Formulary
Grapefruit: Indications, Dosing, Side Effects and Interactions
Grapefruit juice is a food substance included only for its potential to interact with drugs.
MedNext Academy | 3 min read
Grapefruit: Indications, Dosing, Side Effects and Interactions
Grapefruit juice is a food substance included only for its potential to interact with drugs.
Drug action
Grapefruit juice is a food substance included only for its potential to interact with drugs.
Interactions
**Severe interactions:**
- The absence of a significant pharmacokinetic interaction with pravastatin has been specifically demonstrated for several products, particularly those that are substrates/inhibitors of CYP3A4 e.g.
- Therefore, CYP3A inhibitors such as azol antifungals, HIV protease inhibitors, clarithromycin, telithromycin, verapamil, diltiazem, indinavir, ciprofloxacin, and grapefruit juice are not anticipated...
- Medicinal products which have effects on tacrolimus Drug/Substance Class or Name Drug interaction effect Recommendations concerning co-administration Grapefruit or grapefruit juice May increase...
**Other interactions (74):**
- Grapefruit juice results in increased peak plasma levels and bioavailability possibly due to an interaction with flavonoids in the fruit juice.
- Therefore grapefruit juice should not be taken together with Cardioplen XL 2.5 mg Prolonged Release Tablets.
- Grapefruit juice is a weak inhibitor of CYP3A4 gut wall metabolism and may give rise to modest increases in plasma levels of sildenafil.
- Concomitant use not recommended Grapefruit juice: ivabradine exposure was increased by 2-fold following the co-administration with grapefruit juice.
- Therefore the intake of grapefruit juice should be avoided.
- Pharmacokinetic interactions The concomitant administration of lurasidone and grapefruit juice has not been assessed.
Medicinal forms
Medicinal forms No licensed medicines listed.
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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