![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by FrequentFryer on January 16, 2008, at 2:32:07
Hi.
I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.Anyone know what kind of reaction Grapefruit juice and an MAOI would have?
Good, Bad, Ugly?
Posted by Justherself54 on January 16, 2008, at 2:32:08
In reply to Help please: MAOI's + Grapefruit juice?, posted by FrequentFryer on January 10, 2008, at 23:46:00
> Hi.
> I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
> Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.
>
> Anyone know what kind of reaction Grapefruit juice and an MAOI would have?
> Good, Bad, Ugly?I don't know if it has any interactions with Naril but you might wake up with a huge case of heartburn..Nardil has that effect on me if I eat something acidic before bed, or if I eat to much of anything before bed..bad acid reflux..
Posted by bleauberry on January 16, 2008, at 2:32:08
In reply to Help please: MAOI's + Grapefruit juice?, posted by FrequentFryer on January 10, 2008, at 23:46:00
I believe grapefruit juice slows down the liver enzyme CYP3A4. Just do a search on your MAOI to see which liver enzymes break it down. Many drugs are involved in the CYP3A4 pathway but your MAOI might not be. Dunno.
Posted by Phoenix1 on January 16, 2008, at 2:32:08
In reply to Help please: MAOI's + Grapefruit juice?, posted by FrequentFryer on January 10, 2008, at 23:46:00
> Hi.
> I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
> Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.
>
> Anyone know what kind of reaction Grapefruit juice and an MAOI would have?Is Temazepam one of the benzo's that has the "grapefruit effect"? I know diazepam is one, but lorazepam isn't. Hmmm, is there a list?
> Good, Bad, Ugly?
Posted by Larry Hoover on January 16, 2008, at 2:32:08
In reply to Help please: MAOI's + Grapefruit juice?, posted by FrequentFryer on January 10, 2008, at 23:46:00
> Hi.
> I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
> Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.
>
> Anyone know what kind of reaction Grapefruit juice and an MAOI would have?
> Good, Bad, Ugly?Temazepam is the product of 3A4 acting on diazepam. It would be unaffected by grapefruit. Grapefruit would have no effect on Nardil metabolism. Your plan is not going to help, methinks.
Lar
Posted by Phoenix1 on January 16, 2008, at 2:32:08
In reply to Re: Help please: MAOI's + Grapefruit juice? » FrequentFryer, posted by Larry Hoover on January 12, 2008, at 11:25:11
> > Hi.
> > I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
> > Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.
> >
> > Anyone know what kind of reaction Grapefruit juice and an MAOI would have?
> > Good, Bad, Ugly?
>
> Temazepam is the product of 3A4 acting on diazepam. It would be unaffected by grapefruit. Grapefruit would have no effect on Nardil metabolism. Your plan is not going to help, methinks.
>
> Lar
>Placebo effect = thwarted :)
Posted by trx resistant on January 16, 2008, at 2:32:08
In reply to Re: Help please: MAOI's + Grapefruit juice? » FrequentFryer, posted by Larry Hoover on January 12, 2008, at 11:25:11
Speaking of grpaefruits . . .I heard that they should be avoided if on Effexor or Cymbalta. Is this true for EMSAM? I'm eating one a day right now becaus I have bad cold.
Posted by Larry Hoover on January 16, 2008, at 2:32:09
In reply to Re: Help please: MAOI's + Grapefruit juice?, posted by trx resistant on January 12, 2008, at 17:43:22
> Speaking of grpaefruits . . .I heard that they should be avoided if on Effexor or Cymbalta. Is this true for EMSAM? I'm eating one a day right now becaus I have bad cold.
No, you're good. 3A4 is a trivial metabolizer of selegiline. Complete blockade of that pathway did not affect concentration of any of the major metabolites.
Lar
Posted by FrequentFryer on January 16, 2008, at 2:32:09
In reply to Re: Help please: MAOI's + Grapefruit juice?, posted by Phoenix1 on January 12, 2008, at 10:44:22
> > Hi.
> > I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
> > Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.
> >
> > Anyone know what kind of reaction Grapefruit juice and an MAOI would have?
>
> Is Temazepam one of the benzo's that has the "grapefruit effect"? I know diazepam is one, but lorazepam isn't. Hmmm, is there a list?
> > Good, Bad, Ugly?
>
>Actually you might be right Grapefruit juice might not effect Temaz to much, (I was thinking they effect all of them and might do to an extent), 500 mg of yellow grapejuice enhances my klomazapam by about 25 % though.
Worst case scenario you might get some healthy vitamins into ya.
Posted by Phoenix1 on January 16, 2008, at 2:32:09
In reply to Re: Help please: MAOI's + Grapefruit juice? » Phoenix1, posted by FrequentFryer on January 12, 2008, at 19:18:16
> > > Hi.
> > > I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
> > > Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.
> > >
> > > Anyone know what kind of reaction Grapefruit juice and an MAOI would have?
> >
> > Is Temazepam one of the benzo's that has the "grapefruit effect"? I know diazepam is one, but lorazepam isn't. Hmmm, is there a list?
> > > Good, Bad, Ugly?
> >
> >
>
> Actually you might be right Grapefruit juice might not effect Temaz to much, (I was thinking they effect all of them and might do to an extent), 500 mg of yellow grapejuice enhances my klomazapam by about 25 % though.
>
> Worst case scenario you might get some healthy vitamins into ya.
>Clonazepam was one I wasn't sure about. I thought i had CONCLUDED that grapefruit didn't have an effect?? Am I wrong?
Posted by Phoenix1 on January 16, 2008, at 2:32:09
In reply to Re: Help please: MAOI's + Grapefruit juice? » FrequentFryer, posted by Larry Hoover on January 12, 2008, at 11:25:11
> > Hi.
> > I am going to take some Temazapam to help me sleep but I have a HUGE tollerance to Bezodiazapines so hence I want to drink some Grapefruit juice beforehand so the Temaz actually works.
> > Thing is I am taking Nardil and dont know how the Grapefruit juice will effect the MAOI.
> >
> > Anyone know what kind of reaction Grapefruit juice and an MAOI would have?
> > Good, Bad, Ugly?
>
> Temazepam is the product of 3A4 acting on diazepam. It would be unaffected by grapefruit. Grapefruit would have no effect on Nardil metabolism. Your plan is not going to help, methinks.
>
> Lar
>Here's an interesting one. (BTW, I take Nardil and grapefruit juice seems to do nothing) But, I just got a prescription for Biaxin for a sinus infection (claithromycin). I take zopiclone (for Americans think eszopiclone). Clarithromycin is a potent inhibitor of CYP3a4 that metabolizes zopiclone. So I would exect an increased effect on the zopiclone? The pharmacist gave me a vacant look and said the computer didn't point out an interaction when I brought this up. She would rather that I didn't bring up any questions unless the answer is in the computer. So much for the helpful old-time pharmacist. Your thoughts? )on the clarithromycin-zopiclone interaction thing)
Phoenix1
Posted by Larry Hoover on January 16, 2008, at 2:36:31
In reply to , posted by on December 31, 1969, at 18:00:00
> Here's an interesting one. (BTW, I take Nardil and grapefruit juice seems to do nothing) But, I just got a prescription for Biaxin for a sinus infection (claithromycin). I take zopiclone (for Americans think eszopiclone). Clarithromycin is a potent inhibitor of CYP3a4 that metabolizes zopiclone. So I would exect an increased effect on the zopiclone? The pharmacist gave me a vacant look and said the computer didn't point out an interaction when I brought this up. She would rather that I didn't bring up any questions unless the answer is in the computer. So much for the helpful old-time pharmacist. Your thoughts? )on the clarithromycin-zopiclone interaction thing)
>
> Phoenix1I would indeed expect a modest to significant interaction between the two. Luckily, there is another metabolic pathway (2E1) for the zopiclone, but you're still going to see an increase in both plasma concentration and AUC (total exposure).
Lar
Posted by Phoenix1 on January 16, 2008, at 2:37:26
In reply to , posted by on December 31, 1969, at 18:00:00
> > Here's an interesting one. (BTW, I take Nardil and grapefruit juice seems to do nothing) But, I just got a prescription for Biaxin for a sinus infection (claithromycin). I take zopiclone (for Americans think eszopiclone). Clarithromycin is a potent inhibitor of CYP3a4 that metabolizes zopiclone. So I would exect an increased effect on the zopiclone? The pharmacist gave me a vacant look and said the computer didn't point out an interaction when I brought this up. She would rather that I didn't bring up any questions unless the answer is in the computer. So much for the helpful old-time pharmacist. Your thoughts? )on the clarithromycin-zopiclone interaction thing)
> >
> > Phoenix1
>
> I would indeed expect a modest to significant interaction between the two. Luckily, there is another metabolic pathway (2E1) for the zopiclone, but you're still going to see an increase in both plasma concentration and AUC (total exposure).
>
> Lar
>Thanks Larry,
You are obviously very knowledgeable! Where did you learn so much about metabolic pathways etc.? Are you from the biz somehow? I'm slowly learning these things, but as a layperson with only some uni. level organic chem and biology, it's a slow go...
Phoenix1
Posted by Larry Hoover on January 16, 2008, at 2:37:26
In reply to , posted by on December 31, 1969, at 18:00:00
> Thanks Larry,
You're welcome.
> You are obviously very knowledgeable! Where did you learn so much about metabolic pathways etc.? Are you from the biz somehow?
A decade ago, I was working as an environmental toxicologist. It's not too hard to adapt that background to humans. I am pretty adept at finding information on the 'net, too.
> I'm slowly learning these things, but as a layperson with only some uni. level organic chem and biology, it's a slow go...
>
> Phoenix1Incremental, yes. I think you're doing well.
Lar
Posted by FrequentFryer on January 16, 2008, at 2:37:26
In reply to , posted by on December 31, 1969, at 18:00:00
Thanks
Posted by FrequentFryer on January 16, 2008, at 2:37:27
In reply to , posted by on December 31, 1969, at 18:00:00
Yep your wrong I can guarentee you yellow grapfruit juice increase's some benzo effects.
Posted by Phoenix1 on January 16, 2008, at 2:37:27
In reply to , posted by on December 31, 1969, at 18:00:00
> Yep your wrong I can guarentee you yellow grapfruit juice increase's some benzo effects.
What am I wrong about? I agreed that grapefruit juice increases blood levels of some benzodiazepines. Like diazepam. That's a scientific fact. But it doesn't effect lorazepam in the slightest. That's also a scientific fact. Then I said I wasn't sure about temazepam and clonazepam. Someone else said temazepam (That's what you were asking about originally) wasn't affected by grapefruit, LarryHoover I believe. Then I made a joke that the placebo effect had been ruined. (The joke was emphasized by the ":)" smiley face symbol). Sorry if this offended you.
It looks like if a benzo is metabolized by the liver, via the CYP3A4 enzyme, then grapefruit will increase it's effects. If it is NOT CYP3A4 metabolized, then grapefruit juice will do absolutely nothing. Like in the case of Lorazepam, or Temazepam (The one you were interested in), grapefruit juice has no effect. So show me where I'm wrong. I'm always learning, and I think I summed this up correctly, but everyone makes mistakes, right?
Phoenix1
Posted by FrequentFryer on January 16, 2008, at 2:37:27
In reply to , posted by on December 31, 1969, at 18:00:00
> > Yep your wrong I can guarentee you yellow grapfruit juice increase's some benzo effects.
>
> What am I wrong about? I agreed that grapefruit juice increases blood levels of some benzodiazepines. Like diazepam. That's a scientific fact. But it doesn't effect lorazepam in the slightest. That's also a scientific fact. Then I said I wasn't sure about temazepam and clonazepam. Someone else said temazepam (That's what you were asking about originally) wasn't affected by grapefruit, LarryHoover I believe. Then I made a joke that the placebo effect had been ruined. (The joke was emphasized by the ":)" smiley face symbol). Sorry if this offended you.
>
> It looks like if a benzo is metabolized by the liver, via the CYP3A4 enzyme, then grapefruit will increase it's effects. If it is NOT CYP3A4 metabolized, then grapefruit juice will do absolutely nothing. Like in the case of Lorazepam, or Temazepam (The one you were interested in), grapefruit juice has no effect. So show me where I'm wrong. I'm always learning, and I think I summed this up correctly, but everyone makes mistakes, right?
>
> Phoenix1
Yeah sory I 100% agree with you, (respect your neurological pharmacological knowlege :)). (needed that answer), and Im not a crazy cracker but I thought someone said. So we agree that grapefruit juice has no effect." or something.
(But I went over the previous posts quickly a bit but couldn't find it) so I dunno maybe I was tripping, it's just this messageboard is extremly outdated \ non user friendly and confusing, (Im in IT... But it dose the job) maybe Bob could afford to give me some $$ to make the site looking nice and easy to use.
This is the end of the thread.
Psycho-Babble Neurotransmitters | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.