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Dr. Bob is Robert Hsiung, MD,
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Posted by Simus on May 27, 2004, at 13:01:10
In reply to Re: Grapefruit Juice Warning, posted by Magdalena on May 27, 2004, at 9:49:34
You can do whatever you like, of course. But regardless of what your doctor says, the scientific evidence of the effect of grapefruit juice on the way the body metabolizes some medications is well documented. Here is another article, and note the references at the end of the page. The Mayo Clinic is a very reputable source.
http://www.consumer-health.com/services/cons_take10.htm
Grapefruit Juice - Is It Always Healthy?Meggan Weisberg
Doctor of Pharmacy Candidate, 2001
Ohio Northern UniversityDid you have a glass of grapefruit juice with breakfast this morning? Have you taken your morning medications? Do you know if grapefruit juice can interact with your medications?
Mr. X did not know. This healthy 29-year-old male woke up one morning and took his common allergy medicine, terfenadine. He had been taking this medicine twice a day for more than a year. He also liked drinking grapefruit juice 2 or 3 times a week and sometimes more often. On this day, he drank two glasses of grapefruit juice and went out to mow the lawn. Moments later, he collapsed and died due to a fatal heart problem.
Even though he had taken exactly the amount prescribed for him, the coroner found that the allergy medicine had reached a dangerous level in his blood. It appeared that grapefruit juice slowed down the body's ability to break down this drug. This may have led to the toxic amounts of the medicine that killed Mr. X.
The Food and Drug Administration (FDA) did not know about these side effects when the medicine was approved. The FDA removed this medicine from the market in 1997 because of the possibility of serious side effects on the heart.
While this problem has not been seen with other allergy medications, terfenadine is not the only medication affected by grapefruit juice! If we only knew then what we know now, Mr. X might still be alive. Every person who is taking medications should check to see if it is safe to drink grapefruit juice.
"Why does grapefruit juice interact with some medications and not others?"
It is not known exactly what grapefruit juice contains that causes these drug interactions. Some researchers think that narningenin, DHB, or both are the compounds in grapefruit juice that may be responsible for the interaction.1,2,3 What we do know is that some drugs need certain natural enzymes in the body to break them down so that medicine can be eliminated from the body.
Grapefruit juice interferes with one of these enzymes, CYP3A4. It may cause some medicine to build up in the body, leading to unwanted side effects. The amount of CYP3A4 found in a person will vary from person to person. People with higher amounts of the enzyme are affected when grapefruit juice is taken with medicine more often than people with lower amounts.
"Do other types of juices or eating a grapefruit interact with medications?"
Not all citrus juices contain narningenin or DHB. For this reason, citrus juices such as orange juice have not been shown to affect this enzyme.2
Different parts of the grapefruit also contain different amounts of these two substances. The peel of the grapefruit is thought to contain more than any other part of the fruit. It is uncertain if eating a grapefruit will cause the same effects as drinking grapefruit juice.
Even different brands of grapefruit juice may have different amounts of these two substances.2, 3 The way the grapefruit juice is processed may be one of the reasons for this. When companies make grapefruit juice, machines use enough pressure to squeeze these substances from all parts of the grapefruit. The consumer does not know how much of these compounds are in the different products. It would be helpful for consumers if the labels of grapefruit juice products contained a warning statement such as "This product contains substances that may interact with certain prescription drugs."
A common misconception is that it takes large amounts of grapefruit juice to interact with medications.1 An 8 oz glass of regular strength grapefruit juice has a similar effect as two or three glasses of double-strength grapefruit juice.
"Do my medications interact with grapefruit juice?"
Every time you are prescribed a new medicine check with your doctor or pharmacist about possible grapefruit juice interactions.
If you have not been drinking grapefruit juice, then do not add it to your diet until you know if it is safe for you. If you are already taking any of your medications with grapefruit juice, do not stop taking it without talking to your doctor first. When you stop drinking grapefruit juice, your doctor may need to adjust the dose of your medicine.
The following is a partial list of medication that interacts with grapefruit juice in some people.
atorvastatin (Lipitor)2
buspirone (Buspar)2
carbamazepine (Tegretol)2
cerivastatin (Baycol)2
cyclosporine (Sandimmune)1, 2, 3
diazepam (Valium)2
erythromycin (E-Mycin, Ery-Tab, E-base, E.E.S., Ery-Ped)
felodipine (Plendil)1, 2, 3, 4
lovastatin (Mevacor)2
methadone (Dolophine, Methadose )2
midazolam (Versed)1, 2, 4, 5
nifedipine (Adalat, Procardia )2, 3
nimodipine (Nimotop)2, 3
nisoldipine (Sular)1, 2, 3, 5
saquinavir (Fortovase, Invirase )3
sertraline (Zoloft)2
sildenafil (Viagra)2
simvastatin (Zocor)2
tacrolimus (Prograf)2
triazolam (Halcion)2Not all of these medications in combination with grapefruit juice will produce as severe a reaction as the one described in the beginning of the article. Researchers continue to investigate grapefruit juice interactions to better predict which medicine should not be taken in combination with grapefruit juice.
Until all the facts are known, ask your pharmacist if your medicine interacts with the antibiotic erythromycin. If it does, then there is a high chance that the medicine will interact with grapefruit juice too.
Before you take your next pill, remember that grapefruit juice has the potential to interact with many prescription drugs. Grapefruit juice may not be healthy for everyone.
References:
1. Spence J.D. Drug interactions with grapefruit juice: Whose responsibility is it to warn the public? Clin Pharmacol Ther 1997;61: 395-200.2. Kane GC, Lipsky JJ. Drug-grapefruit Juice Interactions. Mayo Clin Proc 2000;75:933-942.
3.Fuhr U. Drug Interactions with Grapefruit Juice. Drug Safety 1998 Apr; 18 (4): 251-272
.© 2001 Consumer Health Information Corporation. All rights reserved.
Posted by anxious babe on May 27, 2004, at 13:14:13
In reply to Re: Grapefruit Juice Warning, posted by Simus on May 27, 2004, at 13:01:10
Hi Simus,
I am with you - I do not drink any grapefruit juice. If the label on the meds tell me not too then I don't. I think it's my xanax that has the "Do not drink grapefruit juice" warning on it.
Take care,
anxious babe
Posted by sexylexy on May 27, 2004, at 16:51:39
In reply to RE::: hey yo yo squad » Mrs. C, posted by simus on May 25, 2004, at 22:39:15
Hey Girls,
How are you all? I am doing ok. My boyfriend left today to go home to work for two months and I started my period so I am feeling a touch sad. I am now at 10mg of lexapro and feeling glad about the drop. Its weird, I feel less depressed on 10 than I did on 20, I am sure coming home helpped a lot.
Mystic~ are you not doing well, I hope things get better for you, I know that the 15mg had not kicked in yet, it took me about 2 weeks to see a difference.
Bride~ Hope things are going well with you, my best friend is getting married on the 5th so we are getting crazy trying to get it all together.
It is so fun though, I cannot wait till I get engaged ect.
Anxious Babe~ I am so glad you are here, thanks for such a wonderful contribution.
Mrs.C~ Good to hear that you have been feeling well latley, I started today and made it though PMS pretty well. Any info on the Atkins Diet?
Jlynne~ Hope all is well with you, you sound like your doing well and helping everyone else out!
Simus~ Thanks for the grapefruit warning, I know it is good for dieting so that is important to know its not good for us.
Trucker~ I am glad you are back with us, hope all is going well..how goes the added wellbutrin
LynneDa~ Have you lost anymore weight on 10mg. I am hoping that these 8lbs start getting the hell on off of me..hahaha
Em~ Hope all is going well for you, I dropped down to 10mg at night because 20 seemed to be making me irritable and un-like myself. I feel a lot "cleaner" on 10mg.
Mag- good to know that you and your boyfriend are still doing well, stay away from that weed, it will get ya.
If I left anyone out I am sorry!! Its been a long day.
Love ya
Lexy
Posted by trucker on May 27, 2004, at 16:51:55
In reply to Re: Grapefruit Juice Warning, posted by Simus on May 27, 2004, at 13:01:10
zanax is the only one that i was warned about... and most of us aren't on zanax... i was also told if you think it will affect your meds...don't take them together.
trucker
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Posted by trucker on May 27, 2004, at 16:59:46
In reply to RE:: Hey yo yo's » trucker, posted by Simus on May 27, 2004, at 12:46:10
one this is the lex board, two most of us aren't on zanax, three she has been in school longer than any of us and i am sure she wouldn't steer me wrong... i take welbutrin and lexd and the grapefruit works wonders on weight.. so i don't have to whine about weight gain... my psyc doc goes to studies all the time to stay up to date and are you calling dr-bob stupid or what!!!! p.s. i have lost 20 lbs on the grapefuit and salad diet!!!
trucker
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> > my psyc doc said grapefruit juice is fine, nothing to worry about interaction with meds, and dr bob said basically the same thing and not to believe everything you seee here on these posts.
>
> You need to take your doctor the medical studies and let him/her read them. People have already died from this.
Posted by trucker on May 27, 2004, at 17:02:41
In reply to RE::: hey yo yo squad, posted by sexylexy on May 27, 2004, at 16:51:39
welbutrin is good and i have lost 20 lbs on the grapefruit salad diet
trucker
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Posted by anxious babe on May 27, 2004, at 18:05:02
In reply to Re: Grapefruit Juice Warning-simus, posted by anxious babe on May 27, 2004, at 13:14:13
Hi Trucker,
I didn't mean to offend you if I did - at least that is the way it sounded in your response with the #1) this is the Lex board...and I know that, I am also on Lex, #2)some of us do take a xanax once in a while when needed and I only mentioned the xanax because that is where I saw the label. #3)I never nor would I ever say anything about your doctor or Dr. Bob not knowing anything. I am only here for the support and help and not to critizice anyone ever!
I was just simply agreeing with Simus about the grapefruit juice label, but I didn't in anyway mean to offend anyone...after all I thought that we are all here to help each other and share our ideas and experiences, so again I am sorry if I came off any other than just agreeing with someone.
anxious babe :(
> Hi Simus,
>
> I am with you - I do not drink any grapefruit juice. If the label on the meds tell me not too then I don't. I think it's my xanax that has the "Do not drink grapefruit juice" warning on it.
>
> Take care,
> anxious babe
Posted by trucker on May 27, 2004, at 20:16:39
In reply to Re: Grapefruit Juice Warning-simus, posted by anxious babe on May 27, 2004, at 18:05:02
i don't mean to upset anyone either but i do recomend talking to your doctor, because they know what you are on and if you can use anything
dr-bob said to talk to your psyc doc noit to listen to all the stuff on here.trucker
////////////////////////////////////////////
> Hi Trucker,
>
> I didn't mean to offend you if I did - at least that is the way it sounded in your response with the #1) this is the Lex board...and I know that, I am also on Lex, #2)some of us do take a xanax once in a while when needed and I only mentioned the xanax because that is where I saw the label. #3)I never nor would I ever say anything about your doctor or Dr. Bob not knowing anything. I am only here for the support and help and not to critizice anyone ever!
>
> I was just simply agreeing with Simus about the grapefruit juice label, but I didn't in anyway mean to offend anyone...after all I thought that we are all here to help each other and share our ideas and experiences, so again I am sorry if I came off any other than just agreeing with someone.
>
> anxious babe :(
>
>
>
> > Hi Simus,
> >
> > I am with you - I do not drink any grapefruit juice. If the label on the meds tell me not too then I don't. I think it's my xanax that has the "Do not drink grapefruit juice" warning on it.
> >
> > Take care,
> > anxious babe
>
>
Posted by mystic on May 27, 2004, at 21:08:07
In reply to Re: Grapefruit Juice Warning-simus, posted by anxious babe on May 27, 2004, at 18:05:02
Hey anxious babe..you are fine and you didnt do anything wrong we are all here to help each other and the great thing is we all have our own opinions and sometimes we wont agree...so dont get upset you were just fine and did absolutely nothing wrong...I would never want you to get upset and not come back so please believe me I am really grateful that we have found each other on the posts I'm grateful for allllll your opinions right or wrong...I'm grateful that you contribute the way that you do and I'm grateful that you are an angel and we are all blessed to have you as a yoyo...so please dont think that you offended...we love you...Thanks for being YOU...Mystic
Posted by mystic on May 27, 2004, at 21:40:24
In reply to Re: Grapefruit Juice Warning-simus, posted by trucker on May 27, 2004, at 20:16:39
Hey Lexy...glad to hear you are doing soooo well..you sound great..I wanted to ask you if you went on the lex for anxiety or just depression...My two weeks is saturday on the 15mgs and just hoping that it kicks in soon not sure how much longer I can keep doing this every day..waiting waiting waiting..not sure that I will ever feel good again for any length of time and that scares me to death...Thanks for all your help..luvya Your friend Mystic
Posted by Mrs. C on May 27, 2004, at 21:45:39
In reply to RE::: hey yo yo squad, posted by sexylexy on May 27, 2004, at 16:51:39
Hey Lexy,
I sent you a bunch of info on the diet. Did you not receive it? Check the old posts. I wrote you back right away. I'll send it again if you'd like. Let me know. Take care. Mrs. C
Posted by Magdalena on May 27, 2004, at 23:38:31
In reply to RE::: hey yo yo squad, posted by sexylexy on May 27, 2004, at 16:51:39
Posted by Magdalena on May 27, 2004, at 23:41:58
In reply to Redirected Lexaproers, posted by jlynne on March 13, 2004, at 1:31:16
hey guys i think i am crashing, do you think it has anything to do with the weed incident? oh god i feel like i need the increase asap, im starting to feel like i did before i started the meds!! thank god the p-doc appt is tomorrow...although i have big plans on the weekend and now i am terrified cause im thinking in gonna flip..i know, stay calm, breathe...why is it so hard?
Mag
Posted by Simus on May 28, 2004, at 0:10:04
In reply to RE:: Hey yo yo's, posted by trucker on May 27, 2004, at 16:59:46
Anxious Babe,
Sorry I didn't check sooner. I think this one was aimed at me. You didn't do anything wrong, and we are glad to have you here. So please stick with us.
Trucker,> one this is the lex board,
Lexapro falls within the category of SSRIs, to which the warning pertained.
> two most of us aren't on zanax,
Xanax is commonly used to supplement SSRIs for anxiety symptoms, and several people here are on Xanax.
> three she has been in school longer than any of us
There are some very well-educated people on this board, of which I am one.
> and i am sure she wouldn't steer me wrong...
Even doctors make the occasional mistake or oversight...
> i take welbutrin and lexd and the grapefruit works wonders on weight.. so i don't have to whine about weight gain...
I am glad you found something that works well for weight loss for you, but for you to recommend it to everyone on this board is potentially dangerous.
> my psyc doc goes to studies all the time to stay up to date and are you calling dr-bob stupid or what!!!!
??? No. I never even addressed Dr. Bob in any of these posts. And if I had, I would NEVER have called him anything derogatory. He provides a wonderful service to us all, and I for one am grateful. I simply "cut and past"ed valid medical studies from prestigious medical facilities to help my friends. I have never known Dr. Bob to discourage the exchange of valid information that would help others on this site.
The bottom line is, we are here to help each other. If I had knowingly withheld information and someone ended sick or even dead because of it, I would have had to live with that for the rest of my life. I did what friends do. I warned of imposing danger. And I would do it again.
Posted by Simus on May 28, 2004, at 0:15:33
In reply to crashing? i hope not, posted by Magdalena on May 27, 2004, at 23:41:58
Hang in there, Mag. Your Dr. apppointment is less than 24 hours away. Just take it an hour at a time, or even a minute at a time. Keep us informed on how you are doing. I will be praying for you.
Posted by Simus on May 28, 2004, at 0:24:29
In reply to RE::: hey yo yo squad, posted by sexylexy on May 27, 2004, at 16:51:39
Lexy,
Good to hear from you again! It is especially good to hear that you are doing well. There are a few Yo-Yo's having a hard time of it lately, and they could use another voice of encouragement.
God bless.
Posted by mystic on May 28, 2004, at 6:56:08
In reply to crashing? i hope not, posted by Magdalena on May 27, 2004, at 23:41:58
Mag..calm down everything is going to be fine...I'm not sure what dosage you are on right now I know that you are on paxil?...and the last I recall (and on lex that is difficult sometimes haha) but I think it was 5mgs...So you already know that it is a very low dosage and you are eventually going to have to go up on it and WE ARE HERE FOR YOU...so dont worry...I'm glad that you have an appt today please please let us know how it went and what you are going to do...dont leave us wondering over the weekend ok...You will be fine maybe you are a little nervious about the weekend and dont really realize it..Maybe you could take a xanax or something??...I will say a prayer for you today and hope that you are feeling better and you will be fine we are all here for you...Take care Mag luvya Your friend Mystic
Posted by mystic on May 28, 2004, at 7:07:21
In reply to RE:: Hey yo yo's » trucker, posted by Simus on May 28, 2004, at 0:10:04
Simus ....great great post as always..I know that I do say it but could I please say it again!!!!.. We are allllll so blessed that you are a yo yo and that you contribute to us so much and help us out so much...I do believe there are angels in this world and people that come into our lives at the right time..a time when we need some help and someone to show us that life isnt always easy and we all have to hope that it will get better and to have someone like you to help that happen is more than words can say...I'm very happy that you are feeling so good and able to give us such assistance..I pray that we will always have you around and that we can help you as much as you help us...God bless you Simus and thank you for being such an angel to each and every one of us...Luvya Your friend Always ...Mystic
Posted by mystic on May 28, 2004, at 7:26:05
In reply to Redirected Lexaproers, posted by jlynne on March 13, 2004, at 1:31:16
Trucker dont you disappear on us either...In the posts we all have our opinions and we can agree to disagree...You were trying to give us some advise on how grapefruit is helping you and we appreciate that and simus gave us advise on what she had found and that is great also..Now it is up to people to find out what is right for them..and hopefully along with everything that has to do with these meds we do not try to take anything that will be detrimental to our health and that is all we can do...Listen to the posts.. and make our own decisions..and Trucker I think that is what we all try to do for each other and we appreciate you very much...So hope that we are all good..and we love you and talk to you soon...Your friend Mystic
Posted by LynneDa on May 28, 2004, at 9:00:54
In reply to RE::: hey yo yo squad, posted by sexylexy on May 27, 2004, at 16:51:39
Hi Lexy - Thanks for your update. That is a good sign that you got thru your period okay, even with your b.f. leaving town. Where is he from that he has to go home? How did you meet him?
I'm down to 149 from 152 on the 10mg & I haven't changed a thing with my eating or exercising. I just hope it continues!! Even typing the number 152 is a scary thing cuz my pre-med weight range is 130 - 135. I'm 5'7" so that is a weight range I'm happy with!
Good luck to you on 10mg. I am really hoping to be able to stay at 10mg and just go up to 20mg for a few days before my period. I feel like I've learned a lot in the past 5 months since I've been on 20mg - about how to deal with stress and working through some of my issues - so maybe this has all been a good thing.
I hope you get to start planning a wedding soon :-)
~ Lynne
>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Posted by want info on May 28, 2004, at 9:03:52
In reply to Re: crashing? i hope not » Magdalena, posted by Simus on May 28, 2004, at 0:15:33
hey guys just checking in. i went from 20 to 15 a few weeks ago and had a few really bad days anxiety -wise. im now trying 17.5. i also switched to taking the lex in the AM. since i did that, my appetite seems to have decreased. does that make sense?
Posted by LynneDa on May 28, 2004, at 9:05:58
In reply to RE:: Hey Lexy, posted by mystic on May 27, 2004, at 21:40:24
Hi Mystic - I would give the upgrade 3 weeks before feeling disappointment. In thinking back to my increase to 20mg, it did take a few weeks before I could really feel it. Hang in there sister, you'll get there.
I was feeling yuck last week, but this week has been so much better & for that I'm grateful. I know my last few posts to you were kinda depressing! I am able to deal with things using humor and not get really down. It's so amazing what a difference it is between the week before my period and the week after!
I really hope you get to feeling better!!!
~ Lynne
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>Hey Lexy...glad to hear you are doing soooo well..you sound great..I wanted to ask you if you went on the lex for anxiety or just depression...My two weeks is saturday on the 15mgs and just hoping that it kicks in soon not sure how much longer I can keep doing this every day..waiting waiting waiting..not sure that I will ever feel good again for any length of time and that scares me to death...Thanks for all your help..luvya Your friend Mystic
Posted by LynneDa on May 28, 2004, at 9:12:05
In reply to crashing? i hope not, posted by Magdalena on May 27, 2004, at 23:41:58
Hey Mag, hang in there sweetie! This will pass!! It could be the pot, I don't know. Just talk to your doc and let us know what he/she says. Just remember, the feelings you're having are not really reflecting who you are or where you are in your life, they're just feelings . . . it's just your depression or anxiety talking!
Try to get busy with a small project or something that will absorb you temporarily til you start feeling better, maybe that will help. Talk to us soon, okay :-)
~ Lynne
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
hey guys i think i am crashing, do you think it has anything to do with the weed incident? oh god i feel like i need the increase asap, im starting to feel like i did before i started the meds!! thank god the p-doc appt is tomorrow...although i have big plans on the weekend and now i am terrified cause im thinking in gonna flip..i know, stay calm, breathe...why is it so hard?
>
> Mag
Posted by LynneDa on May 28, 2004, at 9:14:25
In reply to RE::: Simus, posted by mystic on May 28, 2004, at 7:07:21
Ditto to what Mystic said! I admire your faith and know that it must be that which allows you to sound so peaceful!
~ Lynne
>>>>>>>>>>>>>>>>Simus ....great great post as always..I know that I do say it but could I please say it again!!!!.. We are allllll so blessed that you are a yo yo and that you contribute to us so much and help us out so much...I do believe there are angels in this world and people that come into our lives at the right time..a time when we need some help and someone to show us that life isnt always easy and we all have to hope that it will get better and to have someone like you to help that happen is more than words can say...I'm very happy that you are feeling so good and able to give us such assistance..I pray that we will always have you around and that we can help you as much as you help us...God bless you Simus and thank you for being such an angel to each and every one of us...Luvya Your friend Always ...Mystic
Posted by LynneDa on May 28, 2004, at 9:16:58
In reply to hi all., posted by want info on May 28, 2004, at 9:03:52
Hi! You never know what will happen when you change med time and dosage! Our body's chemistry is very cyclical. I hope the 17.5 is right for you - altho how you make that dosage still cracks me up!! I like the appetite thing, that is very good. Maybe I'll try taking mine earlier too and see if my enormous hunger decreases :-).
Have a good weekend!
~ Lynne
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
hey guys just checking in. i went from 20 to 15 a few weeks ago and had a few really bad days anxiety -wise. im now trying 17.5. i also switched to taking the lex in the AM. since i did that, my appetite seems to have decreased. does that make sense?
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