They help to prevent heart attacks and strokes. Do not drink grapefruit juice if you're taking the antiplatelet medicine clopidogrel , as it may mean your medicine works less effectively. If you're taking ticagrelor , grapefruit may increase the effects of your medicine and make you bleed more easily. You do not need to avoid grapefruit if you're taking dipyridamole or low-dose aspirin. Ciclosporin, sirolimus and tacrolimus are medicines that moderate your immune system the body's natural defence system.
If you're taking any of these medicines, do not drink grapefruit juice without consulting your doctor. Entocort is a medicine that contains budesonide and is used to treat Crohn's disease , a condition that affects the digestive system. Do not eat grapefruit or drink grapefruit juice while you're taking this medicine, as the level of budesonide in your blood will increase.
Some medicines used in the treatment of cancers may interact with grapefruit juice. You should check with your doctor before drinking grapefruit juice. This list is not exhaustive and there are a number of other drugs that may interact with grapefruit. The risk of experiencing the effect of a drug interaction as a result of grapefruit can vary a lot from person to person.
For more information check the patient information leaflet that comes with your medicine, or you can ask your pharmacist or GP or call NHS for advice. Read the answers to more questions about medicines. Page last reviewed: 14 September Next review due: 14 September Home Common health questions Medicines Back to Medicines.
Does grapefruit affect my medicine? Grapefruit has vitamin C and potassium, nutrients your body needs to work properly. Grapefruit juice and grapefruit can affect the way your medicines work, and that food and drug interaction can be a concern. The U. Food and Drug Administration has required that some prescription and over-the-counter OTC drugs generally taken by mouth include warnings against drinking grapefruit juice or eating grapefruit while taking the drug.
Here are examples of some types of drugs that grapefruit juice can cause problems interact with:. Grapefruit juice does not affect all the drugs in the categories above. The severity of the interaction can be different depending on the person, the drug, and the amount of grapefruit juice you drink.
Talk to your health care provider or pharmacist, and read any information provided with your prescription or non-prescription OTC drug to find out:. Although only a few heart rhythm medications interact with grapefruit, the side effects can be dangerous.
Collectively called antimicrobials, these anti-infection medications vary widely in their actions and breakdown in the body. Although antimicrobials are one of the most diverse categories of medications, there are only a few medications with known important grapefruit interactions:. Erythromycin is used to treat several types of bacterial infections. Excess levels of this medication can disrupt heart rhythm Grapefruit also increases levels of the HIV medications rilpivirine and maraviroc, in addition to primaquine-related antimalarial drugs.
This may affect heart rhythm or function 1. Alternatives: Clarithromycin is a medication in the same class as erythromycin that does not interact with grapefruit. Doxycycline is both an antibiotic and antimalarial drug that also does not interact with it 1. Some anti-infection medications should not be used with grapefruit, as they can lead to disrupted heart rhythm or function. Drugs like quetiapine and lurasidone are used to treat mood and behavioral disorders.
Increased levels of these drugs can cause heart rhythm changes or sleepiness 1. Furthermore, diazepam, midazolam, and triazolam are sedatives that are sometimes used for panic attacks or other forms of anxiety.
One study compared some of these drugs in nine patients, some of whom consumed grapefruit. Eating grapefruit while taking the mood-related medications above can result in heart rhythm changes, excessive sleepiness, and other drug-specific effects. Blood thinners are used to treat or prevent blood clots. Some of them are affected by grapefruit, including:. Clopidogrel depends on CYPs — the proteins that grapefruit limits — to work.
Thus, it becomes less active when mixed with grapefruit. A study of 7 patients taking clopidogrel with mL of either grapefruit juice or water showed lower activation of the drug with the juice. However, its ability to treat blood clots was not affected Contrarily, grapefruit increases the blood levels of other medications on this list, which can result in bleeding Alternatives: Warfarin Coumadin is used for purposes similar to those of apixaban and rivaroxaban.
While warfarin is sensitive to foods containing vitamin K, its activation is not affected by grapefruit Several blood thinners are affected by grapefruit. This can lead to bleeding or less effective prevention of blood clots. Fentanyl and oxycodone are narcotic pain relievers. Although their blood levels are only slightly affected by small amounts of grapefruit, it may change the length of time they remain in the body 16 , Colchicine is an older medication used to treat gout. Nevertheless, a study showed that drinking mL of grapefruit juice only had a minimal effect on its levels Alternatives: Morphine and Dilaudid are narcotic pain relievers that are not affected by grapefruit 1.
A few erectile dysfunction and prostate medications deserve attention regarding grapefruit interactions:.
Erectile dysfunction medications like sildenafil and tadalafil work by relaxing blood vessels, which increases blood flow to an erection. Because other blood vessels relax with these medications as well, increased blood levels of these drugs caused by grapefruit can decrease blood pressure 8.
Moreover, prostate enlargement medications such as tamsulosin can also cause increased dizziness and low blood pressure when taken with grapefruit Alternatives: Another class of prostate enlargement medications, which includes finasteride and dutasteride, is not significantly affected by grapefruit
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