Undesirable Effects of Citrus Juice on the Pharmacokinetics of Drugs

@article{Saito2005UndesirableEO,
  title={Undesirable Effects of Citrus Juice on the Pharmacokinetics of Drugs},
  author={Mitsuo Saito and Mutsuko Hirata-Koizumi and Mariko Matsumoto and Tsutomu Urano and Ryuichi Hasegawa},
  journal={Drug Safety},
  year={2005},
  volume={28},
  pages={677-694}
}
It is well known that intake of grapefruit juice affects the pharmacokinetics of various kinds of drugs. It has been reported that other citrus juices also interact with certain drugs. To re-evaluate citrus juice-drug interactions based on currently available evidence, a literature search was conducted for new and updated information since the grapefruit juice-drug interaction was last reviewed in 1998. MEDLINE (1998–October 2004) was accessed and more than 200 reports were found. The effects… 
Medicinal importance of grapefruit juice and its interaction with various drugs
TLDR
The phytochemistry of grapefruit Juice, the various drugs involved in the drug – grapefruit juice eraction with their mechanisms of action and the clinical implications of these interactions are discussed.
Orange juice has no effect on CYP 2 D 6-dependent drug metabolism
Citrus juices can interact with a number of medications. As little as 250 ml of grapefruit or orange juice can change the metabolism of drugs. Most drugs affected by citrus juices are known to be
Influence of fruit juices on drug disposition: discrepancies between in vitro and clinical studies
Background: Grapefruit juice is known to alter the pharmacokinetics of over 30 prescription drugs by increasing their bioavailabilities. After the discovery of this interaction almost 20 years ago,
Clinically Significant Grapefruit Juice-Drug Interactions
TLDR
For some drugs such as felodipine and nicardipine, the increased drug concentrations could potentially be associated with an increased frequency of dose-dependent adverse effects, although actual reports of toxicity with drugYgrapefruit juice interactions have been rare.
Review article. Assessing clinical evidence of drug interactions between citrus juices and cyclosporine
TLDR
Grapefruit juice intake increases oral bioavailability of cyclosporine in both healthy volunteers and renal transplant patients, whereas all other types of citrus juices may not have an influence on the oral bio availability of cyclOSporine.
Interaction of Citrus Juices with Cyclosporine: Systematic Review and Meta-Analysis
TLDR
Citrus juices especially GFJ and pomelo juice were found to significantly increase the plasma exposure of cyclosporine while orange juice did not exhibit any significant interaction with cyclospora.
Dose-response relationship for the pharmacokinetic interaction of grapefruit juice with dextromethorphan investigated by human urinary metabolite profiles.
  • Katja Strauch, U. Lutz, N. Bittner, W. Lutz
  • Chemistry, Medicine
    Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association
  • 2009
TLDR
Two effects were highly significant: a delay of total metabolite excretion in the first 2h and an inhibition of the CYP3A4-dependent metabolic pathways.
Interaction of white and pink grapefruit juice with acetaminophen (paracetamol) in vivo in mice.
TLDR
White grapefruit juice increased concentrations of acetaminophen in mice both 1 hour and 2 hours after feeding compared to controls and, in contrast, pink grapefruit Juice increasedacetaminophen concentrations 2 hoursAfter feedingCompared to controls, because acetamol is almost completely absorbed these effects seems to be related to increased elimination half-life of acetaminsophen because of interaction with Grapefruit juice.
Potential risks resulting from fruit/vegetable-drug interactions: effects on drug-metabolizing enzymes and drug transporters.
TLDR
It is concluded that the knowledge of the potential risk of nutrient-drug interactions is still limited and efforts to elucidate potential risks resulting from food- drug interactions should be intensified in order to prevent undesired and harmful clinical consequences.
Grapefruit juice enhances the exposure to oral oxycodone.
TLDR
Dietary consumption of grapefruit products may increase the concentrations and effects of oxycodone in clinical use and only self-reported performance significantly impaired after grapefruit juice.
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TLDR
The data support inhibition of intestinal uptake transporters by fruit juices to decrease drug bioavailability, which would represent a new mechanism for food–drug interactions.
Drug Interactions with Grapefruit Juice
TLDR
Concomitant intake with grapefruit juice increases the concentrations of many drugs in humans and in many cases has the clear potential to reach clinical relevance, as shown by an occasional change in drug effects or tolerability.
Interactions Between Grapefruit Juice and Cardiovascular Drugs
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  • Medicine
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TLDR
Grapefruit juice may enhance drug toxicity for antiarrhythmic agents such as amiodarone, quinidine, disopyramide, or propafenone, and for the congestive heart failure drug, carvediol.
Can grapefruit juice influence ethinylestradiol bioavailability?
TLDR
It is shown that grapefruit juice increases the bioavailable amount of EE2, and a possible explanation may be that grape fruit juice inhibits the metabolic degradation ofEE2.
The effects of grapefruit juice on the pharmacokinetics of erythromycin
TLDR
The results indicate that the bioavailability of erythromycin was increased by the inhibitory effect of grapefruit juice on cytochrome P450 (CYP3A4) 3A4-mediated metabolism in the small intestine.
Grapefruit Juice and Drugs
ConclusionsThe serendipitous finding that grapefruit juice interacts with felodipine was subsequently found to be valid for some other dihydropyridines, but this interaction is probably not limited
Grapefruit juice has no effect on quinine pharmacokinetics
TLDR
The lack of effect of grapefruit juice on quinine pharmacokinetics supports the view that the site of CYP inhibition by grapefruit Juice is mainly in the gut, and it is not necessary to advise patients against ingesting Grapefruit juice at the same time that they take quinines.
Influence of grapefruit juice on the pharmacokinetics of a slow release nifedipine formulation.
TLDR
The data contradict the assumption of a selective inhibition of only one cytochrome P450 subfamily and the observed effect could be clinically significant, especially if other factors affecting the elimination of 1 occur.
Grapefruit juice-drug interactions.
TLDR
In vitro findings support the flavonoid, naringin, or the furanocoumarin, 6',7'-dihydroxybergamottin, as being active ingredients, but a recent investigation indicated that neither of these substances made a major contribution to grapefruit juice-drug interactions in humans.
Grapefruit juice increases oral nimodipine bioavailability.
TLDR
There was evidence for a more pronounced hemodynamic response in the grapefruit juice period and the null hypothesis "relevant interaction" thus could not be rejected for the primary pharmacokinetic parameters AUC and Cmax.
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