Image: Bing Fang | Written by: Six floors | Editor-in-Charge: Ke Xin
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Didn't I show you how to peel grapefruit before? Later, many people asked me some health questions related to grapefruit, and the most asked question was the interaction between grapefruit and short-acting contraceptives.
So today we will take out this private letter to discuss it with you.
▲Image source: Reader's private message
Do oranges, oranges, and grapefruit have a big impact on short-acting contraceptives? Let's move on.
Effect of grapefruit on short-acting contraceptives
First of all, this statement does exist, and I have repeatedly reminded everyone before that before taking medication, at least look at the instructions.
Although some drug instructions are very long, even if you read them, you may not be able to read them all, and there are many unfamiliar words that create dyslexia, but we do need to establish such habits, otherwise a lot of important information will be ignored.
If you have a short-acting contraceptive pill on hand, you can open it.
▲Cut from the instructions of a brand of short-acting contraceptives
Taking a common one on the market as an example, you can see in the "Drug Interactions" column that grapefruit juice is included in drugs and substances that may reduce the clearance of combined oral short-acting contraceptives.
The grapefruit here is the grapefruit, a variety formed by the hybridization of sweet oranges with grapefruit.
Then you may be wondering, why do fruits interact with drugs?
This is back to more than a decade ago, Researchers in Canada found that grapefruit contains an ingredient that may affect drug metabolism, and later found that there are as many as 70 or 80 kinds of drugs involved, including short-acting contraceptives, as well as drugs for the treatment of hypertension, and antibiotics.
Therefore, those who are using these drugs must look at the instructions.
▲ Image source: Giphy
Next, let's talk about this ingredient in grapefruit that affects drug metabolism.
This ingredient is called furancoumarin, and its main effect is to interfere with the action of cytochrome P450, thereby inhibiting enzymes involved in the metabolism of certain drugs, such as CYP3A4. Of course, we don't have exams here, so we don't have to memorize them. Just take a rough look.
In short, when this enzyme is inhibited, it will affect drug metabolism, resulting in the drug content in the serum being affected.
Also take the short-acting contraceptive pill, this ingredient is mainly to reduce the clearance of the drug, the drug that should have been metabolized in one day, due to eating grapefruit, the clearance rate is reduced, the drug component stays in the blood for a longer time, which may occur unexpected bleeding, or significant fluctuations in hormone levels, thus affecting the effect of the drug.
On the contrary, if the clearance rate is accelerated, then it is quickly metabolized, it is possible to reduce the efficacy of the drug, and it is even possible that the drug will fail or fail faster, shorten the time of action of the drug and so on.
Therefore, it has been clearly recommended on the instructions, if you take medicine for contraception, and eat grapefruit during medication, then during the medication and within 28 days after stopping the drug, you should add a barrier contraceptive method, that is, the use of condoms.
If you eat grapefruit occasionally, how long does it take to take the medicine? From the current research, the recommendation for comparative insurance is at least 72 hours apart.
Other citrus and grapefruit fruits
Does it have an effect on short-acting contraceptives?
Speaking of which, I'm sure you'll also be curious, how do you distinguish between grapefruit and other grapefruit? After all, if you can clearly distinguish grapefruit, you can avoid this risk.
In order to answer this question, I consulted the fruit hunter Yang Xiaoyang.
This question does not matter, exposing my knowledge shortcomings, because in fact, if purely from the perspective of whether it contains furancoumarin, there is actually no need to distinguish between grapefruit and grapefruit, because these fruits contain furancoumarin.
So the question that followed me came again, why write a grapefruit juice alone and not the other grapefruit?
The answer given by Teacher Yang is similar to the answer I guessed myself, because the data used in this drug research is mainly foreign data, and in foreign countries, grapefruit is relatively more, so there is no mention of other grapefruit in the drug instructions, but in fact, it is definitely not only grapefruit that needs to be avoided.
So how much needs to be avoided, the old six must be found out by everyone!
So I immediately found a map on the nature, recording a rough family situation of citrus and grapefruit.
▲Image source: Nature
So the lower right corner of this, is the grapefruit we mentioned earlier, but from the research data, containing furan coumarin, in addition to grapefruit, there are several other grapefruit species, also need to avoid, and these may exist in our daily diet or drink.
I continued to communicate and learn from Teacher Yang, and finally found the answer that was basically close to the truth in a study (the following picture was provided by Teacher Yang):
▲Image source: @ Fruit Hunter Yang Xiaoyang
Through such research and analysis, we can roughly understand that the oranges, oranges, and lemons we usually eat can be eaten normally, and there is no need to worry too much, in the words of Teacher Yang, it belongs to the good people.
Other limes, grapefruit, arrow leaf oranges, grapefruit and lime, these 5 categories are not recommended.
Overall, foods to be aware of include fresh grapefruit and products, grapefruit and products, Thai tom yum soup, limes, and lemon tea and milk tea containing limes.
At this point, we have to say that the current short-acting contraceptive pill instructions on the market may need to be revised, and it may not be enough to write a grapefruit juice, which is also irresponsible for drug users. In particular, there are many types of drugs involved, some of which may be at higher risk.
Therefore, it is hoped that the enterprises that produce those drugs can update the instructions in time to expand the scope of diets that need attention.
In short, thank you for your questions, but also thank you for Mr. Yang's help, which not only let us figure out this matter, but also help pharmaceutical companies to improve and optimize their drug instructions to ensure the safe use of drugs for more people.
From this point of view, perhaps we help more people, which is probably the meaning of science popularization.
Well, this issue of the content is here, if you feel that there is something to gain, remember to like, this is not only conducive to the spread of popular science content, but also the greatest encouragement to us.
I love the world.