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One whole grapefruit, or a small glass (200 mL, 6.8 US fl oz) of grapefruit juice, can cause drug overdose toxicity. [1] Fruit consumed three days before the medicine can still have an effect. [ 5 ] The relative risks of different types of citrus fruit have not been systematically studied. [ 1 ]
In pharmaceutical sciences, drug interactions occur when a drug's mechanism of action is affected by the concomitant administration of substances such as foods, beverages, or other drugs. A popular example of drug–food interaction is the effect of grapefruit on the metabolism of drugs.
Still, says Peterson, "most people won't have issues unless they eat large quantities of grapefruit, drink more than one liter per day of grapefruit juice, or consistently eat or drink grapefruit.
Aliskiren is a minor inhibitor of substrate CYP3A4 and, more importantly, P-glycoprotein: It reduces furosemide blood concentration. Atorvastatin may increase aliskiren's blood concentration, but no dose adjustment is needed. Due to possible interaction with ciclosporin, the use of ciclosporin and aliskiren at the same time is contraindicated.
Grapefruit–drug interactions are common, as the juice contains furanocoumarins that interfere with the metabolism of many drugs. This can prolong and intensify the effects of those drugs, leading to multiple side-effects such as abnormal heart rhythms, bleeding inside the stomach, low blood pressure, difficulty breathing, and dizziness.
"FDA Drug Safety Communication: New Warning and Contraindication for blood pressure medicines containing aliskiren (Tekturna)". U.S. Food and Drug Administration (FDA) . 29 June 2021. v
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Grapefruit and grapefruit juice have been found to interact with numerous drugs, in many cases resulting in adverse effects. [4] This happens in two ways: one is that grapefruit can block an enzyme which metabolizes medication, [5] and if the drug is not metabolized, then the level of the drug in the blood can become too high, leading to an adverse effect. [5]