![]() It is necessary for all medical practitioners to be aware of the potential for enhanced serum levels of the affected drugs and the possibility of serious adverse effects. However there has been a lack of awareness of its effects on other medications in patients as well as physicians. Since the accidental discovery of its interaction with felodipine, more than 85 drugs have been identified to have the potential to cause serious adverse reactions. The use of grapefruit juice on its own or in a mixture with other juices is gradually increasing in UK and grapefruit juice is now a regular part of breakfast consumption in most of Western Europe and America. Grapefruit juice sales are gradually increasing since 1970s and reached an average of 24.9 million litres per annum between 20. These compounds might even be used in medications one day to enhance their effectiveness.Cite this article as: BJMP 2012 5(4):a538 It can now help scientists spot potential drug interactions in other foods. ![]() Knowing the compounds responsible for these drug interactions has other benefits, too. The food-grade methods the researchers used can potentially be used to make furanocoumarin-free grapefruit juice commercially. ![]() In contrast to those who drank unaltered grapefruit juice, the people who drank furanocoumarin-free grapefruit juice had blood levels of felodipine similar to those who’d had the orange juice. Their blood was collected over 24 hours to measure felodipine levels. The scientists gave 18 healthy volunteers one of the three juices along with 10 milligrams of felodipine, a blood-pressure drug known to interact with grapefruit juice. In the May issue of the American Journal of Clinical Nutrition, the researchers report that removing furanocoumarins from grapefruit juice took away its drug-altering effects. They compared the modified grapefruit juice with orange juice, which has little effect on CYP3A4, and with unaltered grapefruit juice. Human studies showed that while those two chemicals do have an effect in the body, they don’t account for the full effect of the juice.Ī team of researchers funded by NIH and led by Paul B Watkins at the University of North Carolina at Chapel School of Medicine used a method to remove nearly all of the different types of furanocoumarins from grapefruit juice to test the idea that furanocoumarins really are responsible for the grapefruit juice effect. Two of another class of chemicals called furanocoumarins are abundant in grapefruit juice and also inhibited CYP3A4 in laboratory tests. When purified flavonoids were tested in humans, however, they didn’t show the same effect. Researchers originally thought that compounds called flavonoids were responsible because they’re present in high concentrations in grapefruit juice and were shown to inhibit CYP3A4 in laboratory experiments. Grapefruit juice inhibits this enzyme, causing more of the drugs to enter the blood stream and effectively resulting in doses that are too strong. CYP3A4 is found in the cells that line the small intestine and helps break down about half of all marketed drugs. Now, scientists have identified the ingredients responsible, which may enable manufacturers to create a grapefruit juice that doesn’t have the same effect.Īfter the discovery of the grapefruit juice effect, NIH-funded researchers identified a prominent enzyme called CYP3A4 as the juice’s target. Over 15 years ago, researchers uncovered a dangerous interaction between grapefruit juice and certain medications when they gave volunteers grapefruit juice to mask the taste of a medication.
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