The familiar citrus fruit is rich in vitamin C, vitamin A, potassium, fiber, and antioxidants. It is recommended not just as a food for optimum health, but also for weight loss. Not surprisingly, this has led to an increased popularity in grapefruit. But, the problem with grapefruit is that it is so rich in nutrients, and has so many active ingredients, it can interact with many prescription medicines. And, according to a new study, the results could be fatal. “We’re talking sudden death here,” said Dr. David Bailey, lead author of the study. “People think ‘Naw, that can’t happen,’ but it’s true.”
The study, performed at the Lawson Health Research Institute in Canada, and published in the Canadian Medical Association Journal, was restricted to subjects 45 and older because they were the most likely to have prescription medicines, and were also the most likely to eat grapefruit.
They found that grapefruit reacted to a number of prescription drugs with several different negative results, including sudden death. Those who died suffered a rare…
…form of arrhythmia called torsades de pointes (French for “twisting of the spikes”) that can lead to ventricular fibrillation and the heart stopping. Other side effects included acute kidney failure, respiratory failure, gastrointestinal bleeding, bone marrow suppression in people with damaged immune systems, and renal toxicity.
The culprit is a compound called “furanocoumarin,” which suppresses some of the limiting aspects of blood absorption. When present in the bloodstream, furanocoumarin can allow too much of a prescription drug to be absorbed, resulting in an unintentional overdose.
Twenty years ago, the same team of researchers was the first to study the interaction between grapefruit and prescription drugs. With this most recent study, they have now found 44 different prescription drugs that interact with grapefruit. The most dangerous of them include anti-cancer drugs (like crizotinib and pazopanib), antibiotics (like erythromycin and quinine), and drugs for cardiovascular disease (like apixaban and felodipine).
Bailey noted that other foods, like Seville (bitter) oranges, limes, and pomelos also contain furanocoumarin. Their interactions with prescription drugs have not been studied in the same detail and depth as grapefruit, but since they contain the same active ingredient, it can be surmised that they have similar, if not precisely the same, effects.
The only way to avoid these complications if you take prescription medicines is to avoid grapefruit and grapefruit juice. Unsweetened orange juice and pomegranate juice make decent substitutes for grapefruit juice, although both are much higher in calories and naturally occurring sugars. Tomato juice is also quite healthy, but comes with its own natural sugars, and many brands (especially canned juices) can be very high in added sodium, so check the label. It should be safe to drink these alternatives to grapefruit juice in moderation though.
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