for longer, allowing too much Amlodipine to enter your bloodstream. These higher levels of Amlodipine mean more potent effects of the drug and more substantial side effects.

What happens if I eat grapefruit while taking Amlodipine?

Eating grapefruit while on Amlodipine can cause the same side effects as if you were taking a much higher dose of the drug. Severe cases of dizziness, headaches, vomiting, joint pain, tiredness are possible, as well as liver and muscle damage leading to kidney failure in severe cases.

Can I eat citrus fruit while taking Amlodipine?

Grapefruits are the primary fruit to avoid when taking Amlodipine, including red, pink, white and or Blanco varieties. Seville oranges (used in orange marmalade), pomelos and tangelos (a cross between tangerines and grapefruits) may also have similar effects, so it is best to avoid these fruits when taking Amlodipine.

Sources

FDA- https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm292276.htm

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Grapefruit Juice: Is It Affecting Your Medication?

Most Americans who drink grapefruit juice do so for breakfast -- a time of day when many people also take medications. Grapefruit juice, it turns out, can affect some medications. So you may need to rethink your morning drink.

Don’t drink grapefruit juice if you’re taking any of these medications, unless advised to by your doctor:

  • Some statins (cholesterol-lowering drugs): lovastatin (Mevacor), atorvastatin (Lipitor), simvastatin (Zocor). (Other statins such as fluvastatin (Lescol), pravastatin (Pravachol), and rosuvastatin (Crestor) have little or no interaction with grapefruit juice.)
  • Antihistamines: fexofenadine (Allegra)
  • Some type of calcium channel blockers (blood pressure drugs): felodipine (Plendil), nifedipine (Adalat, Afeditab CR, Procardia)
  • Certain psychiatric drugs: buspirone, triazolam (Halcion), carbamazepine (Tegretol), diazepam (Valium), midazolam (Versed), sertraline (Zoloft)
  • Some immunosuppressants: cyclosporine (Neoral), tacrolimus (Prograf)
  • Certain pain medications: methadone
  • The impotence drug (erectile dysfunction): sildenafil (Viagra)
  • Some HIV medication: saquinavir (Invirase)
  • Some antiarrhythmics: amiodarone (Cordarone, Nexterone, Pacerone)

There are alternatives to many of these drugs. So, talk to your doctor about the possibility of using a different medication if avoiding grapefruit juice is not an option.

When you’re starting a new medication, it’s always a good idea to ask your doctor or pharmacist about any potential interactions between the new medication and foods, supplements, or other drugs you’re already taking.

I like to drink grapefruit juice but hear that it can interfere with some prescription medications. Is that true?

Answer From Katherine Zeratsky, R.D., L.D.

Yes. Grapefruit and certain other citrus fruits, such as Seville oranges, can interfere with several kinds of prescription medications.

Don't take these interactions lightly. Some can cause potentially dangerous health problems. If you take prescription medication, ask your doctor or pharmacist whether your medication interacts with grapefruit or other citrus products.

You may need to eliminate grapefruit products from your diet. Simply taking your medication and grapefruit product at different times doesn't stop the interaction. Alternatively, you can ask your doctor if there's a comparable medication you can take that doesn't interact with grapefruit.

Problems arise because chemicals in the fruit can interfere with the enzymes that break down (metabolize) the medication in your digestive system. As a result, the medication may stay in your body for too short or too long a time. A medication that's broken down too quickly won't have time to work. On the other hand, a medication that stays in the body too long may build up to potentially dangerous levels.

The list of medications that can interact with grapefruit includes commonly prescribed medications that:

  • Fight infection
  • Reduce cholesterol
  • Treat high blood pressure
  • Treat heart problems
  • Prevent organ rejection
  • Treat anxiety
  • Control seizures
  • Minimize motion sickness
  • Treat erectile dysfunction
  • Replace hormones
  • Reduce cough
  • Control pain

Another potential problem is that some foods and drinks may contain grapefruit but don't say so in the name or on the ingredients list. For example, numerous citrus-flavored soft drinks contain grapefruit juice or grapefruit extract.

Play it safe with prescription drugs. Always ask your doctor or pharmacist when you get a new prescription if it interacts with any foods or other medicines. If the answer is yes, ask whether you need to eliminate that food from your diet.

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Feb. 22, 2022

  1. Grapefruit. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Oct. 19, 2018.
  2. Temple NJ, et al., eds. Drug interactions with food and beverages. In: Nutrition Guide for Physicians and Related Healthcare Professionals. 2nd ed. Cham, Switzerland: Springer International Publishing AG; 2017.
  3. Zeratsky KA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 2018.
  4. Grapefruit juice and medicine may not mix. U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm292276.htm. Accessed Oct. 24, 2018.
  5. Auten AA, et al. Hidden source of grapefruit in beverages: Potential interaction with immunosuppressant medications. Hospital Pharmacy. 2013;48:489.

See more Expert Answers

See also

  1. Antibiotics 101
  2. Antibiotics and alcohol
  3. Antibiotics: Are you misusing them?
  4. Antibiotics: Not a magic bullet
  5. Aspirin allergy
  6. Bioidentical hormones: Are they safer?
  7. Don't save leftover pain pills
  8. Grapefruit and meds don't mix
  9. NSAIDs: Do they increase my risk of heart attack and stroke?
  10. Exercise and opioids
  11. Tapering off opioids: When and how
  12. What are opioids and why are they dangerous?

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What blood pressure meds should not be taken with grapefruit?

Here are examples of some types of drugs that grapefruit juice can cause problems (interact) with: Some statin drugs to lower cholesterol, such as Zocor (simvastatin) and Lipitor (atorvastatin). Some drugs that treat high blood pressure, such as Procardia and Adalat CC (both nifedipine).

What fruits interfere with high blood pressure medication?

People taking ACE inhibitors or ARBs should limit their intake of high-potassium foods like bananas, oranges, avocados, tomatoes, white and sweet potatoes and dried fruits —, especially apricots.