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Grapefruit and Grapefruit Juice

Scientific Name(s): Citrus paradisi Macfad.
Common Name(s): Grapefruit

Medically reviewed by Drugs.com. Last updated on Jul 1, 2018.

Clinical Overview

Use

High-quality clinical trials are lacking to support therapeutic applications of grapefruit and grapefruit juice. Limited data suggest potential benefit for certain patient populations in reducing the risk of renal stones and type 2 diabetes, as well as some cardiovascular risk factors (including improvement in systolic blood pressure, high-density lipoprotein [HDL] cholesterol, and arterial stiffness). Some trials also demonstrate reductions in body fat and waist circumference but data regarding use for weight loss are equivocal. Antimicrobial effects have been reported. Consumption of whole grapefruit has been shown in several analyses to provide improved benefits compared to the juice.

Dosing

Quality clinical trials upon which to base therapeutic dosing recommendations for grapefruit are limited.

Cardiovascular risk factors: 1 grapefruit daily for 30 days has been used in a clinical trial to improve lipid profiles. Fresh grapefruit, grapefruit juice, and grapefruit capsules for 6 or 12 weeks, with naringin doses of the formulations ranging from 81 to 142 mg/day, have been used in randomized controlled trials evaluating effects on cardiovascular risk factors in obese adults. In a trial of healthy postmenopausal women, 340 mL/day (providing 201 mg/day of naringenin) of grapefruit juice was administered for 6 months to evaluate effects on arterial stiffness.

Diabetes risk: Pooled results from 3 prospective longitudinal cohort studies (N=187,382; 3,464,641 person-years of follow-up) reported consumption of 2 to 4 servings per week of grapefruit to reduce the risk of type 2 diabetes. In one cohort of women, 2 to 4 servings per week or 5 or more servings per week of grapefruit (1 serving of grapefruit was one-half of a grapefruit) also reduced risk.

Periodontitis: 2 grapefruits per day for 2 weeks were consumed in a trial evaluating effects on vitamin C status of patients with periodontitis.

Weight and related parameters: 8 oz (237 mL) of grapefruit juice, or half of a fresh grapefruit, 3 times a day before each meal for 12 weeks was used in a clinical trial evaluating effects on body weight and metabolic syndrome. In a meta-analysis evaluating effects on body weight, fresh grapefruit, grapefruit juice, or grapefruit capsules (with naringin dosages of the formulations ranging from 81 to 142 mg) were administered for 6 or 12 weeks in the included randomized controlled trials.

Contraindications

None well defined. In patients with major myocardial structural disorders, pink grapefruit should be avoided due to proarrhythmic effects. The potential for drug interactions with grapefruit should be considered in cases in which an increase or decrease of the coadministered drug is clinically important.

Pregnancy/Lactation

Grapefruit has "generally recognized as safe" (GRAS) status when used as food, according to the US Food and Drug Administration. Safety of amounts greater than those in foods are unproven. Consumption of grapefruit juice increases naringenin levels in breast milk.

Interactions

Grapefruit juice has been reported to interact with numerous drugs.

Adverse Reactions

Reports of adverse reactions associated with grapefruit consumption are limited and largely related to drug interactions. Case reports exist of allergy to pectin (a component of grapefruit) and pectin-induced asthma. Constipation and diarrhea have also been reported.

Toxicology

Toxicological studies on whole grapefruit are lacking. A meta-analysis of 3 landmark studies evaluating associations between grapefruit consumption and risk of breast cancer found no increased risk. The grapefruit constituent d-limonene has GRAS status. Grapefruit seed extract has been shown to be toxic to human skin fibroblast cells.

Scientific Family

  • Rutaceae

Botany

Grapefruit (C. paradisi) is a large, dimpled, round citrus fruit measuring 7.6 to 15.2 cm in diameter. It descends from a cross between a pomelo (pummelo) or shaddock (Citrus grandis), a large Malaysian citrus, and a sweet orange, and may have originated as a mutation of another type of citrus tree. The fruit grows in clusters similar to grapes, a possible origin of its name. Noteworthy cultivars of grapefruit include Duncan ("white," seeded), Marsh (seedless), Foster (pink, seeded), Thompson (pink, seedless), and redblush (red, seedless).Carper 1988, Davidson 1991, Ensminger 1993, USDA 2018

History

The Greek philosopher Theophrastus (371 to 287 BC), regarded as the founder of botany, wrote that "citron" could sweeten the breath and was thought to be an antidote to poison. Later, the Roman naturalist Pliny (AD 23 to 79) used the word "citrus" for the first time and labeled the fruit as a medicine. The grapefruit, known at the time as “small shaddock,” was first mentioned by Griffith Hughes (1707 to 1758) as the "forbidden fruit" of Barbados. The name "grapefruit," referring to the clusters of fruit on the trees, was said to have first been used in Jamaica in 1814. In 1823, the grapefruit was introduced in Florida by the French count Odette Phillippe, but it did not gain popularity until the end of the nineteenth century. In the 1930s, the Hollywood Diet, which recommended a limited calorie intake of approximately 800 calories per day and included grapefruit consumption at each meal, became popular. Worldwide production of grapefruit was projected in 2010 at approximately 5.5 million metric tons, and the juice of the fruit, including concentrate, accounts for approximately 42% of all US-processed grapefruit products.Carper 1988, Davidson 1991, Ensminger 1993, USDA 2018

More recently, seed extracts have been used by the cosmetic and food industries.Onakpoya 2017

Chemistry

The chemistry of grapefruit is well studied. Grapefruit is high in polyphenols, with its flavonoid naringin responsible for imparting the bitter taste. Other constituents include sugars, polysaccharides, organic acids, nitrogenous compounds, lipids, carotenoids such as beta-carotene and lycopene (that contribute to pink and red color), vitamins, minerals, flavonoids, and volatile components that contribute to aroma. Grapefruit is high in water and fiber, and contains a small amount of protein. The whole fruit is also a good source of potassium, vitamin C, inositol, bioflavonoids, and pectin; however, the juice alone is not high in pectin. Other vitamins and minerals present in grapefruit are vitamin A, thiamine, folate, vitamin B6, niacin, magnesium, calcium, and iron. The amount of vitamin A can be almost 1,000 times higher in the pink/red variations. In addition, grapefruit has minimal fat and is low in calories and sodium. The peel contains citral (an aldehyde that antagonizes the effects of vitamin A) and other terpenes (including limonene), which are of interest because of their chemoprotective and cholesterol-solvent properties.Carper 1988, Ensminger 1993, Giamperi 2004, Onakpoya 2017, Rampersaud 2017, Sun 2007

Constituents in grapefruit that affect cytochrome P450 (CYP-450) enzymes include the furanocoumarins bergamottin and 6′,7′-dihydroxybergamottin (DHB). DHB has been identified as a principal inhibitory furanocoumarin, with constituents of varying CYP3A inhibitory potencies; this effect is absent with consumption of low-furanocoumarin grapefruit juice.Kawaguchi-Suzuki 2017 Naringin and naringenin also exhibit inhibitory effects on the CYP-450 system but may inhibit CYP enzymes primarily in the intestine and less so in the liver. Concentrations of these inhibitory constituents have been shown to vary among commercially available juices; an approximately 200-fold difference in DHB has been observed among batches of grapefruit juice.Giamperi 2004, Hu 2016, van Erp 2011 Naringenin is a potent inhibitor of organic anion transporting polypeptide (OATP), and grapefruit also interferes with P-glycoprotein (P-gp) and adenosine triphosphate (ATP)–binding cassette drug transporters.Romaszko 2017, van Erp 2011

Uses and Pharmacology

Antimicrobial effects

In vitro data

In vitro screening of a grapefruit seed extract found bactericidal activity against gram-negative and gram-positive bacteria at dilutions up to 1:512.Heggers 2002

Clinical data

In a series of case reports, chewing and swallowing 5 to 6 grapefruit seeds every 8 hours was effective against Klebsiella, Staphylococcus aureus, and Escherichia coli urinary tract infections, but not against Pseudomonas aeruginosa–resistant strains.Oyelam 2005

Cancer

In vitro data

The grapefruit constituents pectin, lycopene, and d-limonene have been evaluated for potential chemotherapeutic roles via antioxidant and apoptosis-inducing activity. Clinical trials have produced mixed results.Giamperi 2004, Sun 2007, van Breemen 2008

Cardiovascular risk factors

Clinical data

Limited clinical trials have been conducted, possibly due to the potential for drug interactions. Two trials in post–coronary bypass patients with atherosclerosis demonstrated improved lipid profiles following whole grapefruit and grapefruit juice consumption.Gorinstein 2004, Gorinstein 2006 Antioxidant-carrying capacity also improved. Systolic and diastolic blood pressure were unchanged throughout the 30-day study.Reshef 2005 A systematic review of randomized controlled trials reporting the effects of grapefruit on body weight and cardiovascular risk factors identified 3 studies that met inclusion criteria (N=250). All participants were overweight or obese, with a mean body mass index (BMI) ranging from 31.4 to 36.8 kg/m2. Fresh grapefruit, grapefruit juice, or grapefruit capsules, with naringin doses of the grapefruit formulations ranging from 81 to 142 mg/day, was given for either 6 or 12 weeks. A reduction in systolic blood pressure (SBP), but not diastolic blood pressure, was reported compared to controls in a meta-analysis of all 3 trials (mean difference, −2.43 mm Hg; no P value reported) but significance was lost in the sensitivity analysis; no heterogeneity was evident in either analysis. Improvement in HDL cholesterol was reported by both the overall and sensitivity analyses as being important (mean difference, +3.21 and +4.6 mg/dL, respectively); heterogeneity was moderate to high. In contrast, no difference in fasting blood glucose, total cholesterol, or low-density lipoprotein (LDL) was found. Subgroup analysis reported fresh grapefruit provides a statistically significant improvement in SBP compared with grapefruit juice (mean difference, −2.48 mm Hg; no P value provided), with low heterogeneity. HDL cholesterol was also reported as statistically significantly improved (+3.56 mg/dL); however, this was incongruent with the P value provided (P=0.06). Constipation and diarrhea were reported as adverse events in 1 trial. Overall, the quality of evidence for the studies was rated as moderate, except for the LDL and HDL results, which were considered low quality.Onakpoya 2017

In a randomized, double-blind, controlled, crossover trial in healthy postmenopausal women (N=48), consumption of grapefruit juice for 6 months (340 mL/day; 201 mg/day of naringenin glycosides) significantly reduced central aortic stiffness compared with placebo (P=0.019).Habauzit 2015 Prolongation of the QTc interval has also been demonstrated in healthy volunteers, as well as in patients with cardiomyopathy, possibly due to the naringenin glycoside content.Piccirillo 2008, Zitron 2005

Cholelithiasis/Nephrolithiasis

Animal and in vitro data

Initial animal and in vitro studies showed the capacity of d-limonene to dissolve gallstones.Sun 2007

Clinical data

Limited human studies have confirmed this effect.Sun 2007 Decreased potential for renal stone formation has been suggested, but is debatable based on studies demonstrating that consumption of grapefruit juice increases the excretion of citrate, calcium, and magnesium similarly to acute loads of orange and apple juice.Goldfarb 2001, Honow 2003, Trinchieri 2002 No additional studies were subsequently identified for inclusion in a systematic review conducted by the CLU Working Group, which investigated dietary treatment of urinary risk factors for renal stone formation. Similar to other citrus fruits, grapefruit and its juice increase citrate excretion and have the potential to reduce the risk of stone formation in renal stone formers with hypocitraturia. However, the additional increase in oxalate excretion caused by grapefruit consumption is offset by the increase in citrate excretion.Prezioso 2015

Diabetes mellitus

Clinical data

Associations between fruit consumption and the risk of type 2 diabetes were assessed using data from 3 prospective longitudinal cohort studies (66,105 women in the Nurses' Health Study [1984-2008], 85,104 women in the Nurses' Health Study II [1991-2009], and 36,173 men from the Health Professionals Follow-up Study [1986-2008]). At baseline, patients did not have diabetes, cardiovascular disease, or cancer. A total of 12,198 participants developed type 2 diabetes during the 3,464,641 person-years of follow-up. The pooled hazard ratio (HR) for risk of type 2 diabetes was 0.95 (95% CI, 0.91 to 0.99) for grapefruit, with the lowest risk observed for blueberries (HR, 0.74; 95% CI, 0.66 to 0.83) and an inverse correlation observed for cantaloupe (HR, 1.1; 95% CI, 1.02 to 1.18). Associations with risk of type 2 diabetes differed significantly among individual fruits. In contrast, greater fruit juice consumption was associated with an increased risk, while substitution of whole fruits for fruit juice lowered this risk (except for strawberries and cantaloupe). Replacing 3 servings per week of grapefruit juice with whole grapefruit lowered the risk of diabetes by 12% (8% to 17%) after multifactorial adjustments, whereas the pooled analysis showed a 7% lower risk for whole fruits (1 serving of grapefruit was equal to one-half of a grapefruit); the highest reduction in diabetes risk occurred with blueberries (33%). No significant associations between risk of type 2 diabetes and total whole fruit consumption, glycemic index/glycemic load of fruits, or flavonoid subtypes were observed. The mechanism of action for grapefruit leads to improved glucose tolerance that appears to result from an increase in glucagonlike peptide 1 due to inhibition of dipeptidyl peptidase 4 by naringin, which is found in high amounts in grapefruit.Muraki 2013

Nutritional supplement

Grapefruit has value as a dietary supplement, similar to other citrus fruits. Grapefruit juice is an excellent source of vitamin C, with the pink variation consistently ranking among the most nutrient dense. It is also a good source of potassium and provides folate, thiamine, magnesium, vitamin B6, iron, niacin, and calcium; pink and red varieties are high in vitamin A, primarily due to beta-carotene. An 8 oz serving of the juice also contains approximately 1.3 g of protein. Grapefruit juice is also rich in polyphenols, especially naringin. Caloric content is provided mostly by sugars (sucrose, fructose, glucose), with 22 g of carbohydrates delivered in an 8 oz serving of 100% juice.Rampersaud 2017 Consumption of the whole fruit has been shown in multiple analyses to provide improved health benefits compared with consuming the juice.Muraki 2013, Onakpoya 2017

Periodontitis

Clinical data

Vitamin C status and bleeding scores were improved in a study of patients with periodontitis who consumed 2 grapefruits a day for 2 weeks.Staudte 2005

Weight loss

Clinical data

Weight loss has been observed in some, but not all, clinical studies; conflicting findings could be due to variability of dosage regimens.Fujioka 2006, Gorinstein 2006 A meta-analysis of randomized controlled trials reported the effects of grapefruit on body weight and cardiovascular risk factors in obese adults (mean BMI ranging from 31.4 to 36.8 kg/m2). A total of 3 studies were identified that met inclusion criteria (N=250) in the systematic review, all of which incorporated lifestyle modifications as part of a weight management regimen. Fresh grapefruit, grapefruit juice, or grapefruit capsules, with naringin doses of the grapefruit formulations ranging from 81 to 142 mg/day, was given for either 6 or 12 weeks. Sensitivity analyses revealed a nonsignificant reduction in body weight but found a statistically significant reduction in body fat (mean difference, −0.49%; P=0.002) and waist circumference (mean difference, −1.15 cm; P<0.0001) in favor of grapefruit over controls in overweight or obese participants. Quality of evidence for the studies was considered moderate.Onakpoya 2017 Another systematic review pointed to preliminary data from a National Health and Nutrition Examination Survey (NHANES) analysis report that demonstrated lower body weight, BMI, and waist circumference in women who consumed any amount of grapefruit (ie, fresh, juice, frozen) compared with nonconsumers.Rampersaud 2017

Dosing

Quality clinical trials upon which to base therapeutic dosing recommendations are limited.

Cardiovascular risk factors

1 grapefruit daily for 30 days has been used in a clinical trial to improve lipid profiles.Gorinstein 2006 Fresh grapefruit, grapefruit juice, and grapefruit capsules for 6 or 12 weeks, with naringin doses of the formulations ranging from 81 to 142 mg/day, have been used in randomized controlled trials evaluating effects on cardiovascular risk factors in obese adults.Onakpoya 2017 In a trial of healthy postmenopausal women, 340 mL/day (providing 201 mg/day of naringenin) of grapefruit juice was administered for 6 months to evaluate effects on arterial stiffness.Habauzit 2015

Diabetes risk

Pooled results from 3 prospective longitudinal cohort studies (N=187,382; 3,464,641 person-years of follow-up) reported consumption of 2 to 4 servings per week of grapefruit to reduce the risk of type 2 diabetes. In one cohort of women, 2 to 4 servings per week or 5 or more servings per week of grapefruit (1 serving of grapefruit was one-half of a grapefruit) also reduced risk.Muraki 2013

Periodontitis

2 grapefruits per day for 2 weeks were consumed in a trial evaluating effects on vitamin C status of patients with periodontitis.Staudte 2005

Weight and related parameters

8 oz (237 mL) of grapefruit juice, or half of a fresh grapefruit, 3 times a day before each meal for 12 weeks was used in a clinical trial evaluating effects on body weight and metabolic syndrome.Fujioka 2006 In a meta-analysis evaluating effects on body weight, fresh grapefruit, grapefruit juice, or grapefruit capsules (with naringin dosages of the formulations ranging from 81 to 142 mg) were administered for 6 or 12 weeks in the included randomized controlled trials.Onakpoya 2017

Pregnancy / Lactation

Grapefruit and grapefruit juice is considered GRAS for use as food. Safety of amounts greater than those in foods are unproven.Ernst 2002 Naringenin concentration has been shown to increase in human breast milk after consumption of a single 250 mL dose of grapefruit juice, with mean concentrations increasing by approximately 35% from baseline within the first 4 hours. Additionally, a low-naringenin diet that limited citrus and tomato products reduced naringenin levels in breast milk.Romaszko 2017

Interactions

Grapefruit seed extract is not the equivalent of grapefruit juice, and it is not known whether extracts of grapefruit seed also have potential to alter drug metabolism. Grapefruit may interact with medications via mechanisms including inhibition of CYP3A4, CYP1A2, CYP2A6, P-gp, ATP-binding cassette drug transporters, and uptake transporters such as OATPs.Seden 2010, van Erp 2011

CYP inhibition appears to occur predominantly via intestinal enzymes and less so via the hepatic system.Hu 2016, van Erp 2011 Studies have indicated an approximate 12-hour half-life of CYP enzyme inhibition, with a mean 62% inhibition still present 5 days after grapefruit consumption.Cohen 2012 The inhibitory effect of grapefruit juice on the CYP1A2 isozyme appears to be weak and uncertain as reflected by equivocal results in pharmacokinetic studies using the substrates caffeine and theophylline. Adding to the uncertainty is the wide variation in inhibitory flavonoids that occurs among grapefruit juice preparations.Hu 2016 Grapefruit juice with concentrations of bergamotten and DHB selected specifically to induce a clinically relevant effect on CYP3A4 with the substrate sunitinib were measured to be at least 23.5 and 2.7 mcmol/L, respectively.van Erp 2011

Abemaciclib: Grapefruit juice may increase the serum concentration of abemaciclib. Avoid combination.Verzenio 2018

Acalabrutinib: CYP3A4 inhibitors (moderate) may increase the serum concentration of acalabrutinib.Calquence 2017

Albendazole: Grapefruit juice may increase serum concentrations of the active metabolite(s) of albendazole. Monitor therapy.Nagy 2002

Aliskiren: Grapefruit juice may decrease the serum concentration of aliskiren. Consider therapy modification.Glaeser 2007, Satoh 2005, Tapaninen 2010, Tekturna August 2010, Vaidyanathan 2008

Amiodarone: Grapefruit juice may decrease serum concentrations of the active metabolite(s) of amiodarone. Grapefruit juice may increase the serum concentration of amiodarone. Avoid combination.Cordarone December 2008, Libersa 2000

Amlodipine: Grapefruit juice may increase the serum concentration of amlodipine. Monitor therapy.Josefsson 1996, Josefsson 2002, Ohnishi 2006, Uesawa 2008, Vincent 2000

Antifungal agents (azole derivatives, systemic): Grapefruit juice may increase the serum concentration of antifungal agents (azole derivatives, systemic). This specifically applies to oral antifungal administration, and the interaction may be different depending on the specific dosage form being used. Monitor therapy.Gubbins 2004, Gubbins 2008, Kawakami 1998, Penzak 1999

Apixaban: CYP3A4 inhibitors (moderate) may increase the serum concentration of apixaban. Monitor therapy.Chang 2017, Eliquis July 2016, Eliquis June 2016

Aprepitant: CYP3A4 inhibitors (moderate) may increase the serum concentration of aprepitant. Avoid combination.Emend 2015

Aripiprazole: CYP3A4 inhibitors (moderate) may increase the serum concentration of aripiprazole. Monitor therapy. Aripiprazole dose reductions may be recommended with concomitant use of a CYP2D6 inhibitor. Aripiprazole dose reductions may be recommended in CYP2D6 "poor metabolizers." See full product monograph for genotype-based dosing information. Aripiprazole dose reduction is not recommended when used as adjunctive therapy for major depressive disorder.Abilify February 2011, Abilify Maintana February 2013, Aung 2010, Azuma 2012, Kubo 2005

Artemether: Grapefruit juice may increase the serum concentration of artemether. Monitor therapy.Coartem April 2009, El-Lakkany 2004, van Agtmael 1999a, van Agtmael 1999b

Asunaprevir: CYP3A4 inhibitors (moderate) may increase the serum concentration of asunaprevir. Avoid combination.Sunvepra 2016

Avanafil: CYP3A4 inhibitors (moderate) may increase the serum concentration of avanafil. Consider therapy modification.Stendra August 2018

Axitinib: Grapefruit juice may increase the serum concentration of axitinib. Avoid combination.Inlyta January 2012, Pithavala 2012

Benidipine: Grapefruit juice may increase the serum concentration of benidipine. Monitor therapy.Codipin 2017, Ohnishi 2006, Uesawa 2008

Benzhydrocodone: CYP3A4 inhibitors (moderate) may increase the serum concentration of benzhydrocodone. Specifically, the concentration of hydrocodone may be increased. Monitor therapy.Apadaz February 2018, Viekira Pak June 2016

Bilastine: Grapefruit juice may decrease the serum concentration of bilastine. Monitor therapy.Ilaxten January 2012

Blonanserin: CYP3A4 inhibitors (moderate) may increase the serum concentration of blonanserin. Monitor therapy.Lonasen 2014, Shang 2017

Bosutinib: CYP3A4 inhibitors (moderate) may increase the serum concentration of bosutinib. Avoid combination.Abbas 2011, Bosulif September 2015, Hsyu 2016

Brexpiprazole: CYP3A4 inhibitors (moderate) may increase the serum concentration of brexpiprazole. Monitor therapy. Brexpiprazole dose reductions are recommended with concomitant use of both a CYP3A4 inhibitor and a moderate or strong CYP2D6 inhibitor. If brexpiprazole is used with a moderate CYP3A4 inhibitor in a patient who is a CYP2D6 poor metabolizer (ie, deficient CYP2D6 activity), the brexpiprazole dose should be reduced to 25% of the usual dose.Rexulti July 2015

Brigatinib: Grapefruit juice may increase the serum concentration of brigatinib. Avoid combination.Alunbrig April 2017

Bromocriptine: CYP3A4 inhibitors (moderate) may increase the serum concentration of bromocriptine. Consider therapy modification.Cycloset October 2015, Lu 2006, Nelson 1990, Parlodel January 2012

Budesonide (systemic): Grapefruit juice may increase the serum concentration of budesonide (systemic). Avoid combination.Entocort June 2011, Seidegard 2009, Uceris January 2013

Budesonide (topical): Grapefruit juice may increase the serum concentration of budesonide (topical). Avoid combination.Uceris October 2014

Buspirone: Grapefruit juice may increase the serum concentration of buspirone. Consider therapy modification.Buspar November 2010, Hanley 2013, Lilja 1998

Cabozantinib: Grapefruit juice may increase the serum concentration of cabozantinib. Avoid combination.Cabometyx April 2016, Cometriq November 2012

Cannabidiol: CYP3A4 inhibitors (moderate) may increase the serum concentration of cannabidiol. Monitor therapy.Epidiolex June 2018, Stott 2013, Watanabe 2007

Cannabis: CYP3A4 inhibitors (moderate) may increase the serum concentration of cannabis. More specifically, tetrahydrocannabinol and cannabidiol serum concentrations may be increased. Monitor therapy. This interaction is mainly expected when physiologically significant amounts of tetrahydrocannabinol (THC, the major known psychoactive component of cannabis) are introduced systemically. While this encompasses the vast majority of medical and recreational cannabis use, some cannabis strains, products, and routes of administration specifically (and often intentionally) minimize systemic THC exposure. While cannabidiol concentrations are also likely increased by CYP3A4 inhibition, the clinical significance of this increase is less clear.Sativex 2014, Watanabe 2007

Carbamazepine: Grapefruit juice may decrease the metabolism of carbamazepine. Monitor therapy.Bonin 2001, Garg 1998, Ho 2001

Celiprolol: Grapefruit juice may decrease the serum concentration of celiprolol. Avoid combination.Ieiri 2012, Lilja 2003, Lilja 2004, Selectol July 2017, Tanaka 2013

Ceritinib: Grapefruit juice may increase the serum concentration of ceritinib. Avoid combination.Zykadia 2014

Cilostazol: CYP3A4 inhibitors (moderate) may increase the serum concentration of cilostazol. Consider therapy modification.Pletal July 2015, Suri 1999, Taniguchi 2007

Cisapride: Grapefruit juice may increase the serum concentration of cisapride. Consider therapy modification.Desta 2001, Gross 1999, Kivisto 1999, Offman 2001

Clomipramine: Grapefruit juice may increase the serum concentration of clomipramine. Monitor therapy.Oesterheld 1997

Clopidogrel: Grapefruit juice may decrease serum concentrations of the active metabolite(s) of clopidogrel. Consider therapy modification.Brandt 2007, Collet 2009, Farid 2007, Holmberg 2014, Hulot 2006, Kazui 2010, Mega 2009, Simon 2009, Tassaneeyakul 2000

Cobimetinib: CYP3A4 inhibitors (moderate) may increase the serum concentration of cobimetinib. Avoid combination.Cotellic Novembe 2015

Codeine: CYP3A4 inhibitors (moderate) may decrease serum concentrations of the active metabolite(s) of codeine. Monitor therapy.Acetaminophen and Codeine 2017, Eissing 2012, Gasche 2004

Colchicine: Grapefruit juice may increase the serum concentration of colchicine. Avoid combination.Colcrys July 2009, Goldbart 2000, Wason 2012

Crizotinib: Grapefruit juice may increase the serum concentration of crizotinib. Avoid combination.Xalkori August 2011

Cyclosporine (systemic): Grapefruit juice may decrease the metabolism of cyclosporine (systemic). Consider therapy modification. This interaction is primarily limited to orally administered cyclosporine.Bistrup 2001, Brunner 1998, Brunner 2000, Ducharme 1993, Ducharme 1995, Edwards 1993, Edwards 1998, Hermann 2002, Hollander 1995, Ioannides-Demos 1997, Ku 1998, Lee 2001, Mehrsai 2003, Min 1996, Proppe 1996, Yee 1994, Yee 1995, Yee 1997

CYP3A4 substrates (high risk with inhibitors): CYP3A4 inhibitors (moderate) may decrease the metabolism of CYP3A4 substrates (high risk with inhibitors). Monitor therapy.Bjornsson 2003, Kawaguchi-Suzuki 2017

Dapoxetine: CYP3A4 inhibitors (moderate) may increase the serum concentration of dapoxetine. Consider therapy modification.Abdlekawy 2017, Priligy December 2013, Priligy September 2013

Dasatinib: Grapefruit juice may increase the serum concentration of dasatinib. Avoid combination.Johnson 2010, Sprycel November 2017

Deflazacort: Grapefruit juice may increase the serum concentration of deflazacort. Avoid combination.Emflaza February 2017

Diltiazem: Grapefruit juice may increase the serum concentration of diltiazem. Monitor therapy.Christensen 2002, Ohnishi 2006, Sigusch 1994

Docetaxel (oral): Grapefruit juice may reduce the clearance and increase the serum concentration of docetaxel (oral). Monitor closely.Valenzuela 2011

Dofetilide: CYP3A4 inhibitors (moderate) may increase the serum concentration of dofetilide. Monitor therapy.Johnson 2001, Tikosyn February 2011, Walker 1996

Domperidone: CYP3A4 inhibitors (moderate) may increase the serum concentration of domperidone. Avoid combination.Apo-Domperidone 2015, Simard 2004, Ward 2004, Yoshizato 2012

Dronabinol: CYP3A4 inhibitors (moderate) may increase the serum concentration of dronabinol. Monitor therapy.Sativex February 2014, Watanabe 2007

Dronedarone: Grapefruit juice may increase the serum concentration of dronedarone. Avoid combination.Multaq June 2009

Efonidipine: Grapefruit Juice may increase the serum concentration of efonidipine. Monitor therapy.Uesawa 2008

Eletriptan: CYP3A4 inhibitors (moderate) may increase the serum concentration of eletriptan. Consider therapy modification.Relpax November 2013

Eliglustat: Grapefruit juice may increase the serum concentration of eliglustat. Avoid combination.Cerdelga August 2014, Terbinafine April 2012

Encorafenib: CYP3A4 inhibitors (moderate) may increase the serum concentration of encorafenib. Consider therapy modification.Braftovi June 2018

Eplerenone: CYP3A4 inhibitors (moderate) may increase the serum concentration of eplerenone. Consider therapy modification. Dosing recommendations may vary depending on indication and international labeling.Inspra May 2016, Inspra June 2014

Erlotinib: Grapefruit juice may increase the serum concentration of erlotinib. Consider therapy modification.Pillai 2013, Rakhit 2008, Tarceva April 2014

Estrogen derivatives: CYP3A4 inhibitors (moderate) may increase the serum concentration of estrogen derivatives. Monitor therapy.Blode 2012, Estrace March 2005, Hilbert 2001, Natazia August 2015, Ortho Tri-Cyclen August 2017, Premarin December 2014, Schubert 1994, Sinofsky 1998, Weber 1996, Yaz August 2017, Zhang 2007

Everolimus: Grapefruit juice may increase the serum concentration of everolimus. Avoid combination.Afinitor October 2010, Zortress March 2010

Felodipine: Grapefruit juice may increase the serum concentration of felodipine. Consider therapy modification.Bailey 1991, Bailey 1993, Bailey 1995, Bailey 1996, Bailey 2000, Bailey 2003, Dresser 2000, Edgar 1992, Goosen 2004, Kakar 2004, Lown 1997, Lundahl 1995, Lundahl 1997, Malhotra 2001, Ohnishi 2006, Paine 2006, Plendil June 2008, Uesawa 2008

Fentanyl: Grapefruit juice may increase the serum concentration of fentanyl. No action required. In a pharmacokinetic study of 12 healthy volunteers, coadministration of grapefruit juice (250 mL of regular strength the evening before, followed by 100 mL of double strength the following morning) and oral transmucosal fentanyl lozenge (10 mcg/kg given 1 hour after grapefruit juice) had no effect on the maximum serum concentration, AUC, or clearance of fentanyl. Kharasch 2004 Grapefruit juice is typically considered a moderate CYP3A4 inhibitor, but because it only inhibits intestinal CYP3A4 and has little effect on hepatic CYP3A4, it is unlikely to affect concentrations of fentanyl, a drug that is administered via non-oral routes (ie, intravenous, transmucosal, transdermal, intranasal, sublingual).Greenblatt 2003, Kupferschmidt 1995, Lown 1997, Lundahl 1997

Fexofenadine: Grapefruit juice may decrease the serum concentration of fexofenadine. Monitor therapy.Allegra July 2007, Bailey 2007, Cvetkovic 1999, Dresser 2002, Glaeser 2007

Flibanserin: CYP3A4 inhibitors (moderate) may increase the serum concentration of flibanserin. Avoid combination.Addyi 2015

Fluvoxamine: Grapefruit juice may increase the serum concentration of fluvoxamine. Monitor therapy.Hori 2003

Guanfacine: CYP3A4 inhibitors (moderate) may increase the serum concentration of guanfacine. Consider therapy modification.Intuniv July 2016

Halofantrine: CYP3A4 inhibitors (moderate) may increase the serum concentration of halofantrine. Consider therapy modification.Baune 1999, Charbit 2002, Halfan October 2001

HMG-CoA reductase inhibitors: Grapefruit juice may increase the serum concentration of HMG-CoA reductase inhibitors. Consider therapy modification.Ando 2005, Butterweek 2009, Edwards 1996, Fukazawa 2004, Holtzman 2006, Kantola 1998, Lilja 1998, Lilja1998, Lilja 1999, Lilja 2000, Lilja 2004, Lipitor June 2009, Lown 1997, Mevacor February 2014, Paine 2005, Schmiedlin-Ren 1997, Zocor February 2015

Hydrocodone: CYP3A4 inhibitors (moderate) may increase the serum concentration of hydrocodone. Monitor therapy. The significance of this interaction may be greater in patients who are also receiving a CYP2D6 inhibitor or with use of a CYP3A4 inhibitor that also inhibits CYP2D6, as CYP2D6 is partially responsible for hydrocodone metabolism.Zohydro August 2014

Ifosfamide: CYP3A4 inhibitors (moderate) may decrease serum concentrations of the active metabolite(s) of ifosfamide. Monitor therapy.Ifex March 2012, Kerbusch 2001, McCune 2005

Ibrutinib: Grapefruit juice may increase the serum concentrations of ibrutinib. Avoid combination.de Jong 2015, Imbruvica August 2017

Itraconazole: Grapefruit juice may decrease the serum concentration of itraconazole. Grapefruit juice may increase the serum concentration of itraconazole. Monitor therapy.Gubbins 2004, Gubbins 2008, Kawakami 1998, Penzak 1999

Ivabradine: Grapefruit juice may increase the serum concentration of ivabradine. Avoid combination.Procoralan January 2015

Ivacaftor: Grapefruit juice may increase the serum concentration of ivacaftor. Avoid combination.Kalydeco January 2012

Ivosidenib: CYP3A4 inhibitors (moderate) may increase the serum concentration of ivosidenib. Consider therapy modification.Tibsovo 2018

Lacidipine: Grapefruit juice may increase the serum concentration of lacidipine. Avoid combination.Motens 2013, Vaxar August 2014

Lapatinib: Grapefruit juice may increase the serum concentration of lapatinib. Avoid combination.Smith 2009, Tykerb August 2011

Lercanidipine: Grapefruit juice may increase the serum concentration of lercanidipine. Avoid combination.Lercanidipine November 2013

Lomitapide: CYP3A4 inhibitors (moderate) may increase the serum concentration of lomitapide. Avoid combination.Juxtapid December 2012

Lurasidone: Grapefruit juice may increase the serum concentration of lurasidone. Avoid combination.Latuda July 2013

Manidipine: CYP3A4 inhibitors (moderate) may increase the serum concentration of manidipine. Monitor therapy.Uno 2006

Methadone (oral): Grapefruit juice may decrease the CYP3A4-induced metabolite of methadone (2-ethylidine-1,5-dimethyl-3,3-diphenylpyrrolidine [EDDP]), with minimal effects on serum concentrations and clearance. Consider this when monitoring EDDP for compliance.Feng 2017

Midostaurin: Grapefruit juice may increase the serum concentration of midostaurin. Consider therapy modification.Dutreix 2013, Rydapt April 2017

Mifepristone: Grapefruit juice may increase the serum concentration of mifepristone. Monitor therapy.Korlym October 2016, Mifeprex March 2016

Mirodenafil: Grapefruit juice may increase the serum concentration of mirodenafil. Avoid combination.Mvix April 2016, Shin 2009

Montelukast: Grapefruit juice may increase the serum concentration of montelukast. Avoid combination.Cingi 2013

Naldemedine: CYP3A4 inhibitors (moderate) may increase the serum concentration of naldemedine. Monitor therapy.Symproic March 2017

Nalfurafine: CYP3A4 inhibitors (moderate) may increase the serum concentration of nalfurafine. Monitor therapy.Ando 2012, Ramitch May 2017

Naloxegol: Grapefruit juice may increase the serum concentration of naloxegol. Avoid combination.Movantik September 2014

Neratinib: CYP3A4 inhibitors (moderate) may increase the serum concentration of neratinib. Avoid combination.Abbas 2011, Nerlynx July 2017

Nicardipine: Grapefruit juice may increase the serum concentration of nicardipine. Monitor therapy.Ohnishi 2006, Uesawa 2008, Uno 2000

Nifedipine: Grapefruit juice may increase the serum concentration of nifedipine. Avoid combination.Adigun 2002, Bailey 1991, Grundy 1998, Miniscalco 1992, Odou 2005, Ohnishi 2006, Pisarik 1996, Procardia March 2006, Rashid 1993, Rashid 1995, Sigusch 1994, Uesawa 2008

Nimodipine: Grapefruit juice may increase the serum concentration of nimodipine. Avoid combination.Fuhr 1998, Nymalize May 2013

Nisoldipine: Grapefruit juice may increase the serum concentration of nisoldipine. Avoid combination.Bailey 1993, Ohnishi 2006, Sular January 2008, Takanaga 2000, Uesawa 2008

Nitrendipine: Grapefruit juice may increase the serum concentration of nitrendipine. Monitor therapy.Ohnishi 2006, Soons 1991, Uesawa 2008

Olaparib: Grapefruit juice may increase the serum concentration of olaparib. Avoid combination.Dirix 2016, Lynparza January 2018

Oxycodone: CYP3A4 inhibitors (moderate) may enhance the adverse/toxic effect of oxycodone. CYP3A4 inhibitors (moderate) may increase the serum concentration of oxycodone. Serum concentrations of the active metabolite oxymorphone may also be increased.Fujiwara 2014, Lalovic 2004, Mignat 2995, Nieminen 2010, OxyContin August 2015, Soderberg 2013, Walsh 2013

Palbociclib: Grapefruit juice may increase the serum concentration of palbociclib. Avoid combination.Ibrance 2015

Panobinostat: Grapefruit juice may increase the serum concentration of panobinostat. Avoid combination.Farydak February 2015

Pazopanib: Grapefruit juice may increase the serum concentration of pazopanib. Avoid combination.Votrient October 2009

Pimozide: Grapefruit juice may increase the serum concentration of pimozide. Avoid combination.Desta 1998, Desta 1999, Flockhart 1996, Orap August 2011

Pirfenidone: CYP1A2 inhibitors may increase the serum concentration of pirfenidone. Avoid combination.Esbriet October 2017 Grapefruit juice may decrease serum concentrations of pirfenidone during a fasted state, as demonstrated in persons of Han Chinese descent.Hu 2016

Pomalidomide: P-gp/ABCB1 inhibitors may increase the serum concentration of pomalidomide. Avoid combination.Pomalyst February 2013

Ponatinib: Grapefruit juice may increase the serum concentration of ponatinib. Consider therapy modification.Iclusig December 2012

Prasugrel: Grapefruit juice may decrease the serum concentration of the active metabolite of prasugrel. Platelet inhibition may be affected. Monitor closely.Holmberg 2015

Praziquantel: Grapefruit juice may increase the serum concentration of praziquantel. Monitor therapy.Biltricide February 2014, Castro 2002

Propafenone: CYP3A4 inhibitors (moderate) may increase the serum concentration of propafenone. Monitor therapy. Concurrent use of a CYP2D6 inhibitor should be avoided in patients receiving proprafenone and a CYP3A4 inhibitor. Patients with genetically deficient CYP2D6 activity should avoid this combination.Rythmol SR November 2011

Prucalopride: P-gp/ABCB1 inhibitors may increase the serum concentration of prucalopride. Monitor therapy.Resotran December 2011

Quinidine: Grapefruit juice may increase the serum concentration of quinidine. Avoid combination.Damkier 1999, Min 1996, Quinidine February 2010

Radotinib: Grapefruit juice may increase the serum concentration of radotinib. Avoid combination.Supect September 2014

Ranolazine: CYP3A4 inhibitors (moderate) may increase the serum concentration of ranolazine. Consider therapy modification.Bjornsson 2003, Jerling 2005, Ranexa November 2008

Regorafenib: Grapefruit juice may increase the serum concentration of regorafenib. Avoid combination.Stivarga September 2012

Ribociclib: Grapefruit juice may increase the serum concentration of ribociclib. Avoid combination.Kisqali March 2017

Rivaroxaban: P-gp/ABCB1 inhibitors may increase the serum concentration of rivaroxaban. Monitor therapy.Kubitza 2008, Xarelto September 2008

Rupatadine: Grapefruit juice may increase the serum concentration of rupatadine. Avoid combination.Rupafin June 2014, Rupafin October 2015, Rupatadine August 2016

Ruxolitinib: Grapefruit juice may increase the serum concentration of ruxolitinib. Consider therapy modification. Grapefruit juice should be avoided in patients receiving ruxolitinib doses of 5 mg daily. Initiation of ruxolitinib for treatment of myelofibrosis should be avoided in patients with platelet counts less than 50*109/L consuming grapefruit juice.Jakafi November 2011, Shi 2012

Salmeterol: CYP3A4 inhibitors (moderate) may increase the serum concentration of salmeterol. Monitor therapy.Manchee 1996, Serevent March 2008

Saxagliptin: CYP3A4 inhibitors (moderate) may increase the serum concentration of saxagliptin. Monitor therapy.Onglyza July 2009, Patel 2011

Sertraline: Grapefruit juice may increase the serum concentration of sertraline. Monitor therapy.Lee 1999, Ueda 2009

Sildenafil: Grapefruit juice may increase the serum concentration of sildenafil. Monitor therapy. This interaction only applies to orally administered sildenafil.Jetter 2002, Lee 2001, Sheu 2003

Silodosin: P-gp/ABCB1 inhibitors may increase the serum concentration of silodosin. Avoid combination.Rapaflo September 2008

Simeprevir: CYP3A4 inhibitors (moderate) may increase the serum concentration of simeprevir. Avoid combination.Olysio November 2013

Simvastatin: Grapefruit juice may increase the serum concentration of simvastatin. Avoid combination.Butterweck 2009, Edwards 1996, Holtzman 2006, Lilja 1998, Lilja 2000, Lilja 2004, Lown 1997, Paine 2005, Schmiedlin-Ren 1997, Zocor February 2015

Sirolimus: Grapefruit juice may increase the serum concentration of sirolimus. Avoid combination.Cohen 2012, Rapamune April 2017

Sonidegib: CYP3A4 inhibitors (moderate) may increase the serum concentration of sonidegib. Consider therapy modification.Odomzo July 2015

Sunitinib: Grapefruit juice may increase the serum concentration of sunitinib. Consider therapy modification.Sutent November 2015, van Erp 2011

Suvorexant: CYP3A4 inhibitors (moderate) may increase the serum concentration of suvorexant. Consider therapy modification.Belsomra August 2014

Tacrolimus (systemic): Grapefruit juice may decrease the metabolism of tacrolimus (systemic). Avoid combination.Fukatsu 2006, Liu 2009, Peynaud 2007, Prograf February 2012, Tsuji 2016

Tacrolimus (topical): Grapefruit juice may decrease the metabolism of tacrolimus (topical). Monitor therapy.Alaiti 1998, Allen 2001, Allen 2002, Beyerler 2006, Conrotto 2006, Draelos 2005, Ghislain 2004, Harper 2005, Kameda 2003, Kawashima 1996, Krueger 2007, Pitarch 2006, Prograf February 1998, Protopic January 2009, Prot-Labarthe 2007, Rubins 2005, Russel 2001, Teshima 2003, Undre 2009

Tamsulosin: CYP3A4 inhibitors (moderate) may increase the serum concentration of tamsulosin. Monitor therapy.Flomax October 2014, Jalyn November 2017, Troost 2011

Temsirolimus: Grapefruit juice may increase the serum concentration of temsirolimus. Avoid combination.Torisel July 2016

Tetrahydrocannabinol: CYP3A4 inhibitors (moderate) may increase the serum concentration of tetrahydrocannabinol. Monitor therapy.Stott 2013, Watanabe 2007

Tezacaftor: CYP3A4 inhibitors (moderate) may increase the serum concentration of tezacaftor. Consider therapy modification.Symdeko February 2018

Ticagrelor: Grapefruit juice may increase the serum concentration of ticagrelor. Monitor therapy.Holmberg 2013

Tolvaptan: CYP3A4 inhibitors (moderate) may increase the serum concentration of tolvaptan. Avoid combination.Jynarque April 2018, Samsca May 2009

Topotecan: P-gp/ABCB1 inhibitors may increase the serum concentration of topotecan. Avoid combination.Chen 1991, Hendricks 1992, Hycamtin October 2007, Jonker 2000, Kruijtzer 2002, Leggas 2004, Maliepaard 1999, Maliepaard 2001

Toremifene: Grapefruit juice may increase the serum concentration of toremifene. Avoid combination.Fareston March 2011

Udenafil: CYP3A4 inhibitors (moderate) may increase the serum concentration of udenafil. Monitor therapy.Shin 2010, Udenafil September 2014

Ulipristal: CYP3A4 inhibitors (moderate) may increase the serum concentration of ulipristal. Avoid combination. Significance of this interaction is greater when ulipristal is used for treatment of uterine fibroid signs/symptoms (Canadian indication).ella August 2010, Fibristal June 2013, Pohl 2013

Venetoclax: Grapefruit juice may increase the serum concentration of venetoclax. Avoid combination.Venclexta April 2016

Verapamil: Grapefruit juice may increase the serum concentration of verapamil. Monitor therapy.Fuhr 2002, Ho 2000, Zaidenstein 1998

Vilazodone: CYP3A4 inhibitors (moderate) may increase the serum concentration of vilazodone. Monitor therapy.Boinpally 2014, Viibryd January 2011

Vincristine (liposomal): P-gp/ABCB1 inhibitors may increase the serum concentration of vincristine (liposomal). Avoid combination.Marqibo August 2012

Zopiclone: CYP3A4 inhibitors (moderate) may increase the serum concentration of zopiclone. Consider therapy modification.Alderman 2001, Aranko 1994, Becquemont 1999, Imovane October 2014, Jalava 1996

Zuclopenthixol: CYP3A4 inhibitors (moderate) may increase the serum concentration of zuclopenthixol. Monitor therapy. Interaction most likely applies to poor CYP2D6 metabolizers or with use of strong CYP2D6 inhibitors.Clopixol January 2011, Davies 2010

Medications for heart failure

Grapefruit juice interacts with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, amiodarone, and warfarin; avoid use in patients with heart failure.Page 2016

Other interaction data

Some studies have reported clinically unimportant pharmacokinetic drug interactions with natural products. Limited information as well as potentially high interpatient variability in clinical response warrants cautious interpretation and/or application of these data in practice.

Fentanyl (transmucosal): Grapefruit juice minimally affected maximum plasma concentration, time to maximum plasma concentration, area under the curve (AUC), and maximal pupil diameter change after administration of oral transmucosal fentanyl. The onset or magnitude of analgesia was deemed unlikely to be affected by CYP3A-related drug interactions when treating breakthrough pain, particularly if careful attention is paid to minimal swallowing and maximal mucosal absorption.Feng 2017

Midazolam: Compared with regular grapefruit juice, low-furanocoumarin grapefruit juice was demonstrated to have no clinically relevant interaction on midazolam metabolism.Kawaguchi-Suzuki 2017

Nadolol: Grapefruit juice had no effect on the elimination half-life of nadolol and a nonstatistically significant decrease on AUC in healthy volunteers.Misaka 2013

Adverse Reactions

Reports of adverse reactions related to grapefruit consumption are limited. Grapefruit juice has been associated with hypotensionOnakpoya 2017, Reshef 2005 and deep vein thrombosis (presumed to be due to an interaction with ethinyl estradiol).Grande 2009 Prolongation of the QTc interval has been demonstrated in healthy volunteers and patients with cardiomyopathy.Piccirillo 2008, Zitron 2005 Case reports of allergy to pectin and pectin-induced asthma exist.Ferdman 2006 Constipation and diarrhea have also been reported in one trial.Onakpoya 2017

Data collected between 2004 and 2013 from 8 US centers in the Drug-Induced Liver Injury Network revealed 15.5% (n=130) of hepatotoxicity cases were caused by herbals and dietary supplements, whereas 85% (n=709) were related to medications. Of the 130 cases of liver injury related to supplements, 65% were from nonbodybuilding supplements and occurred most often in Hispanic/Latino populations compared with non-Hispanic whites and non-Hispanic blacks. Liver transplant was also more frequent in cases of toxicity from nonbodybuilding supplements (13%) than with conventional medications (3%) (P<0.001). Overall, the number of severe liver injury cases was significantly higher with supplements than conventional medications (P=0.02). Of the 217 supplement products implicated in liver injury, grapefruit was among the 22% (n=116) labeled as single-ingredient products.Navarro 2014

Toxicology

Toxicological studies on whole grapefruit are lacking. A meta-analysis of 3 landmark studies evaluating associations between grapefruit consumption and risk of breast cancer (European Prospective Investigation into Cancer and Nutrition [EPIC], the Nurses' Health Study, and the Multiethnic Cohort Study of Diet and Cancer) found no increased risk of breast cancer (HR, 1.06 [95% CI, 0.95 to 1.19]); however, the possibility of an association could not be ruled out.Kim 2008, Monroe 2007, Spencer 2009 The grapefruit constituent d-limonene has GRAS status.Sun 2007 Grapefruit seed extract has been shown to be toxic to human skin fibroblast cells up to concentrations of 1:128 but not 1:512 in antibacterial studies.Heggers 2002

References

Abbas R, Hug BA, Leister C, Burns J, Sonnichsen D. Effect of ketoconazole on the pharmacokinetics of oral bosutinib in healthy subjects. J Clin Pharmacol. 2011;51(12):1721-1727.21148045
Abbas R, Hug BA, Leister C, Burns J, Sonnichsen D. Pharmacokinetics of oral neratinib during co-administration of ketoconazole in healthy subjects. Br J Clin Pharmacol. 2011;71(4):522-527.21395644
Abdlekawy KS, Donia AM, Elbarbry F. Effects of grapefruit juice and pomegranate juice on the pharmacokinetic properties of dapoxetine and midazolam in healthy subjects. Eur J Drug Metab Pharmacokinet. 2017;42(3):397-405.27294349
Abilify (amiodarone) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb; February 2011.
Abilify Maintena (aripiprazole) [prescribing information]. Rockville, MD: Otsuka America Pharmaceutical, Inc., February 2013.
Acetaminophen and Codeine Phosphate Oral Solution [prescribing information]. Morton Grove, IL: Morton Grove Pharmaceuticals, Inc.; November 2017.
Addyi (flibanserin) [prescribing information]. Raleigh, NC: Sprout Pharmaceuticals Inc; August 2015.
Adigun AQ, Mudasiru Z. Clinical effects of grapefruit juice-nifedipine interaction in a 54-year-old Nigerian: a case report. J Natl Med Assoc. 2002;94(4):276-278.11991343
Afinitor (everolimus) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals; October 2010.
Alaiti S, Kang S, Fiedler C, et al. Tacrolimus (FK506) ointment for atopic dermatitis: a phase I study in adults and children. J Am Acad Dermatol. 1998;38(1)69-76.9448208
Alderman CP, Gebauer MG, Gilbert AL, Condon JT. Possible interaction of zopiclone and nefazodone. Ann Pharmacother. 2001;35(11):1378-1380. [PubMed 11724087]9448208
Allegra (fexofenadine hydrochloride) [prescribing information]. Bridgewater, NJ: Sanofi-Aventis; July 2007.
Allen A, Siegfried E, Silverman R, et al. Significant absorption of topical tacrolimus in 3 patients with Netherton syndrome. Arch Dermatol. 2001;137(6)747-750.11405764
Allen DM, Esterly NB. Significant systemic absorption of tacrolimus after topical application in a patient with lamellar ichthyosis. Arch Dermatol. 2002;138(9):1259-1260.12225004
Alunbrig (brigatinib) [prescribing information]. Cambridge, MA: Takeda Pharmaceutical Company Limited; April 2017.Alunbrig.2017.04
Ando A, Oshida K, Fukuyama S, Watanabe A, Hashimoto H, Miyamoto Y. Identification of human cytochrome P450 enzymes involved in the metabolism of a novel kappa-opioid receptor agonist, nalfurafine hydrochloride. Biopharm Drug Dispos. 2012;33(5):257-264.22581509
Ando H, Tsuruoka S, Yanagihara H, et al. Effects of grapefruit juice on the pharmacokinetics of pitavastatin and atorvastatin. Br J Clin Pharmacol. 2005;60(5):494-497.16236039
Apadaz (benzhydrocodone and acetaminophen) [prescribing information]. Coralville, IA: KemPharm Inc; February 2018.
Apo-Domperidone (domperidone) [product monograph]. Toronto, Ontario, Canada: Apotex Inc.; March 2015.
Aranko K, Luurila H, Backman JT, Neuvonen PJ, Olkkola KT. The effect of erythromycin on the pharmacokinetics and pharmacodynamics of zopiclone. Br J Clin Pharmacol. 1994;38(4):363-367.7833227
Aung GL, O'Brien JG, Tien PG, et al. Increased aripiprazole concentrations in an HIV-positive male concurrently taking duloxetine, darunavir, and ritonavir. Ann Pharmacother. 2010;44(11):1850-1854.20978219
Azuma J, Hasunuma T, Kubo M, et al. The relationship between clinical pharmacokinetics of aripiprazole and CYP2D6 genetic polymorphism: effects of CYP enzyme inhibition by coadministration of paroxetine or fluvoxamine. Eur J Clin Pharmacol. 2012;68(1):29-37.21739267
Bailey DG, Spence JD, Munoz C, Arnold JM. Interaction of citrus juices with felodipine and nifedipine. Lancet. 1991;337(8736):268-269.1671113
Bailey DG, Arnold JM, Strong HA, Munoz C, Spence JD. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther. 1993;54(6):589-594.8275614
Bailey DG, Arnold JM, Munoz C, Spence JD. Grapefruit juice--felodipine interaction: mechanism, predictability, and effect of naringin. Clin Pharmacol Ther. 1993;53(6):637-642.8513655
Bailey DG, Arnold JM, Bend JR, Tran LT, Spence JD. Grapefruit juice-felodipine interaction: reproducibility and characterization with the extended release drug formulation. Br J Clin Pharmacol. 1995;40(2):135-140.8562295
Bailey DG, Bend JR, Arnold JM, Tran LT, Spence JD. Erythromycin-felodipine interaction: magnitude, mechanism, and comparison with grapefruit juice. Clin Pharmacol Ther. 1996;60(1):25-33.8689808
Bailey DG, Dresser GK, Kreeft JH, Munoz C, Freeman DJ, Bend JR. Grapefruit-felodipine interaction: effect of unprocessed fruit and probable active ingredients. Clin Pharmacol Ther. 2000;68(5):468-477.11103749
Bailey DG, Dresser GK, Bend JR. Bergamottin, lime juice, and red wine as inhibitors of cytochrome p450 3a4 activity: comparison with grapefruit juice. Clin Pharmacol Ther. 2003;73(6):529-537.12811362
Bailey DG, Dresser GK, Leake BF, Kim RB. Naringin is a major and selective clinical inhibitor of organic anion-transporting polypeptide 1A2 (OATP1A2) in grapefruit juice. Clin Pharmacol Ther. 2007;81(4):495-502.17301733
Baune B, Flinois JP, Furlan V, et al. Halofantrine metabolism in microsomes in man: major role of CYP 3A4 and CYP 3A5. J Pharm Pharmacol. 1999;51(4):419-426.10385214
Becquemont L, Mouaijah S, Escaffre O, Beaune P, Funck-Brentano C, Jaillon P. Cytochrome P-450 3A4 and 2C8 are involved in zopiclone metabolism. Drug Metab Dispos. 1999;27(9):1068-1073.10460808
Belsomra (suvorexant) [prescribing information]. Whitehouse Station, NJ: Merck & Co., Inc.; August 2014.
Beyerler M, Schmid-Grendelmeier P, Hafner J. Significantly elevated systemic levels after occlusive application of topical tacrolimus in atopic dermatitis. Dermatology. 2006;212(3):260-261.16549924
Biltricide (praziquantel) [prescribing information]. Wayne, NJ: Bayer HealthCare Pharmaceuticals Inc; February 2014.
Bistrup C, Nielsen FT, Jeppesen UE, Dieperink H. Effect of grapefruit juice on Sandimmune Neoral absorption among stable renal allograft recipients. Nephrol Dial Transplant. 2001;16(2):373-377.11158415
Bjornsson TD, Callaghan JT, Einolf HJ, et al; Pharmaceutical Research and Manufacturers of America Drug Metabolism/Clinical Pharmacology Technical Working Groups. The conduct of in vitro and in vivo drug-drug interaction studies: a PhRMA perspective. J Clin Pharmacol. 2003;43(5):443-469.12751267
Blode H, Zeun S, Parke S, et al. Evaluation of the effects of rifampicin, ketoconazole and erythromycin on the steady-state pharmacokinetics of the components of a novel oral contraceptive containing estradiol valerate and dienogest in healthy postmenopausal women. Contraception. 2012;86(4):337-344.22445438
Boinpally R, Gad N, Gupta S, Periclou A. Influence of CYP3A4 induction/inhibition on the pharmacokinetics of vilazodone in healthy subjects. Clin Ther. 2014;36(11):1638-1649.25236915
Bonin B, Vandel P, Vandel S, Kantelip JP. Effect of grapefruit intake on carbamazepine bioavailability: a case report. Therapie. 2001;56(1):69-71.11322025
Bosulif (bosutinib) [prescribing information]. New York, NY: Pfizer; September 2015.
Bower S, Hull CJ. Comparative pharmacokinetics of fentanyl and alfentanil. Br J Anaesth. 1982;54(8):871-877.6125162
Braftovi (encorafenib) [prescribing information]. Boulder, CO: Array BioPharma Inc; June 2018.
Brandt JT, Close SL, Iturria SJ, et al. Common polymorphisms of CYP2C19 and CYP2C9 affect the pharmacokinetic and pharmacodynamic response to clopidogrel but not prasugrel. J Thromb Haemost. 2007;5:2429-2436.17900275
Brunner LJ, Pai KS, Munar MY, Lande MB, Olyaei AJ, Mowry JA. Effect of grapefruit juice on cyclosporin A pharmacokinetics in pediatric renal transplant patients. Pediatr Transplant. 2000;4(4):313-321.11079273
Brunner LJ, Munar MY, Vallian J, et al. Interaction between cyclosporine and grapefruit juice requires long-term ingestion in stable renal transplant recipients. Pharmacotherapy. 1998;18(1):23-29.9469677
Buspar (buspirone) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb Company; November 2010.
Butterweck V, Zdrojewski I, Galloway C, Frye R, Derendorf H. Toxicological and pharmacokinetic evaluation of concomitant intake of grapefruit juice and simvastatin in rats after repeated treatment over 28 days. Planta Med. 2009;75(11):1196-1202.19350484
Cabometyx (cabozantinib) tablets [prescribing information]. South San Francisco, CA: Exelixis Inc; April 2016.
Calquence (acalabrutinib) [prescribing Information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; October 2017.
Carper J. Grapefruit. In: The Food Pharmacy: Dramatic New Evidence That Food is Your Best Medicine. New York, NY: Bantam Books; 1988:213-215.
Castro N, Jung H, Medina R, Gonzalez-Esquivel D, Lopez M, Sotelo J. Interaction between grapefruit juice and praziquantel in humans. Antimicrob Agents Chemother. 2002;46(5):1614-1616.11959616
Cerdelga (eliglustat) [prescribing information]. Waterford, Ireland: Genzyme Ireland Ltd; August 2014.
Chang SH, Chou IJ, Yeh YH, et al. Association between use of non-vitamin K oral anticoagulants with and without concurrent medications and risk of major bleeding in nonvalvular atrial fibrillation. JAMA. 2017;318(13):1250-1259.28973247
Charbit B, Becquemont L, Lepere B, Peytavin G, Funck-Brentano C. Pharmacokinetic and pharmacodynamic interaction between grapefruit juice and halofantrine. Clin Pharmacol Ther. 2002;72(5):514-523.12426515
Chen AY, Yu C, Potmesil M, Wall ME, Wani MC, Liu LF. Camptothecin overcomes MDR1-mediated resistance in human KB carcinoma cells. Cancer Res. 1991;51(22):6039-6044.1682041
Christensen H, Asberg A, Holmboe AB, Berg KJ. Coadministration of grapefruit juice increases systemic exposure of diltiazem in healthy volunteers. Eur J Clin Pharmacol. 2002;58(8):515-520.12451428
Cingi C, Toros SZ, Gürbüz MK, et al. Effect of grapefruit juice on bioavailability of montelukast. Laryngoscope. 2013;123(4):816-819.22951980
Citrus xparadisi Macfad. USDA, NRCS. 2018. The PLANTS Database. (http://plants.usda.gov, 27 May 2018). National Plant Data Team, Greensboro, NC 27401-4901 USA.
Clopixol (zuclopenthixol) [product monograph]. Montreal, Quebec: Lundbeck Canada; January 2011.
Coartem (artemether/lumefantrine) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals; April 2009.
Codipin (benidipine hydrochloride) tablets [Korea KR prescribing information]. Available at: http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=199300958. Accessed October 26, 2017.
Cohen EE, Wu K, Hartford C, et al. Phase I studies of sirolimus alone or in combination with pharmacokinetic modulators in advanced cancer patients. Clin Cancer Res. 2012;18(17):4785-4793.22872575
Colcrys (colchicine) [prescribing information]. Philadelphia, PA: AR Scientific; July 2009.
Collet JP, Hulot JS, Pena A, et al. Cytochrome P450 2C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study. Lancet. 2009;373(9660):309-317.19108880
Cometriq (cabozantinib) [prescribing information]. San Francisco, CA: Exelixis; November 2012.
Conrotto D, Carrozzo M, Ubertalli AV, et al. Dramatic increase of tacrolimus plasma concentration during topical treatment for oral graft-versus-host disease. Transplantation. 2006;82(8):1113-1115.17060865
Cordarone (amiodarone) [prescribing information]. Philadelphia, PA: Wyeth Pharmaceuticals; December 2008.
Corlanor (ivabradine) [prescribing information]. Thousand Oaks, CA: Amgen Inc.; April 2015.
Cotellic (cobimetinib) [prescribing information]. South San Francisco, CA: Genetech USA Inc; November 2015
Cvetkovic M, Leake B, Fromm MF, Wilkinson GR, Kim RB. OATP and P-glycoprotein transporters mediate the cellular uptake and excretion of fexofenadine. Drug Metab Dispos. 1999;277(8):866-871.10421612
Cycloset (bromocriptine) [prescribing information]. Tiverton, RI: VeroScience, LLC; October 2015.
Damkier P, Hansen LL, Brosen K. Effect of diclofenac, disulfiram, itraconazole, grapefruit juice and erythromycin on the pharmacokinetics of quinidine. Br J Clin Pharmacol. 1999;48(6):829-838.10594487
Davidson A, Knox C. Grapefruit, pomelo, ugli. In: Fruit: A Connoiseur's Guide and Cookbook. New York, NY: Simon and Schuster; 1991:66.
Davies SJ, Westin AA, Castberg I, et al. Characterisation of zuclopenthixol metabolism by in vitro and therapeutic drug monitoring studies. Acta Psychiatr Scand. 2010;122(6):444-453.20946203
de Jong J, Skee D, Murphy J, et al. Effect of CYP3A perpetrators on ibrutinib exposure in healthy participants. Pharmacol Res Perspect. 2015;3(4):e00156.26171235
Desta Z, Kerbusch T, Soukhova N, Richard E, Ko JW, Flockhart DA. Identification and characterization of human cytochrome P450 isoforms interacting with pimozide. J Pharmacol Exp Ther. 1998;285(2):428-437.9580580
Desta Z, Kerbusch T, Flockhart DA. Effect of clarithromycin on the pharmacokinetics and pharmacodynamics of pimozide in healthy, poor, and extensive metabolizers of cytochrome P450 2D6 (CYP2D6). Clin Pharmacol Ther. 1999;65(1):10-20.9951426
Desta Z, Kivisto KT, Lilja JJ, et al. Stereoselective pharmacokinetics of cisapride in healthy volunteers and the effect of repeated administration of grapefruit juice. Br J Clin Pharmacol. 2001;52(4):399-407.11678783
Dirix L, Swaisland H, Verheul HM, et al. Effect of itraconazole and rifampin on the pharmacokinetics of olaparib in patients with advanced solid tumors: results of two phase I open-label studies. Clin Ther. 2016;38(10):2286-2299.27745744
Draelos Z, Nayak A, Pariser D, et al. Pharmacokinetics of topical calcineurin inhibitors in adult atopic dermatitis: a randomized, investigator-blind comparison. J Am Acad Dermatol. 2005;53(4):602-609.16198779
Dresser GK, Bailey DG,Carruthers SG. Grapefruit juice--felodipine interaction in the elderly. Clin Pharmacol Ther. 2000;68(1):28-34.10945313
Dresser GK, Bailey DG, Leake BF, et al. Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine. Clin Pharmacol Ther. 2002,71(1):11-20.11823753
Ducharme MP, Provenzano R, Dehoorne-Smith M, Edwards DJ. Trough concentrations of cyclosporine in blood following administration with grapefruit juice. Br J Clin Pharm. 1993;36(5):457-459.12959294
Ducharme MP, Warbasse LH, Edwards DJ. Disposition of intravenous and oral cyclosporine after administration with grapefruit juice. Clin Pharmacol Ther. 1995;57(5):485-491.7768070
Dutreix C, Munarini F, Lorenzo S, Roesel J, Wang Y. Investigation into CYP3A4-mediated drug-drug interactions on midostaurin in healthy volunteers. Cancer Chemother Pharmacol. 2013;72(6):1223-1234.24085261
Edgar B, Bailey D, Bergstrand R, Johnsson G, Regårdh CG. Acute effects of drinking grapefruit juice on the pharmacokinetics and dynamics of felodipine--and its potential clinical relevance. Eur J Clin Pharmacol. 1992;42(3):313-317.1577050
Edwards DJ, Ducharme MP, Provenzano R, et al. Effect of grapefruit juice on blood concentrations of cyclosporine. Clin Pharmacol Ther. 1993;53:237.
Edwards D, Bellevue FH 3rd, Woster PM. Identification of 6',7' -dihydroxybergamottin, a cytochrome P450 inhibitor, in grapefruit juice. Drug Metab Dispos. 1996;24(12):1287-1290.8971132
Edwards DJ, Woster PM, and Warbasse LH. Effect of grapefruit juice and seville orange juice on cyclosporine disposition. Clin Pharmacol Ther. 1998;63:149.
Eissing T, Lippert J, Willmann S. Pharmacogenomics of codeine, morphine, and morphine-6-glucuronide: model-based analysis of the influence of CYP2D6 activity, UGT2B7 activity, renal impairment, and CYP3A4 inhibition. Mol Diagn Ther. 2012;16(1):43-53.22352453
Eliquis (apixaban) [prescribing information]. New York, NY: Pfizer Inc; July 2016.
Eliquis (apixaban) [product monograph]. Kirkland, Quebec, Canada: Pfizer Canada Inc.; June 2016.
ella (ulipristal acetate) [prescribing information]. Morristown, NJ: Watson Pharma Inc; August 2010.
El-Lakkany NM, Seif el-Din SH, Badawy AA, et al. Effect of artemether alone and in combination with grapefruit juice on hepatic drug-metabolising enzymes and biochemical aspects in experimental schistosoma mansoni. Int J Parasitol. 2004;34(12):1405-1412.15542101
Emend (aprepitant) [prescribing information]. Whitehouse Station, NJ: Merck & Co Inc; August 2015.
Emflaza (deflazacort) [prescribing information]. Northbrook, IL: Marathon Pharmaceuticals, LLC; February 2017.
Ensminger ME, Ensminger AH. Grapefruit. In: Foods & Nutrition Encyclopedia. Vol 1. 2nd ed. Boca Raton, FL: CRC Press; 1993:1097-1099.
Entocort EC (budesonide) capsules [prescribing information]. San Diego, CA: Prometheus Laboratories Inc; December 2011.
Epidiolex (cannabidiol) oral solution [prescribing information]. Carlsbad, CA: Greenwich Biosciences Inc; June 2018.
Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.11950176
Esbriet (pirfenidone) [prescribing information]. South San Francisco, California: Genentech; October 2017.
Estrace (estradiol) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb Co.; March 2005.
Fareston (toremifene) [prescribing information]. Memphis, TN: GTx Inc; March 2011.
Farid NA, Payne CD, Small DS, et al. Cytochrome P450 3A inhibition by ketoconazole affects prasugrel and clopidogrel pharmacokinetics and pharmacodynamics differently. Clin Pharmacol Ther. 2007;81(5):735-741.17361128
Farydak (panobinostat) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; February 2015.
Fibristal (ulipristal acetate) [product monograph]. Mississauga, ON: Actavis Specialty Pharmaceuticals Co; June 2013.
Feng XQ, Zhu LL, Zhou Q. Opioid analgesics-related pharmacokinetic drug interactions: from the perspectives of evidence based on randomized controlled trials and clinical risk management. J Pain Res. 2017;10:1225-1239.28579821
Ferdman RM, Ong PY, Church JA. Pectin anaphylaxis and possible association with cashew allergy. Ann Allergy Asthma Immunol. 2006;97(6):759-760.17201234
Fibristal (ulipristal acetate) [product monograph]. Mississauga, ON: Actavis Specialty Pharmaceuticals Co; June 2013.
Flockhart DA, Richard E, Woosely RL, et al. A metabolic interaction between clarithromycin and pimozide may result in cardiac toxicity. Clin Pharmacol Ther. 1996;59:189.
Flomax (tamsulosin) [prescribing information]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals Inc; October 2014.
Fuhr U, Maier-Bruggemann A, Blume H, et al. Grapefruit juice increases oral nimodipine bioavailability. Int J Clin Pharmacol Ther. 1998;36(3):126-132.9562227
Fuhr U, Muller-Peltzer H, Kern R, et al. Effects of grapefruit juice and smoking on verapamil concentrations in steady state. Eur J Clin Pharmacol. 2002;58(1):45-53.11956673
Fujioka K, Greenway F, Sheard J, Ying Y. The effects of grapefruit on weight and insulin resistance: relationship to the metabolic syndrome. J Med Food. 2006;9(1):49-54.16579728
Fujiwara Y, Toyoda M, Chayahara N, et al. Effects of aprepitant on the pharmacokinetics of controlled-release oral oxycodone in cancer patients. PLoS One. 2014;9(8):e104215.25121773
Fukatsu S, Fukudo M, Masuda S, et al. Delayed effect of grapefruit juice on pharmacokinetics and pharmacodynamics of tacrolimus in a living-donor liver transplant recipient. Drug Metab Pharmacokinet. 2006;21(2):122-125.16702731
Fukazawa I, Uchida N, Uchida E, Yasuhara H. Effects of grapefruit juice on pharmacokinetics of atorvastatin and pravastatin in japanese. Br J Clin Pharmacol. 2004;57(4):448-455.15025743
Garg SK, Kumar N, Bhargava VK, Prabhakar SK. Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy. Clin Pharmacol Ther. 1998;64(3):286-288.9757152
Gasche Y, Daali Y, Fathi M, et al. Codeine intoxication associated with ultrarapid CYP2D6 metabolism. N Engl J Med. 2004;351(27):2827-2831.15625333
Ghislain PD, De Decker I, Lachapelle JM. Efficacy and systemic absorption of topical tacrolimus used in pyoderma gangrenosum. Br J Dermatol. 2004;150(5):1052-1053.15149540
Giamperi L, Fraternale D, Bucchini A, Ricci D. Antioxidant activity of Citrus paradisi seeds glyceric extract. Fitoterapia. 2004;75(2):221-224.17215845
Glaeser H, Bailey DG, Dresser GK, et al. Intestinal drug transporter expression and the impact of grapefruit juice in humans. Clin Pharmacol Ther. 2007;81(3):362-370.15030930
Goldbart A, Press J, Sofer S, Kapelushnik J. Near fatal acute colchicine intoxication in a child. A case report. Eur J Pediatr. 2000;159(12):895-897.11131346
Goldfarb DS, Asplin JR. Effect of grapefruit juice on urinary lithogenicity. J Urol. 2001;166(1):263-267.11435883
Goosen TC, Cillie D, Bailey DG, et al. Bergamottin contribution to the grapefruit juice-felodipine interaction and disposition in humans. Clin Pharmacol Ther. 2004;76(6):607-617.15592332
Gorinstein S, Caspi A, Libman I, Katrich E, Lerner HT, Trakhtenberg S. Fresh israeli jaffa sweetie juice consumption improves lipid metabolism and increases antioxidant capacity in hypercholesterolemic patients suffering from coronary artery disease: studies in vitro and in humans and positive changes in albumin and fibrinogen fractions. J Agric Food Chem. 2004;52(16):5215-5222.15291499
Gorinstein S, Caspi A, Libman I, et al. Red grapefruit positively influences serum triglyceride level in patients suffering from coronary atherosclerosis: studies in vitro and in humans. J Agric Food Chem. 2006;54(5):1887-1892.16506849
Grande LA, Mendez RD, Krug RT, Verschuyl EJ. Attention—grapefruit! Lancet. 2009;373(9670):1222.19345832
Greenblatt DJ, von Moltke LL, Harmatz JS, et al. Time course of recovery of cytochrome p450 3A function after single doses of grapefruit juice. Clin Pharmacol Ther. 2003;74(2):121-129.12891222
Gross AS, Goh YD, Addison RS, Shenfield GM. Influence of grapefruit juice on cisapride pharmacokinetics. Clin Pharmacol Ther. 1999;65(4):395-401.10223776
Grundy JS, Eliot LA, Kulmatycki KM, Foster RT. Grapefruit juice and orange juice effects on the bioavailability of nifedipine in the rat. Biopharm Drug Dispos. 1998;19(3):175-183.9570001
Gubbins PO, McConnell SA, Gurley BJ, et al. Influence of grapefruit juice on the systemic availability of itraconazole oral solution in healthy adult volunteers. Pharmacotherapy. 2004;24(4):460-467.15098799
Gubbins PO, Gurley BJ, Williams DK, et al. Examining sex-related differences in enteric itraconazole metabolism in healthy adults using grapefruit juice. Eur J Clin Pharmacol. 2008;64(3):293-301.18172627
Habauzit V, Verny MA, Milenkovic D, et al. Flavanones protect from arterial stiffness in postmenopausal women consuming grapefruit juice for 6 mo: a randomized, controlled, crossover trial. Am J Clin Nutr. 2015;102(1):66-74.26016866
Halfan (halofantrine) [prescribing information]. Philadelphia, PA: SmithKline Beecham Pharmaceuticals; October 2001.
Hallberg P, Marten L, Wadelius M. Possible fluconazole-fentanyl interaction-a case report. Eur J Clin Pharmacol. 2006;62(6):491-492.16758267
Hanley MJ, Masse G, Harmatz JS, et al. Effect of blueberry juice on clearance of buspirone and flurbiprofen in human volunteers. Br J Clin Pharmacol. 2013;75(4):1041-1052.22943633
Harper J, Smith C, Rubins A, et al. A multicenter study of the pharmacokinetics of tacrolimus ointment after first and repeated application to children with atopic dermatitis. J Invest Dermatol. 2005;124(4):695-699.15816825
Heggers JP, Cottingham J, Gusman J, et al. The effectiveness of processed grapefruit-seed extract as an antibacterial agent: II. Mechanism of action and in vitro toxicity. J Altern Complement Med. 2002;8(3):333-340.12165191
Hendricks CB, Rowinsky EK, Grochow LB, Donehower RC, Kaufmann SH. Effect of P-glycoprotein expression on the accumulation and cytotoxicity of topotecan (SK&F 104864), a new camptothecin analogue. Cancer Res. 1992;52(8):2268-22678.1348448
Hermann M, Asberg A, Reubsaet JL, Sather S, Berg KJ, Christensen H. Intake of grapefruit juice alters the metabolic pattern of cyclosporine a in renal transplant recipients. Int J Clin Pharmacol Ther. 2002;40(10):451-456.12395977
Hilbert J, Messig M, Kuye O, Friedman H. Evaluation of interaction between fluconazole and an oral contraceptive in healthy women. Obstet Gynecol. 2001;98(2):218-223.11506836
Ho PC, Ghose K, Saville D, et al. Effect of grapefruit juice on pharmacokinetics and pharmacodynamics of verapamil enantiomers in healthy volunteers. Eur J Clin Pharmacol. 2000;56(9-6):693-698.11214778
Ho PC, Saville DJ, Wanwimolruk S. Inhibition of human CYP3A4 activity by grapefruit flavonoids, furanocoumarins and related compounds. J Pharm Pharm Sci. 2001;4(3):217-227.11737987
Hollander AA, van Rooij J, Lentjes GW, et al. The effect of grapefruit juice on cyclosporine and prednisone metabolism in transplant patients. Clin Pharmacol Ther. 1995;57(3):318-324.7697949
Holmberg MT, Tornio A, Joutsi-Korhonen L, et al. Grapefruit juice markedly increases the plasma concentrations and antiplatelet effects of ticagrelor in healthy subjects. Br J Clin Pharmacol. 2013;75(6):1488-1496.23126367
Holmberg MT, Tornio A, Neuvonen M, Neuvonen PJ, Backman JT, Niemi M. Grapefruit juice inhibits the metabolic activation of clopidogrel. Clin Pharmacol Ther. 2014;95(3):307-313.24067745
Holmberg MT, Tornio A, Neuvonen M, Neuvonen PJ, Backman JT, Niemi M. Grapefruit juice inhibits the metabolic activation of clopidogrel. Clin Pharmacol Ther. 2014;95(3):307-313.24067745
Holmberg MT, Tornio A, Hyvärinen H, et al. Effect of grapefruit juice on the bioactivation of prasugrel. Br J Clin Pharmacol. 2015;80(1):139-145.25557052
Holtzman CW, Wiggins BS, Spinler SA. Role of P-glycoprotein in statin drug interactions. Pharmacotherapy. 2006;26(11):1601-1607.17064205
Hönow R, Laube N, Schneider A, Kessler T, Hesse A. Influence of grapefruit-, orange- and apple-juice consumption on urinary variables and risk of crystallization. Br J Nutr. 2003;90(2):295-300.12908889
Hori H, Yoshimura R, Ueda N, et al. Grapefruit juice-fluvoxamine interaction--is it risky or not? J Clin Psychopharmacol. 2003;23(4):422-424.12920426
Hsyu PH, Pignataro DS, Matschke K. Effect of aprepitant, a moderate CYP3A4 inhibitor, on bosutinib exposure in healthy subjects. Eur J Clin Pharmacol. 2017;73(1):49-56.27718000
Hu J, Shang D, Xu X, He X, Ni X, Zhang M, Wang Z, Qiu C, Deng S, Lu H, Zhu X, Huang W, Wen Y. Effect of grapefruit juice and food on the pharmacokinetics of pirfenidone in healthy Chinese volunteers: a diet-drug interaction study. Xenobiotica. 2016;46(6):516-521.26407124
Hulot JS, Bura A, Villard E, et al. Cytochrome P450 2C19 loss-of-function polymorphism is a major determinant of clopidogrel responsiveness in healthy subjects. Blood. 2006;108:2244-2247.16772608
Hycamtin (topotecan) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; October 2007.
Ibrahim AE, Feldman J, Karim A, et al. Simultaneous assessment of drug interactions with low- and high-extraction opioids: application to parecoxib effects on the pharmacokinetics and pharmacodynamics of fentanyl and alfentanil. Anesthesiology. 2003;98(4):853-861.12657846
Ibrance (palbociclib) [prescribing information]. New York, NY: Pfizer Inc; February 2015.
Ieiri I, Doi Y, Maeda K, et al. Microdosing clinical study: pharmacokinetic, pharmacogenomic (SLCO2B1), and interaction (grapefruit juice) profiles of celiprolol following the oral microdose and therapeutic dose. J Clin Pharmacol. 2012;52(7):1078-1089.21593283
Ilaxten (bilastine) [summary of product characteristics]. Buckinghamshire, United Kingdom: A Menarini Farmaceutica Internazionale SRL; January 2012.
Iclusig (ponatinib) [prescribing information]. Cambridge, MA: Ariad Pharmaceuticals; December 2012.
Ifex (ifosfamide) [prescribing information]. Deerfield, IL: Baxter Healthcare; March 2012.
Imbruvica (ibrutinib) [prescribing information]. Horsham, PA: Janssen Biotech Inc; August 2017.
Imovane (zopiclone) [product monograph]. Laval, Quebec, Canada: Sanofi-Aventis Canada Inc; October 2014.
Inlyta (axitinib) [prescribing information]. New York, NY: Pfizer; January 2012.
Inspra (eplerenone) [prescribing information]. New York, NY: Pfizer; May 2016.
Inspra (eplerenone) [product monograph]. Kirkland, Quebec, Canada: Pfizer Canada Inc; June 2014.
Intuniv (guanfacine) [prescribing information]. Wayne, PA: Shire US Inc; July 2016.
Ioannides-Demos LL, Christophidis N, Ryan P, Angelis P, Liolios L, McLean AJ. Dosing implications of a clinical interaction between grapefruit juice and cyclosporine and metabolite concentrations in patients with autoimmune diseases. J Rheumatol. 1997;24(1):49-54.9002010
Drug interaction incident with HIV post-exposure prophylaxis. ISMP Canada Safety Bulletin. 2008;8(3):1-2. http://www.ismp-canada.org/download/ISMPCSB2008-03HIVPEP.pdf. Accessed December 2, 2008.
Jakafi (ruxolitinib) [prescribing information]. Wilmington, DE: Incyte; November 2011.
Jalava KM, Olkkola KT, Neuvonen PJ. Effect of itraconazole on the pharmacokinetics and pharmacodynamics of zopiclone. Eur J Clin Pharmacol. 1996;51(3-4):331-334.9010708
Jalyn (dutasteride and tamsulosin) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; November 2017.
Jerling M, Huan BL, Leung K, Chu N, Abdallah H, Hussein Z. Studies to investigate the pharmacokinetic interactions between ranolazine and ketoconazole, diltiazem, or simvastatin during combined administration in healthy subjects. J Clin Pharmacol. 2005;45(4):422-433.15778423
Jetter A, Kinzig-Schippers M, Walchner-Bonjean M, et al. Effects of grapefruit juice on the pharmacokinetics of sildenafil. Clin Pharmacol Ther. 2002;71(1):21-29.11823754
Johnson FM, Agrawal S, Burris H, et al. Phase 1 pharmacokinetic and drug-interaction study of dasatinib in patients with advanced solid tumors. Cancer. 2010;116(6):1582-1591.20108303
Johnson BF, Cheng SL and Venitz J, “Transient Kinetic and Dynamic Interactions Between Verapamil and Dofetilide, a Class III Antiarrhythmic,” J Clin Pharmacol, 2001, 41(11):1248-56.11697758
Jonker JW, Smit JW, Brinkhuis RF, et al. Role of breast cancer resistance protein in the bioavailability and fetal penetration of topotecan. J Natl Cancer Inst. 2000;92(20):1651-1656.1348448
Josefsson M, Zackrisson AL, Ahlner J. Effect of grapefruit juice on the pharmacokinetics of amlodipine in healthy volunteers. Eur J Clin Pharmacol. 1996;51(2):189-193.8911887
Josefsson M, Ahlner J. Amlodipine and grapefruit juice. Br J Clin Pharmacol. 2002;53(4):405; author reply 6.11966676
Juxtapid (lomitapide) [prescribing information]. Cambridge, MA: Aegerion Pharmaceuticals; December 2012.
Jynarque (tolvaptan) [prescribing information]. Rockville, MD: Otsuka America Pharmaceutical, Inc.; April 2018.
Kakar SM, Paine MF, Stewart PW, Watkins PB. 6'7'-Dihydroxybergamottin contributes to the grapefruit juice effect. Clin Pharmacol Ther. 2004;75(6):569-579.15179411
Kalydeco (ivacaftor) [prescribing information]. Cambridge, MA: Vertex Pharmaceuticals Incorporated; January 2012.
Kameda G, Kramm C Niehues T, Hermsen D, Krutmann J, Niehues T. Unexpected high serum levels of tacrolimus after a single topical application in an infant. J Pediatr. 2003;143(4):462.12970650
Kantola T, Kivistö KT, Neuvonen PJ. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatic acid. Clin Pharmacol Ther. 1998;63(4):397-402.9585793
Kawaguchi-Suzuki M, Nasiri-Kenari N, Shuster J, et al. Effect of low-furanocoumarin hybrid grapefruit juice consumption on midazolam pharmacokinetics. J Clin Pharmacol. 2017;57(3):305-311.27503364
Kawakami M, Suzuki K, Ishizuka T, et al. Effect of grapefruit juice on pharmacokinetics of itraconazole in healthy subjects. Int J Clin Pharmacol Ther. 1998;36(6):306-308.9660036
Kawashima M, Nakagawaw H, Ohtsuki M, Tamaki K, Ishibashi Y. Tacrolimus concentrations in blood during topical treatment of atopic dermatitis. Lancet. 1996;348(9036):1240-1241.8898050
Kazui M, Nishiya Y, Ishizuka T, et al. Identification of the human cytochrome P450 enzymes involved in the two oxidative steps in the bioactivation of clopidogrel to its pharmacologically active metabolite. Drug Metab Dispos. 2010;38(1):92-99.19812348
Kerbusch T, Jansen RL, Mathot RA, et al. Modulation of the cytochrome P450-mediated metabolism of ifosfamide by ketoconazole and rifampin. Clin Pharmacol Ther. 2001;70(2):132-141.11503007
Kharasch ED, Whittington D, Hoffer C. Influence of hepatic and intestinal cytochrome P4503A activity on the acute disposition and effects of oral transmucosal fentanyl citrate. Anesthesiology. 2004;101(3):729-737.15329598
Kim EH, Hankinson SE, Eliassen AH, Willett WC. A prospective study of grapefruit and grapefruit juice intake and breast cancer risk. Br J Cancer. 2008;98(1):240-241.18026192
Kisqali (ribociclib) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; March 2017.
Kivisto KT, Niemi M, Fromm MF. Functional interaction of intestinal CYP3A4 and P-glycoprotein. Fundam Clin Pharmacol. 2004;18(6):621-626.15548232
Korlym (mifepristone) [prescribing information]. Menlo Park, CA: Corcept Therapeutics Incorporated; October 2016.
Krueger GG, Eichenfield L, Goodman JJ, et al. Pharmacokinetics of tacrolimus following topical application of tacrolimus ointment in adult and pediatric patients with moderate to severe atopic dermatitis. J Drugs Dermatol. 2007;6(2):185-193.17373177
Kruijtzer CMF, Beijnen JH, Rosing H, et al. Increased oral bioavailability of topotecan in combination with the breast cancer resistance protein and p-glycoprotein inhibitor GF120918. J Clin Oncol. 2002;20(13):2943-2950.12089223
Ku YM, Min KE, Flanigan MJ. The effect of grapefruit juice on microemulsion cyclosporine (Neoral) pharmacokinetics in healthy volunteers. Pharmacotherapy. 1998;18:442.
Kubitza D, Mueck W, Becka M. No interaction between rivaroxaban - a novel, oral, direct factor Xa inhibitor - and atorvastatin [abstract PO62]. Pathophysiol Haemost Thromb. 2008;36(suppl 1):A40.
Kubo M, Koue T, Inaba A, et al. Influence of itraconazole co-administration and CYP2D6 genotype on the pharmacokinetics of the new antipsychotic aripiprazole. Drug Metab Pharmacokinet. 2005;20(1):55-64.15770075
Kupferschmidt HH, Ha RH, Ziegler WH, et al. Interaction between grapefruit juice and midazolam in humans. Clin Pharmacol Ther. 1995;58(1):20-28.7628179
Lalovic B, Phillips B, Risler LL, Howald W, Shen DD. Quantitative contribution of CYP2D6 and CYP3A to oxycodone metabolism in human liver and intestinal microsomes. Drug Metab Dispos. 2004;32(4):447-454.15039299
Latuda (lurasidone) [prescribing information]. Marlborough, MA: Sunovion Pharmaceuticals; July 2013.
Lee AJ, Chan WK, Harralson AF, Buffum J, Bui BC. The effects of grapefruit juice on sertraline metabolism: an in vitro and in vivo study. Clin Ther. 1999;21(11):1890-1899.10890261
Lee M, Min DI. Determination of sildenafil citrate in plasma by high-performance liquid chromatography and a case for the potential interaction of grapefruit juice with sildenafil citrate. Ther Drug Monit. 2001;23(1):21-26.11206038
Lee M, Min DI, Ku YM, Flanigan M. Effect of grapefruit juice on pharmacokinetics of microemulsion cyclosporine in African American subjects compared with Caucasian subjects: does ethnic difference matter? J Clin Pharmacol. 2001;41(3):317-323.11269572
Leggas M, Adachi M, Scheffer GL, et al. Mrp4 confers resistance to topotecan and protects the brain from chemotherapy. Mol Cell Biol. 2004;24(17):7612-7621.15314169
Lercanidipine [summary of product characteristics]. Devon, UK: Arrow Generics Limited; November 2013.
Libersa CC, Brique SA, Motte KB, et al. Dramatic inhibition of amiodarone metabolism induced by grapefruit juice. Br J Clin Pharmacol. 2000;49(4):373-378.10759694
Lilja JJ, Backman JT, Laitila J, Luurila H, Neuvonen PJ. Itraconazole increases but grapefruit juice greatly decreases plasma concentrations of celiprolol. Clin Pharmacol Ther. 2003;73(3):192-198.12621384
Lilja JJ, Juntti-Patinen L, Neuvonen PJ. Orange juice substantially reduces the bioavailability of the beta-adrenergic-blocking agent celiprolol. Clin Pharmacol Ther. 2004;75(3):184-190.15001969
Lilja JJ, Kivisto KT, Backman JT, Lamberg TS, Neuvonen PJ. Grapefruit juice substantially increases plasma concentrations of buspirone. Clin Pharmacol Ther. 1998;64(6):655-660.9871430
Lilja JJ, Kivistö KT, Neuvonen PJ. Grapefruit juice-simvastatin interaction: effect on serum concentrations of simvastatin, simvastatin acid, and HMG-CoA reductase inhibitors. Clin Pharmacol Ther. 1998;64(5):477-483.9834039
Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice increases serum concentrations of atorvastatin and has no effect on pravastatin. Clin Pharmacol Ther. 1999;66(2):118-127.10460065
Lilja JJ, Kivistö KT, Neuvonen PJ. Duration of effect of grapefruit juice on the pharmacokinetics of the CYP3A4 substrate simvastatin. Clin Pharmacol Ther. 2000;68(4):384-390.11061578
Lilja JJ, Neuvonen M, Neuvonen PJ. Effects of regular consumption of grapefruit juice on the pharmacokinetics of simvastatin. Br J Clin Pharmacol. 2004;58(1):56-60.15206993
Lipitor (atorvastatin) [prescribing information]. New York, NY: Pfizer; June 2009.
Liu C, Shang YF, Zhang XF, et al. Co-administration of grapefruit juice increases bioavailability of tacrolimus in liver transplant patients: a prospective study. Eur J Clin Pharmacol. 2009;65(9):881-885.19629461
Lonasen (blonanserin) [KR prescribing information]. Available at: http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=200906540. Accessed September 22, 2014.
Lown KS, Bailey DG, Fontana RJ, et al. Grapefruit juice increases felodipine oral availability in humans by decreasing intestinal CYP3A protein expression. J Clin Invest. 1997;99(10):2545-2553.9153299
Lu WJ, Huang K, Lai ML, Huang JD. Erythromycin alters the pharmacokinetics of bromocriptine by inhibition of organic anion transporting polypeptide C-mediated uptake. Clin Pharmacol Ther. 2006;80(4):421-422.17015059
Lundahl J, Regardh CG, Edgar B, Johnsson G. Relationship between time of intake of grapefruit juice and its effect on pharmacokinetics and pharmacodynamics of felodipine in healthy subjects. Eur J Clin Pharmacol. 1995;49(1-2):61-67.8751023
Lundahl J, Regårdh CG, Edgar B, Johnsson G. Effects of grapefruit juice ingestion--pharmacokinetics and haemodynamics of intravenously and orally administered felodipine in healthy men. Eur J Clin Pharmacol. 1997;52(2):139-145.9174684
Lynparza (olaparib) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; January 2018.
Malhotra S, Bailey DG, Paine MF, Watkins PB. Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther. 2001;69(1):14-23.11180034
Maliepaard M, van Gastelen MA, de Jong LA, et al. Overexpression of the BCRP/MXR/ABCP gene in a topotecan-selected ovarian tumor cell line. Cancer Res. 1999;59(18):4559-4563.10493507
Maliepaard M, van Gastelen MA, Tohgo A, et al. Circumvention of breast cancer resistance protein (BCRP)-mediated resistance to camptothecins in vitro using non-substrate drugs or the BCRP inhibitor GF120918. Clin Cancer Res. 2001;7(4):935-941.11309344
Manchee GR, Eddershaw PJ, Ranshaw LE, et al. The aliphatic oxidation of salmeterol to alpha-hydroxysalmeterol in human liver microsomes is catalyzed by CYP3A. Drug Metab Dispos. 1996;24(5):555-559.8723736
Marqibo (vincristine) [prescribing information]. South San Francisco, CA: Talon Therapeutics; August 2012
McCune JS, Risler LJ, Phillips BR, Thummel KE, Blough D, Shen DD. Contribution of CYP3A5 to hepatic and renal ifosfamide N-dechloroethylation. Drug Metab Dispos. 2005;33(7):1074-1081.15821045
Mega JL, Close SL, Wiviott SD, et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med. 2009;360(4):354-362.19106084
Mehrsai AR, Pourmand G, Mansour D, et al. Effect of grapefruit juice on serum concentration of cyclosporine in Iranian renal transplant patients. Transplant Proc. 2003;35(7):2739-2741.14612100
Mevacor (lovastatin) [prescribing information]. Whitehouse Station, NJ: Merck & Co; February 2014.
Mifeprex (mifepristone) [prescribing information]. New York, NY: Danco Laboratories, LLC; March 2016.
Mignat C, Wille U, Ziegler A. Affinity profiles of morphine, codeine, dihydrocodeine and their glucuronides at opioid receptor subtypes. Life Sci. 1995;56(10):793-799.7885194
Min DI, Ku YM, Geraets DR, Lee H. Effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of quinidine in healthy volunteers. J Clin Pharmacol. 1996;36(5):469-476.8739026
Min DI, Ku YM, Perry PJ, et al. The effect of grapefruit juice on cyclosporine pharmacokinetics in renal allograft recipients. Pharmacotherapy. 1996;16:516.
Miniscalco A, Lundahl J, Regårdh CG, Edgar B, Eriksson UG. Inhibition of dihydropyridine metabolism in rat and human liver microsomes by flavonoids found in grapefruit juice. J Pharmacol Exp Ther. 1992;261(3):1195-1199.1602384
Misaka S, Miyazaki N, Yatabe MS, et al. Pharmacokinetic and pharmacodynamic interaction of nadolol with itraconazole, rifampicin and grapefruit juice in healthy volunteers. J Clin Pharmacol. 2013;53(7):738-745.23677858
Monroe KR, Murphy SP, Henderson BE, et al. Dietary fiber intake and endogenous serum hormone levels in naturally postmenopausal Mexican American women: the Multiethnic Cohort Study. Nutr Cancer. 2007;58(2):127-135.17640158
Motens (lacidipine) [summary of product characteristics]. Middlesex, United Kingdom: GSK UK; September 2013.
Movantik (naloxegol) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; September 2014.
Multaq (dronedarone) [prescribing information]. Bridgewater, NJ: Sanofi-Aventis US; June 2009.
Muraki I, Imamura F, Manson JE, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013;347:f5001.23990623
Mvix 50 mg tablet (mirodenafil) [KR prescribing information]. http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=200708298. Accessed April 7, 2016.
Nagy J, Schipper HG, Koopmans RP, et al. Effect of grapefruit juice or cimetidine coadministration on albendazole bioavailability. Am J Trop Med Hyg. 2002;66(3):260-263.12139218
Natazia (estradiol valerate/dienogest) [prescribing information]. Whippany, NJ: Bayer HealthCare; August 2015.
Navarro VJ, Barnhart H, Bonkovsky HL, et al. Liver injury from herbals and dietary supplements in the U.S. drug-induced liver injury network. Hepatology. 2014;60(4):1399-1408.25043597
Nelson MV, Berchou RC, Kareti D, LeWitt PA. Pharmacokinetic evaluation of erythromycin and caffeine administered with bromocriptine. Clin Pharmacol Ther. 1990;47(6):694-697.2357864
Nerlynx (neratinib) [prescribing information]. Los Angeles, CA: Puma Biotechnology Inc; July 2017.
Nieminen TH, Hagelberg NM, Saari TI, et al. Grapefruit juice enhances the exposure to oral oxycodone. Basic Clin Pharmacol Toxicol. 2010;107(4):782-788.20406214
Nymalize (nimodipine) [prescribing information]. Atlanta, GA: Arbor Pharmaceuticals Inc; May 2013.
Odomzo (sonidegib) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; July 2015.
Odou P, Ferrari N, Barthélémy C, et al. Grapefruit juice-nifedipine interaction: possible involvement of several mechanisms. J Clin Pharm Ther. 2005;30(2):153-158.15811168
Oesterheld J, Kallepalli BR. Grapefruit juice and clomipramine: shifting metabolic ratios. J Clin Psychopharmacol. 1997;17(1):62-63.9004067
Offman EM, Freeman DJ, Dresser GK, Munoz C, Bend JR, Bailey DG. Red wine-cisapride interaction: comparison with grapefruit juice. Clin Pharmacol Ther. 2001;70(1):17-23.11452240
Ohnishi A, Ohtani H, Sawada Y. Major determinant factors of the extent of interaction between grapefruit juice and calcium channel antagonists. Br J Clin Pharmacol. 2006;62(2):196-199.16842394
Olkkola KT, Palkama VJ, Neuvonen PJ. Ritonavir's role in reducing fentanyl clearance and prolonging its half-life. Anesthesiology. 1999;91(3):681-685.10485779
Olysio (simeprevir) [prescribing information]. Titusville, NJ: Janssen Products, LP, November 2013.
Onakpoya I, O'Sullivan J, Heneghan C, Thompson M. The effect of grapefruits (Citrus paradisi) on body weight and cardiovascular risk factors: A systematic review and meta-analysis of randomized clinical trials. Crit Rev Food Sci Nutr. 2017;57(3):602-612.25880021
Onglyza (saxagliptin) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb; July 2009.
Orap (pimozide) [prescribing information]. Sellersville, PA: Teva Pharmaceuticals USA; August 2011.
Ortho Tri-Cyclen (norgestimate/ethinyl estradiol) [prescribing information]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; August 2017.
OxyContin (oxycodone hydrochloride controlled-release) [prescribing information]. Stamford, CT: Purdue Pharma L.P.; August 2015.
Oyelami OA, Agbakwuru EA, Adeyemi LA, Adedeji GB. The effectiveness of grapefruit (Citrus paradisi) seeds in treating urinary tract infections. J Altern Complement Med. 2005;11(2):369-371.15865506
Page RL 2nd, O'Bryant CL, Cheng D, et al; American Heart Association Clinical Pharmacology and Heart Failure and Transplantation Committees of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Drugs That May Cause or Exacerbate Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2016;134(6):e32-e69.27400984
Paine MF, Criss AB, Watkins PB. Two major grapefruit juice components differ in time to onset of intestinal CYP3A4 inhibition. J Pharmacol Exp Ther. 2005;312(3):1151-1160.15485894
Paine MF, Widmer WW, Hart HL, et al. A furanocoumarin-free grapefruit juice establishes furanocoumarins as the mediators of the grapefruit juice-felodipine interaction. Am J Clin Nutr. 2006;83(5):1097-1105.16685052
Palkama VJ, Neuvonen PJ, Olkkola KT. The CYP 3A4 inhibitor itraconazole has no effect on the pharmacokinetics of I.V. fentanyl. Br J Anaesth. 1998;81(4):598-600.9924238
Parlodel (bromocriptine) [prescribing information]. Suffern, NY: Novartis Pharmaceuticals Corporation; January 2012.
Patel CG, Li L, Girgis S, Kornhauser DM, Frevert EU, Boulton DW. Two-way pharmacokinetic interaction studies between saxagliptin and cytochrome P450 substrates or inhibitors: simvastatin, diltiazem extended-release, and ketoconazole. Clin Pharmacol. 2011;3:13-25.22287853
Penzak SR, Gubbins PO, Gurley BJ, et al. Grapefruit juice decreases the systemic availability of itraconazole capsules in healthy volunteers. Ther Drug Monit. 1999;21(3):304-309.10365642
Peynaud D, Charpiat B, Vial T, Gallavardin M, Ducerf C. Tacrolimus severe overdosage after intake of masked grapefruit in orange marmalade. Eur J Clin Pharmacol. 2007;63(7):721-722.17530235
Piccirillo G, Magrì D, Matera S, et al. Effects of pink grapefruit juice on QT variability in patients with dilated or hypertensive cardiomyopathy and in healthy subjects. Transl Res. 2008;151(5):267-272.18433709
Pillai VC, Venkataramanan R, Parise RA, et al. Ritonavir and efavirenz significantly alter the metabolism of erlotinib--an observation in primary cultures of human hepatocytes that is relevant to HIV patients with cancer. Drug Metab Dispos. 2013;41(10):1843-1851.23913028
Pisarik P. Blood pressure-lowering effect of adding grapefruit juice to nifedipine and terazosin in a patient with severe renovascular hypertension. Arch Fam Med. 1996;5(7):413-416.8665000
Pitarch G, Torrijos A, Mahiques L, et al. Systemic absorption of topical tacrolimus in pyoderma gangrenosum. Acta Derm Venereol. 2006;86(1)64-65.16585995
Pithavala YK, Tong W, Mount J, et al. Effect of ketoconazole on the pharmacokinetics of axitinib in healthy volunteers. Invest New Drugs. 2012;30(1):273-281.20740300
Plendil (felodipine) [product monograph]. Mississauga, Ontario: AstraZeneca Canada; June 2008.
Pletal (cilostazol) [prescribing information]. Rockville, MD: Otsuka America Pharmaceutical, Inc.; July 2015.
Pohl O, Osterloh I, Gotteland JP. Effects of erythromycin at steady-state concentrations on the pharmacokinetics of ulipristal acetate. J Clin Pharm Ther. 2013;38(6):512-517.24102384
Pomalyst (pomalidomide) [prescribing information]. Summit, NJ: Celgene Corporation; February 2013.
Premarin (conjugated estrogens) [prescribing information]. Philadelphia, PA: Wyeth Pharmaceuticals, Inc.; December 2014.
Prezioso D, Strazzullo P, Lotti T, et al; CLU Working Group. Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group. Arch Ital Urol Androl. 2015;87(2):105-120.26150027
Priligy (dapoxetine) [summary of product characteristics]. Wooburn Green, Buckinghamshire, United Kingdom: A. Menarini Farmaceutica Internazionale SRL; December 2013.
Priligy (dapoxetine) [summary of product characteristics]. Mapletree Business City, Singapore: A. Menarini Singapore Pte. Ltd.; September 2013.
Procardia (nifedipine) [prescribing information]. New York, NY: Pfizer; March 2006.
Procoralan (ivabradine) [prescribing information]. Suresnes Cedex, France: Les Laboratoires Servier; January 2015.
Prograf (tacrolimus) [prescribing information]. Deerfield, IL: Astellas Pharma US; February 2012.
Proppe D, Visser K, Bartels R, et al. Grapefruit juice selectively modifies cyclosporine a metabolite patterns in renal transplant patients. Clin Pharmacol Ther. 1996;59:138.
Prot-Labarthe S, Therrien R, Champagne MA, Duval M, Joubert C. Toxic serum levels of tacrolimus after topical administration in an infant with severe cutaneous graft-versus-host disease. Bone Marrow Transplant. 2007;40(3):295-296.17549052
Protopic (tacrolimus) topical [prescribing information]. Deerfield, IL: Astellas Pharma US; January 2009.
Quinidine gluconate [prescribing information]. Philadelphia, PA: Mutual Pharmaceutical Co; February 2010.
Rakhit A, Pantze MP, Fettner S, et al. The effects of CYP3A4 inhibition on erlotinib pharmacokinetics: computer-based simulation (SimCYP) predicts in vivo metabolic inhibition. Eur J Clin Pharmacol. 2008;64(1):31-41.18000659
Ramitch (nalfurafine) capsule [KR prescribing information]. Available at: http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=201307707. Accessed May 2017.
Rampersaud GC, Valim MF. 100% citrus juice: Nutritional contribution, dietary benefits, and association with anthropometric measures. Crit Rev Food SciNutr. 2017;57(1):129-140.25831042
Ranexa (ranolazine) [prescribing information]. Palo Alto, CA: CV Therapeutics; November 2008.
Rapaflo (silodosin) [prescribing information]. Corona, CA: Watson Pharmaceuticals; September 2008.
Rapamune (sirolimus) [prescribing information]. Philadelphia, PA: Pfizer Inc.; April 2017.
Rashid J, McKinstry C, Renwick AG, Dirnhuber M, Waller DG, George CF. Quercetin, an in vitro inhibitor of CYP3A, does not contribute to the interaction between nifedipine and grapefruit juice. Br J Clin Pharmacol. 1993;36(5):460-463.12959295
Rashid TJ, Martin U, Clarke H, Waller DG, Renwick AG, George CF. Factors affecting the absolute bioavailability of nifedipine. Br J Clin Pharmacol. 1995;40(1):51-58.8527268
Raucoules-Aimé M, Kaidomar M, Levron JC, et al. Hepatic disposition of alfentanil and sufentanil in patients undergoing orthotopic liver transplantation. Anesth Analg. 1997;84(5):1019-1024.9141924
Relpax (eletriptan) [prescribing information]. New York, NY: Pfizer Inc; November 2013.
Reshef N, Hayari Y, Goren C, Boaz M, Madar Z, Knobler H. Antihypertensive effect of sweetie fruit in patients with stage I hypertension. Am J Hypertens. 2005;18(10):1360-1363.16202862
Resotran (prucalopride) [product monograph]. Toronto, Ontario, Canada: Janssen; December 2011.
Rexulti (brexpiprazole) [prescribing information]. Rockville, MD: Otsuka America Pharmaceuticals, Inc.; July 2015.
Romaszko E, Marzec-Wróblewska U, Badura A, Buciński A. Does consumption of red grapefruit juice alter naringenin concentrations in milk produced by breastfeeding mothers? PLoS One. 2017;12(10):e0185954.28982188
Rubins A, Gutmane R, Valdmane N, Stevenson P, Foster C, Undre N. Pharmacokinetics of 0.1% tacrolimus ointment after first and repeated application to adults with moderate to severe atopic dermatitis. J Invest Dermatol. 2005;125(1):68-71.15982304
Rupafin (rupatadine) [Brazil prescribing information]. Sao Paulo, Brazil: Biosintetica Farmaceutica Ltda.; June 2014.
Rupafin (rupatadine) [Singapore prescribing information]. Alcobendas, Madrid, Spain: Italfarmaco, S.A.; October 2015.
Rupatadine [UK summary of product characteristics]. Palau-solita i Plegamans, Spain: J. Uriach & Cia., S.A.; August 2016.
Russel RK, Richardson N, Wilson DC. Systemic absorption with complications during topical tacrolimus treatment for orofacial Crohn disease. J Pediatr Gastroenterol Nutr. 2001;32(2):207-208.11321395
Rydapt (midostaurin) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; April 2017.
Rythmol SR (propafenone) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; November 2011.
Saari TI, Laine K, Neuvonen M, et al. Effect of voriconazole and fluconazole on the pharmacokinetics of intravenous fentanyl. Eur J Clin Pharmacol. 2008;64(1):25-30.17987285
Samsca (tolvaptan) [prescribing information]. Tokyo, Japan: Otsuka Pharmaceutical; May 2009.
Sativex (tetrahydrocannabinol and cannabidiol oromucosal spray) [UK summary of product characteristics]. Wiltshire, UK: GW Pharma Ltd; February 2014.
Satoh H, Yamashita F, Tsujimoto M, et al. Citrus juices inhibit the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos. 2005;33(4):518-523.15640378
Schmiedlin-Ren P, Edwards DJ, Fitzsimmons ME, et al. Mechanisms of enhanced oral availability of CYP3A4 substrates by grapefruit constituents. Decreased enterocyte CYP3A4 concentration and mechanism-based inactivation by furanocoumarins. Drug Metab Dispos. 1997;25(11):1228-1233.9351897
Schubert W, Cullberg G, Edgar B, Hedner T. Inhibition of 17 beta-estradiolmetabolism by grapefruit juice in ovariectomized women. Maturitas. 1994;20(2-3):155-163.7715468
Seden K, Dickinson L, Khoo S, Back D. Grapefruit-drug interactions. Drugs. 2010;70(18):2373-2407.21142260
Seidegard J, Randvall G, Nyberg L, Borgå O. Grapefruit juice interaction with oral budesonide: equal effect on immediate-release and delayed-release formulations. Pharmazie. 2009;64(7):461-465.19694184
Selectol (celiprolol) [KR product information]. Available at: http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=200001290. Accessed July 13, 2017.
Serevent (salmeterol) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; March 2008.
Shang DW, Wang ZZ, Hu HT, et al. Effects of food and grapefruit juice on single-dose pharmacokinetics of blonanserin in healthy Chinese subjects. Eur J Clin Pharmacol. 2018;74(1):61-67.28975417
Sheu MT, Wu AB, Yeh GC, Hsia A, Ho HO. Development of a liquid chromatographic method for bioanalytical applications with sildenafil. J Chromatogr B Analyt Technol Biomed Life Sci. 2003;791(1-2):255-262.12798185
Shi JG, Chen X, Emm T, et al. The effect of CYP3A4 inhibition or induction on the pharmacokinetics and pharmacodynamics of orally administered ruxolitinib (INCB018424 Phosphate) in healthy volunteers. J Clin Pharmacol. 2012;52(6):809-818.21602517
Shin KH, Chung YJ, Kim BH, et al. Effect of ketoconazole on the pharmacokinetics of udenafil in healthy Korean subjects. Br J Clin Pharmacol. 2010;69(3):307-310.20233203
Shin KH, Kim BH, Kim TE, et al. The effects of ketoconazole and rifampicin on the pharmacokinetics of mirodenafil in healthy Korean male volunteers: an open-label, one-sequence, three-period, three-treatment crossover study. Clin Ther. 2009;31(12):3009-3020.20110038
Sigusch H, Henschel L, Kraul H, Merkel U, Hoffmann A. Lack of effect of grapefruit juice on diltiazem bioavailability in normal subjects. Pharmazie. 1994;49(9):675-679.7972311
Sigusch H, Hippius M, Henschel L, Kaufmann K, Hoffmann A. Influence of grapefruit juice on the pharmacokinetics of a slow release nifedipine formulation. Pharmazie. 1994;49(7):522-524.8073064
Simard C, Michaud V, Gibbs B, et al. Identification of the cytochrome P450 enzymes involved in the metabolism of domperidone. Xenobiotica. 2004;34(11-12):1013-1023.15801545
Simon T, Verstuyft C, Mary-Krause M, et al. Genetic determinants of response to clopidogrel and cardiovascular events. N Engl J Med. 2009;360(4):363-375.19106083
Sinofsky FE, Pasquale SA. The effect of fluconazole on circulating ethinylestradiol levels in women taking oral contraceptives. Am J Obstet Gynecol. 1998;178(2):300-304.9500490
Smith DA, Koch KM, Arya N, Bowen CJ, Herendeen JM, Beelen A. Effects of ketoconazole and carbamazepine on lapatinib pharmacokinetics in healthy subjects. Br J Clin Pharmacol. 2009;67(4):421-426.19371315
Soderberg Lofdal KC, Andersson ML, Gustafsson LL. Cytochrome p450-mediated changes in oxycodone pharmacokinetics/pharmacodynamics and their clinical implications. Drugs. 2013;73(6):533-543.23605691
Soons PA, Vogels BA, Roosemalen MC, et al. Grapefruit juice and cimetidine inhibit stereoselective metabolism of nitrendipine in humans. Clin Pharmacol Ther. 1991;50(4):394-403.1914375
Spencer EA, Key TJ, Appleby PN, et al. Prospective study of the association between grapefruit intake and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control. 2009;20(6):803-809.19224379
Sprycel (dasatinib) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb Company; November 2017.
Staudte H, Sigusch BW, Glockmann E. Grapefruit consumption improves vitamin C status in periodontitis patients. Br Dent J. 2005;199(4):213-217.16127404
Stendra (avanafil) [prescribing information]. Mountain View, CA: Vivus; August 2018.
Stivarga (regorafenib) [prescribing information]. Wayne, NJ: Bayer HealthCare Pharmaceuticals; September 2012.
Stott C, White L, Wright S, Wilbraham D, Guy G. A phase I, open-label, randomized, crossover study in three parallel groups to evaluate the effect of rifampicin, ketoconazole, and omeprazole on the pharmacokinetics of THC/CBD oromucosal spray in healthy volunteers. Springerplus. 2013;2(1):236.23750331
Sular (nisoldipine) [prescribing information]. Atlanta, GA: Sciele Pharma; January 2008.
Sun J. D-Limonene: safety and clinical applications. Altern Med Rev. 2007;12(3):259-264.18072821
Sunvepra (asunaprevir) [product monograph]. Montreal, Canada: Bristol-Myers Squibb Canada; March 2016.
Supect (radotinib) capsules [KR prescribing information]. http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=201200121. Accessed September 1, 2014.
Suri A, Forbes WP, Bramer SL. Effects of CYP3A inhibition on the metabolism of cilostazol. Clin Pharmacokinet. 1999;37(suppl 2):61-68.10702888
Sutent (sunitinib) [prescribing information]. New York, NY: Pfizer Inc; November 2015.
Symdeko (tezacaftor and ivacaftor) [prescribing information]. Boston, MA: Vertex Pharmaceuticals Inc; February 2018.
Symproic (naldemedine) [prescribing information]. Florham Park, NJ: Shionogi Inc; March 2017.
Takanaga H, Ohnishi A, Murakami H, et al. Relationship between time after intake of grapefruit juice and the effect on pharmacokinetics and pharmacodynamics of nisoldipine in healthy subjects. Clin Pharmacol Ther. 2000;67(3):201-214.10741622
Tanaka S, Uchida S, Miyakawa S, et al. Comparison of inhibitory duration of grapefruit juice on organic anion-transporting polypeptide and cytochrome P450 3A4. Biol Pharm Bull. 2013;36(12):1936-1941.24292052
Taniguchi K, Ohtani H, Ikemoto T, Miki A, Hori S, Sawada Y. Possible case of potentiation of the antiplatelet effect of cilostazol by grapefruit juice. J Clin Pharm Ther. 2007;32(5):457-459.17875111
Tapaninen T, Neuvonen PJ, Niemi M. Grapefruit juice greatly reduces the plasma concentrations of the OATP2B1 and CYP3A4 substrate aliskiren. Clin Pharmacol Ther. 2010;88(3):339-342.20664534
Tarceva (erlotinib) [prescribing information]. Northbrook, IL: OSI Pharmaceuticals, LLC; April 2014.
Tassaneeyakul W, Guo LQ, Fukuda K, Ohta T, Yamazoe Y. Inhibition selectivity of grapefruit juice components on human cytochromes P450. Arch Biochem Biophys. 2000;378(2):356-363.10860553
Tekturna (aliskiren) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals; August 2010.
Terbinafine [prescribing information]. Peachtree City, GA: Exelan Pharmaceuticals Inc; April 2012.
Teshima D, Ikesue H, Itoh Y, Urabe K, Furue M, Oishi R. Increased topical tacrolimus absorption in generalized leukemic erythroderma. Ann Pharmacother. 2003;37(10):1444-1447.14519034
Tibsovo (ivosidenib) [prescribing information]. Cambridge, MA: Agios Pharmaceuticals Inc; July 2018.
Tikosyn (dofetilide) [prescribing information]. New York, NY: Pfizer Inc, February 2011.
Torisel (temsirolimus) [prescribing information]. Philadelphia, PA: Pfizer Inc., July 2016.
Trinchieri A, Lizzano R, Bernardini P, et al. Effect of acute load of grapefruit juice on urinary excretion of citrate and urinary risk factors for renal stone formation. Dig Liver Dis. 2002;34(suppl 2):S160-S163.12408462
Troost J, Tatami S, Tsuda Y, et al. Effects of strong CYP2D6 and 3A4 inhibitors, paroxetine and ketoconazole, on the pharmacokinetics and cardiovascular safety of tamsulosin. Br J Clin Pharmacol. 2011;72(2):247-256.21496064
Tsuji H, Ohmura K, Nakashima R, et al. Efficacy and safety of grapefruit juice intake accompanying tacrolimus treatment in connective tissue disease patients. Intern Med. 2016;55(12):1547-1552.27301503
Tykerb (lapatinib) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; August 2011.
Uceris (budesonide) extended release tablets [prescribing information]. San Diego, CA: Santarus Inc; January 2013.
Uceris (budesonide) rectal foam [prescribing information]. Raleigh, NC: Salix Pharmaceuticals Inc; October 2014.
Udenafil 100/200 mg tablets [KR prescribing information]. http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=20050025. Accessed September 22, 2014.
Ueda N, Yoshimura R, Umene-Nakano W, Kornhauser DM, Frevert EU, Boulton DW. Grapefruit juice alters plasma sertraline levels after single ingestion of sertraline in healthy volunteers. World J Biol Psychiatry. 2009;10(4, pt 3):832-835.19172438
Uesawa Y, Mohri K. Relationship between lipophilicities of 1,4-dihydropyridine derivatives and pharmacokinetic interaction strengths with grapefruit juice. Yakugaku Zasshi. 2008;128(1):117-22.18176062
Undre NA, Moloney FJ, Ahmadi S, Stevenson P, Murphy GM. Skin and systemic pharmacokinetics of tacrolimus following topical application of tacrolimus ointment in adults with moderate to severe atopic dermatitis. Br J Dermatol. 2009;160(3):665-669.19076975
Uno T, Ohkubo T, Motomura S, Sugawara K. Effect of grapefruit juice on the disposition of manidipine enantiomers in healthy subjects. Br J Clin Pharmacol. 2006;61(5):533-537.16669846
Vaidyanathan S, Camenisch G, Schuetz H, et al. Pharmacokinetics of the oral direct renin inhibitor aliskiren in combination with digoxin, atorvastatin, and ketoconazole in healthy subjects: the role of p-glycoprotein in the disposition of aliskiren. J Clin Pharmacol. 2008;48(11):1323-1338.18784280
Valenzuela B, Rebollo J, Pérez T, Brugarolas A, Pérez-Ruixo JJ. Effect of grapefruit juice on the pharmacokinetics of docetaxel in cancer patients: a case report. Br J Clin Pharmacol. 2011;72(6):978-981.21692829
van Agtmael MA, Gupta V, van der Graaf CA, et al. The effect of grapefruit juice on the time-dependent decline of artemether plasma levels in healthy subjects. Clin Pharmacol Ther. 1999;66(4):408-414.10546925
van Agtmael MA, Gupta V, van der Wosten TH, et al. Grapefruit juice increases the bioavailability of artemether. Eur J Clin Pharmacol. 1999;55(5):405-410.10456492
van Breemen RB, Pajkovic N. Multitargeted therapy of cancer by lycopene. Cancer Lett. 2008;269(2):339-351.18585855
van Erp NP, Baker SD, Zandvliet AS, et al. Marginal increase of sunitinib exposure by grapefruit juice. Cancer Chemother Pharmacol. 2011;67(3):695-703.20512335
Vaxar (lacidipine) [KR prescribing information]. http://drug.mfds.go.kr/html/bxsSearchDrugProduct.jsp?item_Seq=200511002. Accessed August 19, 2014.
Venclexta (venetoclax) [prescribing information]. North Chicago, IL: AbbVie Inc; April 2016.
Verzenio (abemaciclib) [prescribing information]. Indianapolis, IN: Lilly USA LLC; August 2018.
Viekira Pak (ombitasvir, paritaprevir, and ritonavir tablets; dasabuvir tablets) [prescribing information]. North Chicago, IL: AbbVie Inc.; June 2016.
Viibryd (vilazodone) [prescribing information]. New Haven, CT: Trovis Pharmaceuticals; January 2011.
Vincent J, Harris SI, Foulds G, et al. Lack of effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of amlodipine. Br J Clin Pharmacol. 2000;50(5):455-463.11069440
Votrient (pazopanib) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; October 2009.
Walker DK, Alabaster CT, Congrave GS, et al. Significance of Metabolism in the Disposition and Action of the Antidysrhythmic Drug, Dofetilide. In Vitro Studies and Correlation With In Vivo Data. Drug Metab Dispos, 1996;24(4):447-455.8801060
Walsh SL, Heilig M, Nuzzo PA, Henderson P, Lofwall MR. Effects of the NK1 antagonist, aprepitant, on response to oral and intranasal oxycodone in prescription opioid abusers. Addict Biol. 2013;18(2):332-343.22260216
Ward BA, Morocho A, Kandil A, et al. Characterization of human cytochrome P450 enzymes catalyzing domperidone N-dealkylation and hydroxylation in vitro. Br J Clin Pharmacol. 2004;58(3):277-287.15327587
Wason S, DiGiancinto JL, Davis MW. Effects of grapefruit juice and Seville orange juice on the pharmacokinetic properties of colchicine in healthy subjects. Clin Ther. 2012;34(10):2161-2173.22940371
Watanabe K, Yamaori S, Funahashi T, Kimura T, Yamamoto I. Cytochrome P450 enzymes involved in the metabolism of tetrahydrocannabinols and cannabinol by human hepatic microsomes. Life Sci. 2007;80(15):1415-1419.17303175
Weber A, Jager R, Borner A, et al. Can grapefruit juice influence ethinylestradiol bioavailability? Contraception. 1996;53(1):41-47.8631189
Xalkori (crizotinib) [prescribing information]. New York, NY: Pfizer; August 2011.
Xarelto (rivaroxaban) [product monograph]. Toronto, Canada: Bayer; September 2008.
Yaz (drospirenone/ethinyl estradiol) [prescribing information]. Whippany, NJ: Bayer HealthCare; August 2017.
Yee GC, Stanley DL, Ruiz J, et al. Effect of grapefruit juice on oral cyclosporine pharmacokinetics. Pharmacotherapy. 1994;14:377.
Yee GC, Stanley DL, Pessa LJ, et al. Effect of grapefruit juice on blood cyclosporine concentration. Lancet. 1995;345(8955):955-956.7715295
Yee GC, Adams VR, Pessa L, et al. Comparison on one versus two doses of grapefruit juice on oral cyclosporine pharmacokinetics. Pharmacotherapy. 1997;17:1112.
Yoshizato T, Kotegawa T, Imai H, et al. Itraconazole and domperidone: a placebo-controlled drug interaction study. Eur J Clin Pharmacol. 2012;68(9):1287-1294.22418831
Zaidenstein R, Dishi V, Gips M, et al. The effect of grapefruit juice on the pharmacokinetics of orally administered verapamil. Eur J Clin Pharmacol. 1998;54(4):337-340.9696960
Zhang H, Cui D, Wang B, et al. Pharmacokinetic drug interactions involving 17alpha-ethinylestradiol: a new look at an old drug. Clin Pharmacokinet. 2007;46(2):133-157.17253885
Zitron E, Scholz E, Owen RW, et al. QTc prolongation by grapefruit juice and its potential pharmacological basis: HERG channel blockade by flavonoids. Circulation. 2005;111(7):835-838.15710766
Zocor (simvastatin) [prescribing information]. Whitehouse Station, NJ: Merck and Co; February 2015.
Zohydro ER (hydrocodone bitartrate) [prescribing information]. San Diego, CA: Zogenix Inc; August 2014.
Zortress (everolimus) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals; March 2010.
Zykadia (ceritinib) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; April 2014.

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