Watch it, grapefruit can double medication dosage!

We all know that whether we are well or indisposed, eating fruits nourishes the body and predisposes us to sound health. However, many people carry this knowledge too far, such that they take medications with fruit juices!
Physicians counsel that while it’s okay to eat fruit or juice it, it should not be in combination with any form of medications. Rather, they say, medications should be taken with water and never with any other liquid – fruit juice or alcohol.

Though doctors warn that fruit and medicine should be separated, one fruit you may definitely not toy with when it comes to medications is grapefruit or any fruit in the citrus family for that matter.

Indeed, experts say that the number of drugs that can be risky when taken with grapefruit is on the rise, largely due to the development of new medications and chemical formulations, many of which you may never know about but which your physician prescribes, nevertheless, as the case may be.

They warn that when you take your medications with grapefruit, it may result in potentially fatal side effects. What are these drugs and what are the likely side effects if used with grapefruits? These ones…

Cholesterol-lowering drugs

According to Consultant Interventional Cardiologist, Dr. Adeyemi Johnson, ordinarily, cholesterol can be the body’s friend or foe, depending on its levels in the body. If anything, the physician says, cholesterol is an essential substance that is necessary for the normal functioning of our body.

“Trouble only comes when the blood has high levels of it; it becomes a silent danger that puts us at risk of a heart attack. That is why doctors encourage their patients to avoid unhealthy foods such as fast foods, egg yolks, red meat, and cheese,” Johnson says.

Physicians say while we may not totally do without these foods, they must be eaten sparingly and in little quantities.

Family doctor, Femi Awoniyi, says high levels of LDL (bad cholesterol) lead to a build-up of cholesterol in the arteries – a major risk factor for coronary heart disease, and a cause of heart attacks. It becomes absolutely necessary to reduce blood lipid levels and thus lower the cardiovascular risk. Consequently, patients at risk are given cholesterol-lowering drugs.

However, if you make a mistake of taking your specialised drug with grapefruit or any citrus fruit such as tangerine, orange, lemon or lime, Awoniyi says, it can dangerously increase the level of the drug in your body and make it act as if you have taken overdose.

“This can cause life-threatening muscle damage called rhabdomyolysis – the breakdown of muscle tissue that leads to the release of muscle fibre contents into the blood. The symptoms include muscle pain, especially in the shoulders, thighs or lower back; muscle weakness or trouble moving arms or legs; abdominal pain, nausea or vomiting, fever, rapid heart rate; confusion, dehydration, or lack of consciousness,” experts warn.

In fact, Awoniyi says, if you are on any medication, you should avoid grapefruit and its citrus sisters outright because the effect of grapefruit juice can last for more than 24 hours in the body.

“The juice and the medication do not need to be taken together before a potential harmful reaction could occur. Even if you take grapefruit in the morning and take your medications much later in the day, the drug-grapefruit interaction will still be as potent as ever.

“There can still be an interaction if you take the pill the night before or 12 hours before consuming grapefruit or grapefruit juice,” he says.

Diabetes medication

On its own, diabetes is a life-threatening condition that needs medical supervision to reduce its destructive capacity in the body. And, like any debilitating disease, patients need to take medications under the supervision of a competent physician.

Again, diabetes comes with a list of foods that patients may or may not eat; and it’s the responsibility of each patient to know where to draw the line. But beyond this is the fact that you may also not take your drugs with juices of grapefruit, lemon, lime, orange or tangerine.

“The main reason is this: interaction of certain diabetes drug may cause hypoglycemia – a medical emergency that involves an abnormally diminished content of glucose in the blood. The term literally means low blood sugar,” Awoniyi warns.

Hypertension/heart disease drugs

Hypertension or high blood pressure is regarded as a silent killer because, in many cases, patients don’t know they are already hypertensive or on the borderline until the damage has been done. And that is why people who are age 40 and over – or those with family history of the disease -are encouraged to monitor their blood pressures religiously, while also maintaining healthy diets that are rich in fruit and vegetable, with less intake of salt.

Physicians do prescribe medications in the management of these diseases also, but the patient must realise that there is caution when it comes to eating fruit and taking this class of drugs.

Awoniyi says grapefruit or grapefruit products may dangerously increase the level of some of the drugs that are used in the treatment of high blood pressure and heart disease.

The bottom line

A certified dietician, Katherine Zeratsky, notes that “Problems arise because chemicals in the fruit can interfere with the enzymes that break down the medication in your digestive system. As a result, the medication may stay in your body for too short or too long a time.”

She adds that a medication that’s broken down too quickly won’t have time to work; while a medication that stays in the body for too long can increase to potentially dangerous levels, causing serious side effects.

So, to be safe, take your drugs with water; and if you must eat fruit, avoid the stated ones.

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