As I watched one of the national news feeds yesterday, I was reminded of how unaware the public is to one of the more serious drug-food interactions.
The subject of the feature was the adverse interaction between many drugs and grapefruit. It was presented as a “startling revelation” that there is a detrimental interaction between certain drugs and grapefruit when either the fruit or the juice from it is consumed concurrently with these medications.
The truth is that the medical community identified this harmful interaction at least ten years ago and now pharmacists routinely attach alert notices to certain prescription medications involved in these interactions.
The new information here is that the number of drugs that can cause a deadly interaction with grapefruit has doubled in just the last few years. At present, 85 drugs interact with grapefruit to cause injury, 43 of which cause serious or deadly interactions.
The list of drugs that interact with grapefruit now includes many blood pressure medications, most of the cholesterol-lowering drugs, certain cardiac drugs, some anti-seizure medications, specific chemotherapy drugs and a few antibiotic medications.
What astounded me about this news broadcast was that the medical expert being interviewed recommended that patients who have been prescribed these medications “stop taking their medications and call their physicians for alternatives”.
The easier solution and a much better recommendation would be to simply STOP EATING GRAPEFRUIT!
Many of the drugs that interact with grapefruit are maintenance medications, those that patients take every day for chronic medical conditions. If a patient is achieving good therapeutic effects (especially long-term) with a drug therapy, it’s considered irresponsible to discontinue that drug in favor of a specific food in the diet.
The safer action is to keep the patient’s medical condition stable with that specific drug and to DISCONTINUE EATING THE OFFENDING FOOD.
As healthy and tasty as grapefruit is, if taken with certain medications it can be deadly. As little as one-half grapefruit, or the equivalent in juice, can interfere with the metabolism of certain drugs. A chemical in grapefruit called furanocoumarin causes some drugs to stay in the body much longer than expected and create an overdose effect when subsequent drug doses are given. Patients have died from respiratory failure, kidney failure and internal bleeding as a result of this accumulated drug effect.
As mentioned, this has been known for a long time and patients are now being warned about this serious interaction. The problem, however, remains a public health hazard for two reasons.
First, many people don’t read warning labels and, secondly, grapefruit is usually a food consumed as part of a healthy diet. People don’t associate a food as simple as grapefruit with having a deadly effect, and the problem is becoming more widespread as additional new drugs come on the market that have this potential interaction with grapefruit.
While it’s important to have news features to educate the public concerning this dangerous drug-food interaction, it should be emphasized that the recommended plan should be elimination of the offending food, not the beneficial drug.
It’s much easier to delete grapefruit from the diet than it is to find a replacement drug that would work as well as the one prescribed by your doctor, particularly if that drug is working well to control a medical condition.
Thoughts? Comments? I’d love to hear them!