GSE (grapefruit seed extract) and coumadin

[temp69]

a bad mix? does anyone know?

 

[Ross]

grape fruits a no no, so I imagine seed extract is too.

 

[Guest]

In my warfarin seminar I have a case where a woman was supposedly taking grapefruit seed extract while on warfarin. She developed a very high INR and a hematoma (collection of blood like a super bad bruise). The doctors anaylzed the greapefruit seed extract and found that there was only water and a preservative in the bottle. It turns out that nobody had tested the preservative before. It turned out to be a major inhibitor of warfarin metabolism, so it caused the high INR. Bottom line you may not be getting what you pay for.

 

[dick0236]

Al, what is the scoop on Grapefruit meat and grapefruit juice? Over the years I have seen much conflicting info. My lates info is Grapefruit meat is OK, but straight grapefruit juice should be limited. Grapefruit meat and juice has always been one of my favorites and I ate it for years until I saw a warning. I continue to eat both but I now limit it.

 

[temp69]

Hey Al thanks so much

Hey Al thanks so much

interesting about the preservative. my coumadin nurse told me to go ahead and give it a try for a day or two and then check my inr. I'll report anything of note. And thanks again for your prompt attention to my quesiton.

 

[MNmom]

grapefruit is a problem too?

grapefruit is a problem too?

That hadnt been on my list...I never knew grapefruit could have an affect on INR. My mom told me she couldnt have grapefruit because of her lipitor, and i felt bad for her!
No wonder my cardiologist waited so long before suggesting surgery- he wanted to wait as long as possible before putting me on coumadin.

 

[Ross]

Al, what is the scoop on Grapefruit meat and grapefruit juice? Over the years I have seen much conflicting info. My lates info is Grapefruit meat is OK, but straight grapefruit juice should be limited. Grapefruit meat and juice has always been one of my favorites and I ate it for years until I saw a warning. I continue to eat both but I now limit it.

Don't feel alone Dick, I do too!

 

[catwoman]

Seems that if you're consistent in your intake of grapefruit or it being a once-in-awhile item in your diet, it shouldn't be a problem. If you have half a grapefruit every day for breakfast, you'll find yourself adjusting your INR if you notice a change. If you eat it once in a while,it won't affect your INR to make much of a difference.

Only if you start something that does affect your INR and you adjust for it, then stop, now that would be a problem.

Am I correct in my assumption?

Or does grapefruit interact in some other way with warfarin, as I've read it does with other Rxes?

 

[KristyW]

Just musing here...

It's my understanding that grapefruit & grapefruit juice have effects on several medications that are "standard" doses. For instance it can greatly increase the effect of statins to the point of toxicity, and there is no "testing" to adjust the dose of a statin for each person/diet...therefore the "No Grapefruit" policy on that.

However, warfarin patients are tested at least every month, so if grapefruit affects that, the INR test will help the doctors adjust the dosage.

Just random thoughts.

 

[terryj]

Okay how did I miss the grapefruit juice thing? My husband has been on coumadin for nearly 7 years and he is on Zocor. I fixed him 2 grapefuit juice and vodkas the other day. He had his INR tested yesterday. I guess we will see if I messed with his INR. No more grapefruit juice. I thought I had this all down to a science.

 

[KristyW]

Terry,

I don't think that grapefruit/grapefruit juice does affect INR or warfarin, BUT I'm suprised that the literature for the Zocor doesn't warn you about the grapefruit juice though.