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Ask
the Pharmacist By Ron and Marla Chapleau |
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Q: I know that grapefruit juice can interact with my Lipitor but I just heard that orange juice can affect some drugs too. Do I have to stop drinking OJ? A: It has long been known that grapefruit and its juice can significantly increase levels of certain medications such as felodipine (Plendil), nifedipine (Adalat), sildenafil (Viagara) and atorvastatin (Lipitor), to name just a few. These interactions occur because the part of our liver that is responsible for breaking down these drugs also must metabolize grapefruit. Our liver, much like ourselves, frequently can only perform one function at a time and the result is higher levels of the drugs in our body and a greater potential for side effects. We now know that there are also medicines that are known to interact with apple and orange juice and yes, grapefruit again. However, the interaction is completely different than the well-known interactions we were talking about earlier. This interaction is due to an OATP (organic anion transporting peptide) inhibition caused by the fruit juices, resulting in a decreased absorption of medication. Reduced absorption means that the affected drugs are likely to be less effective. Drinking these juices can reduce blood levels of aliskiren (Rasilez) by 60 per cent, atenolol (Tenormin) and fexofenidine (Allegra) by 40 per cent, ciprofloxacin by 20 per cent, and levothyroxine (Synthroid, Eltroxin) by 10 per cent.
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The effect of these fruit juices on the OATP does
not seem to last more than four hours so you can get around this
interaction by separating the juice from the medicine by at least four
hours. Unfortunately, the same cannot be said for the grapefruit
interaction involving the liver which can last for days, so avoiding
the grapefruit altogether is necessary for this interaction. For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination
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