Kate Dubinski, QMI Agency
|(QMI Agency files) |
Grapefruit can kill.
The same London science team that 20 years ago released groundbreaking research showing grapefruit can cause some drugs to have fatal side effects now says its warnings aren't being heeded.
The number of prescriptions that can have serious side effects because of grapefruit or grapefruit juice has jumped from 17 in 2008 to 44 this year, said Dr. David Bailey, a scientist who studies drug interactions at London's Lawson Health Research Institute.
"This is a safety concern. We know the science of it but we want to make sure it's applied more to protect the guy on the street," Bailey said. "What is really striking is the number of drugs we develop that have these serious side effects."
The drugs that interact badly with grapefruit -- it basically causes patients to overdose on low doses -- are commonly used in cancer treatment, cardiovascular disease, psychiatry and gastrointestinal diseases.
"There are 27 more drugs than there were in 2008, and 13 of those 27 have the potential to cause sudden death," Bailey said.
Bailey and his team published a primer for doctors in the Canadian Medical Association Journal that gets distributed to all physicians in Canada.
"There's such a greater need for health-care professionals -- doctors and pharmacists and other people on the health-care team -- to understand the grapefruit juice-drug interaction," Bailey said. "We have to get serious about it."
People over 45 are most likely to eat grapefruit or to drink grapefruit juice. They're also more likely to use some of the drugs that have bad interactions with grapefruit.
In total, there are more than 85 drugs that interact with grapefruit, but 44 of those can cause serious problems.
The drugs that interact with grapefruit have three distinct characteristics -- they're taken orally, they have a very low-to-intermediate bioavailability and they are metabolized by one specific enzyme in the gut.
For drugs with very low bioavailability -- meaning only a small portion of it is absorbed in the blood stream -- eating a grapefruit hours before taking the medication can be the same as taking multiple doses of the drug.
Drugs that can interact badly with grapefruit include cholesterol-lowering statin drugs such as Zocor or Lipitor, blood pressure-lowering drugs such as Nifediac and Afeditab, certain organ transplant rejection drugs and some antibiotics.
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