Eplerenone works similarly to losartan, but its levels are increased when taken with grapefruit. Losartan (Cozaar) is affected by grapefruit juice leading to reduced effects, no longer able to limit the ability to control blood pressure. This leads to a rapid drop in blood pressure, which can be dangerous if left unattended. One study found that nifedipine blood levels were significantly increased when drinking about 2 cups (500ml) of grapefruit juice. The last 2 drugs on this list work by decreasing the action of a hormone called angiotensin 2, which naturally raises blood pressure. They work by changing the way blood vessels use calcium, dilating them and lowering blood pressure. The first 2 drugs on this list are called calcium channel blockers. Some blood pressure drugs Most blood pressure drugs are not affected by grapefruit juice except for the following 4 drugs: Felodipine The drug Nifedipine (Procardia) The drug Losartan (Cozaar) Eplerenone (Inspra). Alternatives to some cholesterol medications that interact with grapefruit include: pravastatin (Pravachol), rosuvastatin (Crestor) and fluvastatin (Lescol). ![]() One study found that drinking a glass of grapefruit juice with simvastatin or lovastatin increased blood statin levels by 260%. Grapefruit juice significantly increased levels of 3 common statins that cause rhabdomyolysis: Atorvastatin (Lipitor) Lovastatin (Mevacor) Simvastatin (Zocor). Leads to muscle weakness, pain, and sometimes kidney damage. Statins can cause rhabdomyolysis and breakdown of muscle tissue. Helps to improve blood lipoprotein levels and reduce heart disease mortality in patients at risk for hyperlipidemia. Certain cholesterol medications (commonly known as statins) Statins work by limiting the natural production of cholesterol. Here are the causes of those interactions:ģ.1. So grapefruit juice can affect people differently even if they take the same medicine. Some people have a lot of enzymes and others only a little. The amount of CYP3A4 enzyme in the gut varies from person to person, says Dr. The result is making too much of the drug in your body. Grapefruit juice contains chemicals called furanocoumarins that block the action of CYP3A4, so instead of being metabolized, more of the drug enters the bloodstream and stays in the body longer. The cause of such interactions is that the drug is normally metabolized in the liver and small intestine by a group of specialized proteins called cytochromes (CYP3A4). ), which causes less of the drug to enter the bloodstream and the medicine may not work as well. These proteins help move a drug into our cells for absorption. Instead of changing metabolism, grapefruit juice can affect proteins in the body (also known as drug transporters. ) enters the bloodstream less, reducing the effectiveness of the drug. According to Shiew Mei Huang, PhD, US Food and Drug Administration, grapefruit juice can increase levels of the active ingredient fexofenadine (for example, Allegra is commonly used to relieve symptoms of seasonal allergies. Although grapefruit and grapefruit juice are part of a healthy diet, many patients who love this fruit have expressed concerns about their potential to interact with medications they are taking.
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