Grapefruit Controversy

[JimChicago]

There's a news article about Japanese TV linking the anecdotal account of a man's death alledgedly due to the interaction of grapefruit and warfarin

and the Florida citrus growers response alledging that there is no such interaction according to the experts they consulted -

article at:
http://www.theledger.com/apps/pbcs.dll/article?AID=/20040917/NEWS/409170416/1001/BUSINESS

 

[Ross]

I like my grapefruit juice. I ain't dead yet!

 

[Gemma]

Hmm,
I know grapefruit juice is to be avoided in people taking statins (as stated in the article). Al Lodwick's page on food interactions says that people dramatically increasing the amount of fruit they eat will probably have a higher INR, but doesn't specifically mention grapefruit juice.
No mention of how much juice the Japanese man drank. Maybe that's got something to do with it?

 

[Johnny Stephens]

Back when I was taking Plendil for blood pressure (pre-surgery days), I was cautioned not to drink grapefruit juice, as it magnifies the effect of the drug (as I recall, they said it could triple the effect.)

The pharmacy even had one of those yellow warning stickers stuck on the bottle.

 

[Harpoon]

Grapefruit juice and amiodarone do NOT get along well together and while I was on amiodarone I stayed the hell away from the juice as much as I could and hated every moment of it.


Amiodarone is potent, dangerous stuff in and of itself anyways and after learning more about it since I came off, I'm glad I did get off the stuff.


Beyond that, I don't think there's really any alarm bells to be rung when it coems to taking warafin along with grapefruit juice any more than there would be for any other (non-alcoholic) beverage, with the possible exception of some diet drinks and V8 juice which can have high concentrations of vitamin K.


It's all relative to moderation though.

I think it's only a few tablespoons of water that's needed to make you drown. Does that mean no one should ever drink more than half a cup of water a day?

No, not really.


Of course anyone can find an extreme case of just about anything they'd want to. I want to know what else the guy was up to while he was drinking said grapefruit juice? Is that the "official" cause of death, consuming grapefruit juice while on warafin??? How much warafin? How much grapefruit juice?

It's too simplistic to say that drinking grapefruit juice while on warafin can cause death, heck, I have a 10oz bottle of grapefruit juice every Tuesday and Wednesday morning while in one of my art classes and I've been taking warafin every day for almost two years now.

I'm still alive right?

Why did he die and not me?

 

[hensylee]

Grapefruit juice is contraindicated in several meds. I am taking one now and being told not to use it (is it maybe Atenolol). Maybe the acid negates the effectiveness of the drugs? A friend brought some grapefruit from S Fl and said 'you might not be able to use these because of meds', so I assumed he was not using the fruit either. He has diabetes II. He's not on statins but he is on diabetes meds.

The Florida Juice industry is going to say it's not a problem. They don't want to be sued. They have already lost a bunch of business because of the no-carb diets.

I hate the stuff, so it isn't a problem. Don't see how y'all can stand that bitter stuff. We used to have a yard full of orange/grapefruit/tangerine trees, but we just didn't use the fruit much. Shame on us - health in the back yard and not even using it!

 

[liamty]

When Steves inr was wildly fluctuating a while ago my investigating discovered that grapefruit conflicted with medications, and it included warfarin. I'll look for the info. Steve had been eating the occassional piece but not too much. I'll start searching AGAIN!!!!!

 

[Guest]

Those people who did the Japanese TV story contacted me and I let them know that I would not be involved in a project whose only point was to scare people into not taking a drug that they desperately needed. Looks like they went ahead and did the story anyhow. (It was actually some Japanese living in LA who did it.)

Warfarin comes in two forms that are mirror images of each other (think of your hands). Only the left-handed form works in people. The enzyme in grapefruit juice only affects the right handed form. So yes, grapefruit juice interferes with the metabolism of warfarin but as far as any effect in people, it is negligible.

One of my students wrote a good analysis of this with warfarin and other drugs. You can read it at http://www.warfarinfo.com/grapefruit-juice.htm

 

[Rich]

Ann,
You are right about the Atenolol.
My wife takes it also and is not allowed any grapefruit.
Bad for her because she loves the stuff.
I'm with you, it gags me.