Talk:Grapefruit–drug interactions

Most items on the list have no citation

Shouldn't we remove items without citation? The list has become... Explosive. It mentioned modafnil but then the modafnil article mentioned completely different enzymes. 99.104.126.16 (talk) 19:50, 1 February 2012 (UTC)

merge with Grapefruit juice

Grapefruit juice article really is all about drugs and their interaction with grapefruit juice, not anything else about the juice. Gzuckier 21:05, 22 November 2006 (UTC)

I agree, move Grapefruit juice to List of drugs affected by grapefruit. JKW 23:08, 2 January 2007 (UTC)

I'm with Gzukier -- keep this separate. I needed to use this list and I was glad to find it as a discrete article. This is really a pharmacological article -- grapefruit is only chosen because it contains certain chemicals. Notice that orange juice is mentioned at the bottom. Apollo 17:05, 12 January 2007 (UTC)

It would be overwhelming to the juice article, as it involves many other non-grapefruit sources, and should merely be referenced there and any other article about a food source with bergamottin. 99.104.126.16 (talk) 19:50, 1 February 2012 (UTC)

Solution to Grapefruit/Grapefruit juice/List of drugs affected by grapefruit

It seems like we have three articles on the same fundamental point - grapefruit juice acts on certain CYP enzymes.

I propose that we eliminate "grapefruit juice" and "list of drugs affected by grapefruit" entirely (redirect to grapefruit), since they revolve entirely around the CYP inhibition effect. Instead of those pages, we can have a brief note in the main grapefruit article about the CYP interactions. That way a reader can follow the link to CYP3A4 or whatever if they want specific information about that.

This way, people who want to know about grapefruits can get relevant information in the article. The article is about grapefruits, not about enzyme/drug interactions - a mere note that it will occur, a brief warning for consumers, and a link to the appropriate articles should suffice. CYP3A4 adequately covers the information expressed in grapefruit juice/list of drugs affected, and does so under a more appropriate title.

Any thoughts, suggestions? My primary concern is that we have multiple articles with the same information, and that we could condense this information and put it into more appropriate articles. 129.170.202.243 07:04, 17 January 2007 (UTC)

I think "List of affected drugs" is a useful article (bias: I initially created this page). I agree that this page and grapefruit juice overlap a lot, however. I think the article about CYP3A4 should discuss the enzyme and its function, and leave its interactions to this page. I will admit that this page isn't very useful if so incomplete. njaard 03:44, 20 January 2007 (UTC)

Bupropion interacts with grapefruit juice???

According to Micromedex, Wellbutrin package insert, and Lexi-comp, bupropion is metabolized mainly by CYP2B6. Lexi-comp mentions that CYP3A4 only plays a minor role in bupropion metabolism. Grapefruit juice is an inhibitor of CYP3A4. Therefore I think bupropion does NOT interact with grapefruit juice.

Reference [1] concluded that multiple doses of bupropion does NOT induce CYP2B6, CYP3A4, and CYP2E1 in human. It doesn't support a major interaction with grapefruit juice.

My suggestion would be removing buproprion from the list. —Preceding unsigned comment added by Jellen (talk • contribs) 05:56, 18 October 2007 (UTC)

You can exclude nearly no medizine that is substrate of a CYP-450. Grapefruit is a inhibitor of CYP 1A2, 2D6, 2C19, 2C9, 3A4, 2C8 and maybe others!

http://www.pharmazeutische-zeitung.de/index.php?id=titel_13_2004 http://www.pharmazeutische-zeitung.de/fileadmin/pza/2004-13/0413TAbb4.JPG —Preceding unsigned comment added by 93.181.30.189 (talk) 13:55, 13 April 2011 (UTC)

I found no evidence for an Bupropion - grapefruit juice interaction. The article in pharmazeutische-zeitung.de is some kind of nice review, still it doesn't support this statement. --Mhvie (talk) 23:25, 21 January 2012 (UTC)

Missing alot

You are missing alot of substances here, specifically most of the opiates. Tramadol, Oxycodone, Hydrocodone, etc. Plus Codeine interacts with grapefruit juice, but in this case it is weakened by grapefruit juice's CYP3A4 inhibition. —Preceding unsigned comment added by 68.8.17.27 (talk • contribs)

Thank you for your suggestion. When you feel an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the edit this page link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes — they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to). WLU 17:18, 15 June 2007 (UTC)

The other thing I feel that's missing is a list of foods that exhibit the grapefruit effect. I know starfruit also does. I'd like to know if there were others. Potkettle 15:05, 20 July 2007 (UTC)

I'd first heard of this interaction in relation to Caffeine, but do not see it listed. I'm not a science writer, and would therefore prefer to refrain from editing this article, but I would appreciate it if someone better qualified could correct this minor oversight. --Mr kitehead (talk) 01:59, 27 January 2010 (UTC)

Codeine Metabolism

The citation on the line about codeine and tramadol is ONLY a citation for codeine being metabolized by CYP3A4 (which is consistent with the section title). The sentence, however, includes the much more complex and important point "It reduces the amount of codeine converted by CYP3A4 into norcodeine thus increasing the amount metabolised into morphine.", but there is no citation for that. In a quick search of PubMed, I found no support for this claim (zero results for a search on 'grapefruit codeine' as well as searching on 'bergamottin' and 'naringin' plus codeine). Though this statement could be true, I'm not able to confirm it or find primary support for it.

As a first, minor step, I moved the reference citation. I'm continuing to look into this, hopefully find something else to link to.

One thing that is inaccurate on this list is the claim that quetiapine and carbamazepine are only affected in a minor way by grapefruit juice. This is not true; the interactions are major, and the consequences for bipolar or epileptic patients taking these drugs can be devastating. Quetiapine is extensively metabolized by the CYP3A4 enzyme (Bakken et al, 2008). This is, of course the same enzyme process that is inhibited by grapefruit juice, but what a lot of people don't realize is that pomegranate juice has an even more dramatic effect on drugs metabolized this way (Hidaka et al, 2005). Take a look at that Hidaka article and see what a number pomegranate juice does on Tegretol (carbamazepine) absorption. In fact, evidence suggests that both pomegranate and starfruit have a much larger effect on this metabolization process than does grapefruit (Fujita et al, 2004). These facts need to be much better and more widely known than they are. This is particularly true because pomegranate juice is such a widespread product now. Let's get the word out about just how dangerous these drug interactions are.

Bakken, G., et al. (2008). Metabolism of quetiapine by CTP3A4 and CYP3A5 in presence or absence of cytochrome b5. Drug Metabolism and Disposition, Nov. 20 (Epub ahead of print).

Fujita, K., et al. (2004). Potent inhibition by star fruit of human cytochrome P450 3A activity. Drug Metabolism and Disposition, 32, 581-583.

Hidaka, M., et al. (2005). Effects of pomegranate juice on human cytochrome P450 3A and carbamazepine pharmacokinetics in rats. Drug Metabolism and Disposition, 33, 644-648. —Preceding unsigned comment added by 67.90.153.194 (talk) 18:50, 24 November 2008 (UTC)

Rename

This page is more than just a list, it should probably be moved to Grapefruit-medication interaction or something similar. WLU 17:49, 16 August 2007 (UTC)

Inappropriate link

the following should be a reference, it's almost useless as a link and totally inappropriate. WLU (talk) 22:18, 2 January 2008 (UTC)

• Arayne M, Sultana N, Bibi Z (2005). "Grape fruit juice-drug interactions". Pak J Pharm Sci. 18 (4): 45–57. PMID 16380358.{{cite journal}}: CS1 maint: multiple names: authors list (link)

I cannot follow you - it is a working link to a relevant publication on a high level --Mhvie (talk) 23:31, 21 January 2012 (UTC)

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This article is hard to read

I'm a reasonably smart guy, albeit with little background in anatomical science, but I'm having a lot of trouble understanding either the symptons or the significance of the grapefruit-juice effect. The article seems to be filled with scientific jargon, which, while it may be a good medical description of the phenomenon--and, if it is, certainly should remain in the article--tells me very little about why I should care about this. I take an anti-anxiety medication under a drug class that's mentioned on the list, without its very common brand name being listed (let's set aside how this requires information synthesis that I, but not all readers, happened to be aware of, when trying to read a reference guide on a potentially-dangerous pharmaceutical problem), but after reading this article, I have no idea what to make of this interaction. All I understand is that it may increase blood concentration, but is not, somehow, absorbed through the intestine. Anyone care to explain more plainly what this means in the article, and what its associated dangers are? I'd try to be more specific, or even edit myself, but as I'm complaining about my lack of understanding, that seems paradoxical. Thanks!65.117.234.99 (talk) 14:30, 11 November 2009 (UTC)

I agree with the above. Too dense. 71.127.3.139 (talk) 13:07, 3 March 2010 (UTC)

"List of products containing grapefruit"?

Guys

Should we have a companion page "List of products containing grapefruit"?

This would be useful to many readers of "List of drugs affected by grapefruit", specifically, those using the drugs.

Stevechelt (talk) 19:12, 27 May 2010 (UTC)

Recent edits

An anonymous user, operating from two different IP addresses, has recently repeatedly posted claims that the "grapefruit effect" is also caused by other citrus flavourings. This claim has been questioned. Wikipedia policy is that, if any statement in an article is challenged or questioned, the onus is on the person wishing to keep the information there to provide a reliable source to support it. It may be that what the anonymous editor says is true, but we cannot assume that it is true just because some anonymous person chooses to edit Wikipedia and say so, because unfortunately many people edit Wikipedia and make false claims. JamesBWatson (talk) 21:29, 2 February 2012 (UTC)

The BBC article I mention below also has the claim of other citrus fruits causing the same problems.MidlandLinda (talk) 21:38, 26 November 2012 (UTC)

Two new articles for inclusion.

The BBC has this news item http://www.bbc.co.uk/news/health-20497086 which is in layman's English and one of it's links is this http://www.nhs.uk/chq/Pages/2474.aspx?CategoryID=73&SubCategoryID=103 from NHS Direct and therefore official advice. They look as if they could be usefully included in this page, but I think it would need a rewrite to insert them neatly and I do not feel competent to do this. MidlandLinda (talk) 21:34, 26 November 2012 (UTC)

Also http://abcnews.go.com/blogs/health/2012/11/26/grapefruit-medicine-interaction-warning-expanded (list of drugs has been expanded).