Recently, it is a good season to eat grapefruit, and after tea and dinner, many people love to peel one and eat it. But the "naughty" grapefruit frequently causes accidents... Who did Yuzu mess with?
Case:
Ms. Lin, who has suffered from high blood pressure for many years, has been taking medication on time, paying attention to diet, and her blood pressure is well controlled. But a few days ago, Ms. Lin suddenly appeared dizzy, nervous, tired, almost fainted, but fortunately was sent to the hospital by her family in time. After the doctor learned of Ms. Lin's medication history and diet, he judged that the culprit who caused the sudden drop in blood pressure was Yuzu.
What is "wrong" with Yuzu?
The main research on the effect of grapefruit on drugs is focused on "grapefruit". Whether the grapefruit we commonly eat has an impact on the effect of the drug and how much it affects it, there is no sufficient research data.
When it comes to the effects of grapefruit on drugs, felodipine can be said to be indispensable.
It was first found that grapefruit or grapefruit juice can have an effect on the blood concentration of the drug, which is due to the fact that patients drink grapefruit juice after taking the conventional dose of felodipine, and the drug is overdose, resulting in excessive blood pressure.
The antihypertensive changes brought about by grapefruit juice
Why does grapefruit affect the antihypertensive effect of felodipine?
This is mainly because grapefruit contains a substance called "furancoumarin", which has a certain inhibitory effect on the liver's drug metabolism enzyme CYP3A4 enzyme.
Non-loredipine is a drug metabolized by the liver CYP3A4 enzyme, so drugs or substances that inhibit or induce the CYP3A4 enzyme will affect the blood concentration of nonlodipine, thereby affecting the effect of the drug.
Relevant research data show that during the period of taking felodipine extended-release tablets, eating grapefruit or drinking grapefruit juice will increase the blood concentration of felodipine by about 2 times.
What are the medications affected by grapefruit
1XX horizon
Nifedipine, amlodipine, felodipine, lasidipine, nicardipine.
2XX lol
Propranolol, metoprolol tartrate.
3 statin lipid-lowering drugs
The most serious adverse effect of statin lipid-lowering drugs is muscle toxicity. High concentrations of statins can easily cause myalgia, myositis and rhabdomyolysis.
Studies have shown that drinking 1 cup of grapefruit juice while taking lipid-lowering drugs (simvastatins) increases the blood concentration by 260%.
4 Amiodarone in antiarrhythmic drugs
Studies have shown that drinking 300mL of grapefruit juice while taking amiodarone increased blood concentrations by 84% compared to people who did not drink grapefruit juice.
Although only a few anti-arrhythmic drugs are affected by grapefruit juice, once affected, the consequences can be severe.
5 Drugs with cardiotoxicity
The gastrointestinal motility drug cisapride and the antihistamine astemizole can cause prolongation of the QT interval, torsades de pointes, and fatal arrhythmias. When combined with grapefruit juice, the blood concentration of cisapride and astemizole increases significantly.
6 other
Losartan, eplerenone.
Application of CYP3A4 enzyme
The furancoumarin in grapefruit inhibits the activity of the CYP3A4 enzyme in the liver. However, this enzyme is involved in the metabolism of nearly half of the drugs used today.
This includes sleeping pills and anti-cancer drugs used by some special patients, as well as antibiotics, painkillers and contraceptives that many people often eat.
Different drugs are affected differently. But overall, furfuran coumarin can make drugs enter the bloodstream in 2 to 10 times as much.
Tips
➤ Do not eat at the same time: taking medicine and eating grapefruit at the same time is equivalent to invisibly increasing the dose of the drug. Increasing the dose of antihypertensive drugs can easily cause hypotension, which is very dangerous, ranging from dizziness and fatigue to shock.
➤ Do a good job of blood pressure monitoring: Patients who take antihypertensive drugs for a long time should usually do a good job of monitoring blood pressure and adjust the appropriate antihypertensive drugs according to changes in blood pressure. To know blood pressure, reduce blood pressure to meet the standard.
Source: Zhejiang Provincial People's Hospital