SciQuest.org

Certain medications should not be taken within hours of drinking grapefruit juice...and it appears even orange juice and apple juice may have interactions that affect the drug levels of certain medications.

The juices block absorption by latching onto an enzyme in the intestines called CYP3A4. It can cause abnormally high levels of the medication or block absorption of the medication in other instances. We have know this about grapefruit juice, but scientists now find orange juice and apple juice may have similar effects.

Here are a few of the drugs affected with grapefruit juice:

• statins -(Lipitor, lovastatin (Mevacor), simvastatin (Zorcor)
• calcium channel blockers- diltiazem (Cardiazem, others) felodipine (Plendil), nicardipine (Cardene) nifedipine (Procardia, Adalat) nisoldipine(Sular), verapamil (Covera, Verelan)
• other heart drugs- (amiodarone (Cordarone, Pacerone), cilostazol (Pletal, generics) losartin (Cozaar,Hyzaar)
• immunosuppressant drugs
• sedatives -diazepam (Valium), midazolam (Versed), triazolam (Halcion)
• other neurological medications- buspirone(BuSpar), carbamezepine(Tegretol), sertraline(Zoloft)
• impotence drugs- (Viagra, Cialis, Levitra)

So what's the advise for a person taking any of these drugs?

You are probably safe if you drink grapefruit juice or eat grapefruit in the morning and take your meds at night. Remember, don't take your meds with a "greyhound cocktail".
We are still learning about other juices. To be on the safe side, take your medications with water, not citrus juice.

Other drugs may also be affected. New research shows the allergy drug, fexofenadine (brand name Allegra) was only 1/2 absorbed into the bloodstream when taken with grapefruit juice compared with water.

Take home message: Water to wash down pills.