More than 85 drugs have been identified that interact with grapefruit — either in whole, concentrate or fresh juice form — but not all of these have serious consequences. However, 26 new drugs that can cause serious harm when combined with grapefruit have been found in the last four years alone.
Dr. David Bailey, a clinical pharmacologist at the Lawson Health Institute Research Center in London, Ontario recently told NBC News that these discoveries bring the total to 43. These severe interactions can cause acute kidney failure, respiratory failure, gastric bleeding and even sudden death. He also said that 13 drugs might be lethal when mixed with grapefruit.
Bailey, a lead author on a recent study published in the Canadian Medical Association Journal, said, “It’s hard to avoid putting a drug out on the market that is not affected by grapefruit juice.”
Why grapefruit causes negative drug interactions
The reason that grapefruits along with some other citrus fruits including limes, pomelos and Seville oranges — the kind used in marmalades — is that they produce an organic chemical compound called furanocoumarins. These enzymes interfere with a human digestive enzyme called CYP3A4, which helps metabolize toxic substances and keeps them from entering the bloodstream.
This enzyme inactivates the effects of about 50 percent of all medications, so doctors adjust for this when prescribing them. The trouble comes when the furanocoumarins, found in grapefruits, inhibit the enzyme because the drugs can become concentrated in a patient’s bloodstream. The drugs can become so concentrated, in fact, it can be equivalent to getting a triple or double dose of medication.
Drugs known to interact with grapefruit do carry warnings, but Bailey said he believes that neither doctors nor patients may take the threat seriously enough.
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