What is the chemical in Grapefruit keeps AED's from working?

[forward2007]

Does anyone know the actual chemical in Grapefruit that keeps anti-epileptic drug's (or at least Tegretol) from working? If I remember this right grapefruit speeds up the metabolism of the Tegretol so you end up having less of the medication in your system than you think you do. I can't remember if Grapefruit affects other anti-epileptic drug's or not. The reason I am asking is some of the vitamin C products on the market have Bioflavonoids that come from Grapefruit. But Oranges, Lemons, Limes, and Tangerines also have Bioflavonoids and the Dr's/Pharmacists never say don't eat Oranges, Lemons, Limes, or Tangerines with Tegretol.

[alivenwell]

Does anyone know the actual chemical in Grapefruit that keeps AED's (or at least Tegretol) from working? If I remember this right grapefruit speeds up the metabolism of the Tegretol so you end up having less of the medication in your system than you think you do. I can't remember if Grapefruit affects other AED's or not. The reason I am asking is some of the vitamin C products on the market have Bioflavonoids that come from Grapefruit. But Oranges, Lemons, Limes, and Tangerines also have Bioflavonoids and the Dr's/Pharmacists never say don't eat Oranges, Lemons, Limes, or Tangerines with Tegretol.

Check out....

Vitamins and seizures


I think it mentions grapefruit.

[forward2007]

Nevermind, I was wrong. Here's some info-

http://bipolar.about.com/od/medicati...rapefruitj.htm

http://www.mayoclinic.com/health/foo...rition/AN00413

[forward2007]

Just a heads up-one of those articles says EVEN THE BIOFLAVONOIDS WILL INTERACT WITH MEDICATIONS.

[BuckeyeFan]

I have seen dilantin listed as inter-acting with grapefruit.

[brain]

Grapefruit can't be eaten, drunk (straight up)
or mixed with other juices with a lot of medications,
not just with anti-epileptic drugs!

It's not just the enzymes, but also the acidity
content is also high - and worse, those who are
on blood thinners, who have had surgeries, who
are in danger of bleeding - must shun Grapefruit
as if it were the most toxic fruit on earth!

Grapefruit is both a blessing and a curse!

[RobinN]

Gads I wish I was on medication... I HATE grapefruit!

(just joking folks... about the medication, not the grapefruit.... YUCK)

[TexasTravel]

Grapefruit has never really bothered me until Sunday.

I took a nap after eating a lunch with some grapefruit in it. I had strange seizure by my standards. Most of my seizures are during sleep. It wakes me up, I panic thinking it is 10 years ago and that I should be at work. But, after 15 minutes or so, I recover for the most part and know where I am and when it is. The only thing remaining is a feeling of drained energy like after crying hard, if you know what I mean.

Sunday's seizure also occured in my sleep. I did come around with 1 hour or so, enough to know where I am and when it is but there is still a strange feeling left.

To this minute, I still feel like I am walking on another planet. Like I am here but not really. I cannot sleep and have not slept more than 1.5 hours in the past 36 or so.

I rarely have seizures like this so it is very strange to me.

All as the result of eating 1/2 of a grapefruit.

[spinnymommy]

I have always loved grapefruit, but didn't eat it very often because the rest of my family doesn't like it. It was no big deal to go without it.

Until I was told I can't have it anymore! Now I crave it. Oh well. As long as I can still eat chocolate.

[Bernard]

Another good reference for you forward2007:

The characteristics of medications that interact with grapefruit are well defined. The most significant of these characteristics is metabolism by the intestinal cytochrome P450 3A4 (CYP 3A4) system. CYP 3A4 is found in the liver and intestinal tract. Intestinal CYP 3A4 concentration can be decreased by 47 percent within four hours of grapefruit consumption.4 One study5 has shown that the interaction persists for up to 72 hours; therefore, it would be prudent to avoid grapefruit products for 72 hours before taking a medication with which they may interact.

Another study6 reported that consuming 8 oz of grapefruit juice can inhibit intestinal CYP 3A4 concentration for 24 to 72 hours. Therefore, separating the times of medication administration and grapefruit consumption is not a plausible solution.5,6 It is important to note that because of genetic polymorphism, persons have varying amounts of intestinal CYP 3A4; consequently, the extent of an interaction is not predictable from patient to patient.7,8

The substance or substances in grapefruit that inhibit intestinal CYP 3A4 have not been identified. In addition, grapefruit may decrease the intestinal transport of drugs into the circulation.7 Because intestinal CYP 3A4 is affected, the interaction will only occur with oral formulations. Studies of the intravenous form of drugs that are substrates of hepatic CYP 3A4 and have the potential to interact with grapefruit failed to demonstrate any effect on plasma concentration.

Management of Grapefruit-Drug Interactions

[montse]

I love grapefruit, my father in law cultivates it (they make wine) and I can say I have eaten a lot of it, I never had noticed a relation.

[alivenwell]

I love grapefruit, my father in law cultivates it (they make wine) and I can say I have eaten a lot of it, I never had noticed a relation.

I also love and eat grapefruit. I never noticed adverse side effects from it. I do eat a lot of oranges because they're less pungent in flavor.

Does this possibly have to do with sugar content of grapefruit? Some people eat grapefuit with sugar sprinkled on the top. I like it straight. Or, does it matter if the grapefruit is pink?

This makes me wonder if the fruit is sprayed or treated with a pesticide. I always wash fruit or buy organic stuff.

Guess I'll look at healthy dark chocolate. There have to be other acidic foods like this that have the same effect.

My personal favorite is an orange anytime.

[brain]

I also love and eat grapefruit.

Does this possibly have to do with sugar content of grapefruit? Some people eat grapefuit with sugar sprinkled on the top. I like it straight. Or, does it matter if the grapefruit is pink?

Pink Seedless is a HYBRID.

I do use sugar, however, I also had tried to dilute
it with water, but it effected the anti-epileptic drugs.
However, I do not use a lot of sugar, about less
than 1/4th cup per 1 gallon if it's all 100% pure
(straight up) pink seedless grapefruit juice, but if
it's been diluted, I use far less.

Was informed that I could have 4 oz of it, but that
was like teasing me with it. I'm a rabid grapefruit
lover, and my mom has a pink seedless tree in her
yard, so it was a very difficult thing here.

So we've canned it altogether this year to see if
it makes any difference and so far it doesn't
appear to have made any differences, which I
will be going over with this with my Doctors later
on because we really miss our Grapefruit Juice!

[Bernard]

Here's a twist:

... At the University of Chicago, scientists are studying grapefruit juice in combination with an experimental anticancer compound, hoping to boost the drug's weak effects. In Florida, Bioavailability Systems LLC, a small biotechnology company, claims to have purified the grapefruit compounds responsible for the boosting effect and has been able to improve the blood levels of an anti-HIV drug. "This is definitely a lemons to lemonade story," says James Harris, founder and chief scientific officer of the company.

The approach aims to tackle a major problem for drug manufacturers: the great degree of variation in how people absorb drugs. Partly to blame is the fact that individuals have different levels of an enzyme in the intestines and liver, called CYP3A4, that breaks down drugs before they even have the chance to get into the bloodstream. People with very active CYP3A4 get lower amounts of drugs into their systems than those with low levels of the enzyme.

But powerful compounds in the grapefruit called furanocoumarins obliterate CYP3A4 in the gut. The result: More drug gets into the bloodstream. For some anticholesterol statins, for example, taking one tablet with a glass of grapefruit juice "is like taking at least 10 tablets with a glass of water," says David Bailey, a pharmacologist at the University of Western Ontario who discovered the grapefruit effect in the early 1990s. It's why some major blockbusters, like the statin Mevacor or the anticancer drug Gleevec, contain warnings against taking these drugs with grapefruit juice.

But for certain drugs that have a hard time reaching optimal blood levels at prescribed doses, some doctors are interested in intentionally boosting the effects with grapefruit. Generally, the idea would be to give a booster to all patients who are taking a weak drug. While some patients may have naturally low levels of the CYP3A4 enzyme and thus wouldn't need it, there's no practical way to test individuals right now, so researchers are using a blanket approach. As long as a drug does not have what is known as a "narrow therapeutic window" -- meaning that a relatively small increase in dose makes it toxic -- boosting shouldn't necessarily lead to large increases in side effects, the theory goes. ...

Grapefruit Effect On Drug Levels Has Sweeter Side

[spinnymommy]

It sure would be nice if a way were found to reliably use the grapefruit juice to reduce the amount of med needed. It wouldn't put less med in my body I don't think, but it sure would be cheaper. And I could drink grapefruit juice again !!!!

[jgbmartin]

Thank God for this board...I learn something new everyday.
It seems like there is information all over the internet...but this is the only place to really find out all the different triggers, remedies, etc.

[Torak]

Gads I wish I was on medication... I HATE grapefruit!

(just joking folks... about the medication, not the grapefruit.... YUCK)

I love grapefruit. Don't eat it much though.

Strangely... my dog loves grapefruit too. Any citrus fruit. Grapefruit, oranges, clementines, satsumas... my dog adores them.

It's funny, because if she's asleep and I start eating a satsuma i'll save some pieces for her (5 or 6) and she'll suddenly wake up and the nose will start going like mad and she'll look around like mad with an expression of panic on her face, thinking that she's missed the goodies.

If she's awake when you start, well... she'll never leave you alone, stuck to you like glue.

Strange because I've never heard of a dog with a mad fetish for citrus fruit before.

[haird18]

I have heard some some info over lemons and limes,and certain organges too. I have adifference in eating other fruits and vegetables.
David

[Dutch mom]

This one is about food and drugs interactions, mentioned is grapefruit, diary, fatty foods, fibers and more.
http://www.uspharmacist.com/econnect...ent/8_1983.htm

[RobinN]

Obviously the less drugs the better the body has to function properly.
I do believe that was the intent when it was designed.