After reading more info. on this drug, and understanding what it does. Whilst taking the tablet with grapefruit juice is such a dangerous combination, Does that include all citrus fruit juice's, Like fresh orange, tropical/exotic fruit juices, etc.. Would there be any danger with others fruit juices.
Tacrolimus and fruit juice interactions?
Question posted by transplant2org on 12 Jan 2010
Last updated on 5 May 2023 by sad_guppy
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4 Answers
sad_guppy
6 May 2023
It really only concerns the grapefruit juice and pomegranate juice, high antioxidant, -- and the main problem -- P450 3A4 enzyme inhibitors. As far as a couple answers above me, I'm not sure about lime juice as I've absolutely never heard that one. I drink limeade and lemonade frequently (for a careful post transplant patient) and there's never been any interaction in my tacro levels nor has their ever been any concern about it when brought up with my nutritionist. Just take a closer look at high antioxidant fruit juices as well as the main inhibiting fruit juices. It doesn't just seem to be blanket citrus or this or that. Something about the specifics in certain fruits. So the best bet is just to be vigilant about everything individually.
For me, grapefruit juice clearly caused and acute and immediate Access in plasma concentration of tacrolimus for me, I was supposed to be at 10 according to the dosage and it was up at about 29. Never had this issue with lime juice or the like (I'll use orange juice, lime juice, or my favorite pineapple juice to help me pull out of a low blood sugar crash).
mike2lt
10 April 2020
YES! Lime juice, starfruit, and pomegranate are a few others. If you look hard enough, you will find data on them in small studies from academic institutions. Like grapefruit, they inhibit the Cytochrome P450 system in the liver which metabolizes Tacrolimus and some other drugs, causing increased and possibly toxic levels of Tacrolimus in the body. In my opinion, these data have not been added to the official prescribing information for the drug because it is now generic, and, therefore, nobody is incentivised to do so.
endlessPred
17 Feb 2012
Am on tac for two years. No grapefruit juice. It causes a malabsorption and you are not getting the right dose when you drink it. As you know, the tac has to be constant to do its job.
Other juices are fine as long as they are not holding a mix of it. Reading the label is my best bet.
Good luck with it.
Marvell
27 Jan 2010
No, the problem/interaction only exists for grapefruit juice. All other fruit (orange, apple, grape, etc.) juices are fine to take with tacrolimus.
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