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Grape Fruit PDF
Grape Fruit PDF
Grape Fruit PDF
1, January/February 2007
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of the large variety of possible drugdrug and fooddrug interactions that are documented to occur with warfarin. (This topic is to be addressed in a future contribution to this Journal.) With the vast array of prescription and over-the-counter medications many of them with low therapeutic indices available to the consumer, but also foodstuffs, herbs, dietary and nutritional supplements, as well as abusive substances such as tobacco and alcohol, the possibility of unwanted interactions should be considered.11 Since altered drug response due to interactions is often widely variable among individuals, the outcome is difficult to predict and avoiding the known interacting combinations will help prevent adverse repercussions. The history taking from every patient should therefore include a careful enquiry into possible sources of drug interactions, and the provision of appropriate advice.
JOHN L STRAUGHAN, BSc (Pharm), MB ChB, BSc (Hons) (Pharm), Dip Clin Pharm (USA), FPS, MFPM (RCP)
References
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Drug Saf 2005; 28: 677694. 2. 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: 11511160. 3. Sica DA. Interaction of grapefruit Juice and calcium channel blockers. Am J Hypertens 2006; 19: 768773. 4. Paine MF, Widmer WW, Hart HL, et al. A furanocoumarin-free grapefruit juice establishes furanocoumarins as the mediators of the grapefruit juicefelodipine interaction. Am J Clin Nutr 2006; 83: 10972105. 5. Martin J, Krum H. Fooddrug interaction: grapefruit juice augments drug bioavailability: mechanism, extent and relevance. Eur J Clin Nutr 2004; 58, 19. 6. Bailey DG, Dresser GK. Interactions between grapefruit juice and cardiovascular drugs. Am J Cardiovase Drugs 2004; 4: 281297. 7. Goho C. Oral midazolam-grapefruit juice drug interaction. Pediatr Dent 2001; 23: 365366. 8. Ozdemir M, Aktan Y, Boydag BS, et al. Interaction between grapefruit juice and diazepam in humans. Eur J Drug Metab Pharmacokinet 1998; 23: 5559. 9. Lilja JJ, Raaska K, Neuvonen PJ. Effects of grapefruit juice on the pharmacokinetics of acebutolol. Br J Clin Pharmacol 2005; 60: 659663. 10. Sullivan DM, Ford MA, Boyden TW. Grapefruit juice and the response to warfarin. Am J Health Syst Pharm 1998; 53: 15811583. 11. Mertens-Talcott SU, Zadezensky I, De CastroWV , et al. Grapefruit drug interactions: can interactions with drugs be avoided? J Clin Pharmacol 2006; 46: 13901416.