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. Natural Standard content

Grapefruit (Citrus paradisi)

Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain grapefruit. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacist or health care provider before starting.



Evidence

Scientists have studied grapefruit for the following health problems:

Heart disease, high cholesterol
Grapefruit has been observed to lower blood pressure and cholesterol levels. There is only limited research specifically using grapefruit to treat heart disease in humans. It is not clear what dose is safe or effective.
Eczema
One study suggests that grapefruit may provide benefits in treating eczema. However, this study is small, and therefore it is unclear whether there is any benefit from grapefruit for this condition.
Kidney stones
Grapefruit juice may increase or decrease the risk of developing certain types of kidney stones. Limited research and mixed study results exist. Further data are needed to make a firm conclusion. Please speak with a qualified health care provider before taking grapefruit in supplemental amounts if you have or are prone to kidney stones.


Unproven Uses

Grapefruit has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before taking grapefruit for any unproven use.

Antibacterial
Antifungal
Antiparasitic
Antiseptic
Cancer
Common cold		 Dieting
Insecticidal
Itchiness due to liver disease
Kidney stones
Liver protection
Stomach ulcers
Traveler's diarrhea


Potential Dangers

Allergies

Allergic reactions may occur.

Side Effects

Some people may experience headache. If grapefruit extract is applied to the skin, it may cause skin irritation. In theory, grapefruit may lower potassium levels in the blood. Grapefruit may increase or decrease the development of kidney stones; study results are conflicting. Tooth enamel may be affected, and aldosterone levels may be altered. The way that the liver breaks down many drugs, herbs and supplements may be changed by grapefruit, which may lead to interactions.

Pregnancy And Breast-Feeding

Grapefruit juice seems to be safe during pregnancy and breast-feeding, but there are no data specifically on the safety of grapefruit pectin or grapefruit extract in these situations.


Interactions

Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements.

Interactions With Drugs

Grapefruit affects the activities of many drugs, with potentially serious effects. Interactions with various drugs can occur when using any part of the grapefruit, including grapefruit juice or peel. If you take prescription drugs and are considering using a product that contains grapefruit, it is a good idea for you to discuss this with your health care provider or pharmacist. Some examples are below.

Grapefruit is likely to increase the adverse effects associated with heart and blood pressure drugs, such as amiodarone (Cordarone), cilostazol (Pletal), losartan (Cozaar), amlodipine (Norvasc), lovastatin (Mevacor), atorvastatin (Lipitor), simvastatin (Zocor) and the class of drugs called calcium channel blockers. Calcium channel blockers include nifedipine (Procardia), nimodipine (Nimotop), felodipine (Plendil), nislodipine (Sular), barnidipine (Vasexten), nitrendipine (Cardif), nicardipine (Cardene) pranidipine, lercanidipine, diltiazem (Cardizem) and verapamil (Calan). Grapefruit may increase the risk of bleeding when used with anticoagulants (blood thinners), such as warfarin (Coumadin). Grapefruit may also increase side effects associated with drugs such as carbamazepine (Tegretol), erythromycin (Ery-Tab, EES), clarithromycin (Biaxin), buspirone (BuSpar), midazolam (Versed), triazolam (Halcion), alprazolam (Xanax), diazepam (Valium), caffeine, clomipramine (Anafranil), estrogen (in birth control pills or hormone replacement therapies), indinavir (Crixivan), saquinavir (Fortovase, Invirase), ritonavir (Norvir), pimozide (Orap), Zopiclone (Imovane), cyclosporine (Sandimmune, Neoral), sertraline (Zoloft), scopolamine (Transderm-Scop), terfenadine (Seldane), cisapride (Propulsid), amitriptyline (Elavil), methylprednisolone (Medrol), astemizole (Astemizol), albendazole (Albenza), praziquantel (Biltricide), halofantrine (Halfan), dextromethorphan (contained in many over-the-counter cough and cold remedies), omeprazole (Prilosec) and tacrolimus.

Grapefruit may reduce the effectiveness of other prescription drugs. Examples include vinblastine (Oncovin), etoposide, ifosfamide (Ifex), sildenafil (Viagra), quinidine, losartan (Cozaar), digoxin (Lanoxin), theophylline (Slo-Bid), itraconazole (Sporanox), amprenavir (Agenerase) and fexofenadine (Allegra).

Interactions With Herbs And Dietary Supplements

Grapefruit may increase side effects associated with use of the antiparasitic agent artemether and may cause potassium levels in the blood to fall too low if used with licorice (Glycyrrhiza glabra). Grapefruit may also interact with menthol or peppermint oil, possibly increasing effects. Grapefruit contains vitamin C.


Dosing

The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. Appropriate dosing should be discussed with a health care provider before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.

There are no standard or well-studied doses of grapefruit, and many different doses are used traditionally.

Adults (Aged 18 Or Older)

Seed extract: For treating eczema, a dose of 150 milligrams taken by mouth three times daily has been used.

Pectin: A dose of five grams of grapefruit pectin taken by mouth three times daily with meals has been used.

Children (Younger Than 18)

There are not enough scientific data to recommend grapefruit seed extract or grapefruit pectin supplements in children, and grapefruit is not recommended because of potential side effects. However, grapefruit is rich in vitamin C and appears to be safe when used as a food or drink.


Summary

Grapefruit has been suggested as a treatment for several conditions, but there is not enough scientific evidence to support the use of grapefruit for any medical disorder. Grapefruit may interact with many prescription drugs, with possibly serious effects, and should be used only after discussing possible interactions with a health care provider or pharmacist. When used as a fruit or as juice, grapefruit is probably safe in pregnant or breast-feeding women and in children. Consult your health care provider immediately if you have any side effects.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.


Resources

  1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
  2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Grapefruit

Natural Standard reviewed more than 435 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

  1. Adigun AQ, Mudasiru Z. Clinical effects of grapefruit juice-nifedipine interaction in a 54-year-old Nigerian: a case report. J Natl Med Assoc 2002;Apr, 94(4):276-278.
  2. Ameer B. Grapefruit juice and kidney stones. Ann Intern Med 1998;Dec 1, 129(11):913. Comment in: Ann Intern Med 1998;Apr 1, 128(7):534-540.
  3. Andersen V, Pedersen N, Larsen NE, et al. Intestinal first pass metabolism of midazolam in liver cirrhosis: effect of grapefruit juice. Br J Clin Pharmacol 2002;Aug, 54(2):120-124.
  4. Anderson KE, Greenblatt DJ. Assessing and managing drug-nutrient interactions. J Am Pharm Assoc (Wash) 2002;Sep-Oct, 42(5 Suppl 1):28-29.
  5. Bailey DG, Dresser GK, Kreeft JH, et al. Grapefruit-felodipine interaction: effect of unprocessed fruit and probable active ingredients. Clin Pharmacol Ther 2000;Nov, 68(5):468-477.
  6. Bailey DG, Arnold JM, Bend JR, et al. Grapefruit juice-felodipine interaction: reproducibility and characterization with the extended release drug formulation. Br J Clin Pharmacol 1995;Aug, 40(2):135-140.
  7. Banfield C, Gupta S, Marino M, et al. Grapefruit juice reduces the oral bioavailability of fexofenadine but not desloratadine. Clin Pharmacokinet 2002;41(4):311-318.
  8. Bartle WR. Grapefruit juice might still be factor in warfarin response. Am J Health Syst Pharm 1999;Apr 1, 56(7):676.
  9. Becquemont L, Verstuyft C, Kerb R, et al. Effect of grapefruit juice on digoxin pharmacokinetics in humans. Clin Pharmacol Ther 2001;Oct, 70(4):311-316.
  10. Benton RE, Honig PK, Zamani K, et al. Grapefruit juice alters terfenadine pharmacokinetics, resulting in prolongation of repolarization on the electrocardiogram. Clin Pharmacol Ther 1996;Apr, 59(4):383-388.
  11. Bistrup C, Nielsen FT, Jeppesen UE, et al. Effect of grapefruit juice on Sandimmun Neoral absorption among stable renal allograft recipients. Nephrol Dial Transplant 2001;16(2):373-377.
  12. Bonin B, Vandel P, Vandel S, Kantelip JP. Effect of grapefruit intake on carbamazepine bioavailability: a case report. Therapie 2001;Jan-Feb, 56(1):69-71.
  13. Bourian M, Runkel M, Krisp A, et al. Naringenin and interindividual variability in interaction of coumarin with grapefruit juice. Exp Toxicol Pathol 1999;Jul, 51(4-5):289-293.
  14. Brunner LJ, Pai KS, Munar MY, et al. Effect of grapefruit juice on cyclosporin A pharmacokinetics in pediatric renal transplant patients. Pediatr Transplant 2000;Nov, 4(4):313-321.
  15. Brunner LJ, Munar MY, Vallian J, et al. Interaction between cyclosporine and grapefruit juice requires long-term ingestion in stable renal transplant recipients. Pharmacotherapy 1998;Jan-Feb, 18(1):23-29.
  16. Cadranel JF, Di Martino V, Devergie B. Grapefruit juice for the pruritus of cholestatic liver disease. Ann Intern Med 1997;Jun 1, 126(11):920-921. Comment in: Ann Intern Med 1996;Oct 15, 125(8):701.
  17. Castro N, Jung H, Medina R, et al. Interaction between grapefruit juice and praziquantel in humans. Antimicrob Agents Chemother 2002;May, 46(5):1614-1616.
  18. Cerda JJ, Robbins FL, Burgin CW, et al. The effects of grapefruit pectin on patients at risk for coronary heart disease without altering diet or lifestyle. Clin Cardiol 1988;11(9):589-594.
  19. Charbit B, Becquemont L, Lepere B, et al. Pharmacokinetic and pharmacodynamic interaction between grapefruit juice and halofantrine. Clin Pharmacol Ther 2002;Nov, 72(5):514-523.
  20. Cheng KL, Nafziger AN, Peloquin CA, Amsden GW. Effect of grapefruit juice on clarithromycin pharmacokinetics. Antimicrob Agents Chemother 1998;Apr, 42(4):927-929.
  21. Christensen H, Asberg A, Holmboe AB, Berg KJ. Coadministration of grapefruit juice increases systemic exposure of diltiazem in healthy volunteers. Eur J Clin Pharmacol 2002;Nov, 58(8):515-520. Epub 2002;Oct 16.
  22. Curhan GC, Willett WC, Rimm EB, et al. Prospective study of beverage use and the risk of kidney stones. Am J Epidemiol 1996;Feb 1, 143(3):240-247.
  23. Demarles D, Gillotin C, Bonaventure-Paci S, et al. Single-dose pharmacokinetics of amprenavir coadministered with grapefruit juice. Antimicrob Agents Chemother 2002;May,46(5):1589-1590.
  24. Desta Z, Kivisto KT, Lilja JJ, et al. Stereoselective pharmacokinetics of cisapride in healthy volunteers and the effect of repeated administration of grapefruit juice. Br J Clin Pharmacol 2001;Oct, 52(4):399-407.
  25. Di Marco MP, Edwards DJ, Wainer IW, Ducharme MP. The effect of grapefruit juice and seville orange juice on the pharmacokinetics of dextromethorphan: the role of gut CYP3A and P-glycoprotein. Life Sci 2002;Jul 26, 71(10):1149-1160.
  26. Ducharme MP, Warbasse LH, Edwards DJ. Disposition of intravenous and oral cyclosporine after administration with grapefruit juice. Clin Pharmacol Ther 1995;May, 57(5):485-491.
  27. Eagling VA, Profit L, Back DJ. Inhibition of the CYP3A4-mediated metabolism and P-glycoprotein-mediated transport of the HIV-1 protease inhibitor saquinavir by grapefruit juice components. Br J Clin Pharmacol 1999;Oct, 48(4):543-552. Comment in: Br J Clin Pharmacol 2001;Aug, 52(2):216-217.
  28. Ebert U, Oertel R, Kirch W. Influence of grapefruit juice on scopolamine pharmacokinetics and pharmacodynamics in healthy male and female subjects. Int J Clin Pharmacol Ther 2000;Nov, 38(11):523-531.
  29. Egashira K, Fukuda E, Onga T, et al. Pomelo-induced increase in the blood level of tacrolimus in a renal transplant patient. Transplantation 2003;Apr 15, 75(7):1057.
  30. Goho C. Oral midazolam-grapefruit juice drug interaction. Pediatr Dent 2001;Jul-Aug, 23(4):365-366.
  31. Goldfarb DS, Asplin JR. Effect of grapefruit juice on urinary lithogenicity. J Urol 2001;Jul, 166(1):263-267.
  32. Gross AS, Goh YD, Addison RS, Shenfield GM. Influence of grapefruit juice on cisapride pharmacokinetics. Clin Pharmacol Ther 1999;Apr, 65(4):395-401.
  33. Gupta MC, Garg SK, Badyal D, et al. Effect of grapefruit juice on the pharmacokinetics of theophylline in healthy male volunteers. Methods Find Exp Clin Pharmacol 1999;Dec, 21(10):679-682.
  34. Ha HR, Chen J, Leuenberger PM, et al. In vitro inhibition of midazolam and quinidine metabolism by flavonoids. Eur J Clin Pharmacol 1995;48(5):367-371.
  35. Hakim IA, Harris RB, Ritenbaugh C. Citrus peel use is associated with reduced risk of squamous cell carcinoma of the skin. Nutr Cancer 2000;37(2):161-168.
  36. Hashimoto K, Shirafuji T, Sekino H, et al. Interaction of citrus juices with pranidipine, a new 1,4-dihydropyridine calcium antagonist, in healthy subjects. Eur J Clin Pharmacol 1998;Nov-Dec, 54(9-10):753-760.
  37. Hermann M, Asberg A, Reubsaet JL, et al. Intake of grapefruit juice alters the metabolic pattern of cyclosporin A in renal transplant recipients. Int J Clin Pharmacol Ther 2002;Oct, 40(10):451-456.
  38. Hermans K, Stockman D, Van den Branden F. Grapefruit and tonic: a deadly combination in a patient with the long QT syndrome. Am J Med 2003;Apr 15, 114(6):511-512.
  39. Ho PC, Ghose K, Saville D, Wanwimolruk S. Effect of grapefruit juice on pharmacokinetics and pharmacodynamics of verapamil enantiomers in healthy volunteers. Eur J Clin Pharmacol 2000;Dec, 56(9-10):693-698.
  40. Ho PC, Chalcroft SC, Coville PF, Wanwimolruk S. Grapefruit juice has no effect on quinine pharmacokinetics. Eur J Clin Pharmacol 1999;Jul, 55(5):393-398.
  41. Hollander AA, van Rooij J, Lentjes GW, et al. The effect of grapefruit juice on cyclosporine and prednisone metabolism in transplant patients. Clin Pharmacol Ther 1995;Mar, 57(3):318-324.
  42. Honig PK, Wortham DC, Lazarev A, Cantilena LR. Grapefruit juice alters the systemic bioavailability and cardiac repolarization of terfenadine in poor metabolizers of terfenadine. J Clin Pharmacol 1996;Apr, 36(4):345-351.
  43. Honow R, Laube N, Schneider A, et al. Influence of grapefruit-, orange- and apple-juice consumption on urinary variables and risk of crystallization. Br J Nutr 2003;Aug, 90(2):295-300.
  44. Hugen PW, Burger DM, Koopmans PP, et al. Saquinavir soft-gel capsules (Fortovase) give lower exposure than expected, even after a high-fat breakfast. Pharm World Sci 2002;Jun, 24(3):83-86.
  45. Hukkinen SK, Varhe A, Olkkola KT, Neuvonen PJ. Plasma concentrations of triazolam are increased by concomitant ingestion of grapefruit juice. Clin Pharmacol Ther 1995;Aug, 58(2):127-131.
  46. Ionescu G, Kiehl R, Wichmann-Kunz F, et al. Oral citrus seed extract in atopic eczema: in vitro and in vivo studies on intestinal microflora. J Orthomol Med 1990;5(3):155-157.
  47. Jetter A, Kinzig-Schippers M, Walchner-Bonjean M, et al. Effects of grapefruit juice on the pharmacokinetics of sildenafil. Clin Pharmacol Ther 2002;71(1):21-29.
  48. Josefsson M, Ahlner J. Amlodipine and grapefruit juice. Br J Clin Pharmacol 2002;Apr, 53(4):405. Author reply, 406.
  49. Josefsson M, Zackrisson AL, Ahlner J. Effect of grapefruit juice on the pharmacokinetics of amlodipine in healthy volunteers. Eur J Clin Pharmacol1996;51(2):189-193.
  50. Kanazawa S, Ohkubo T, Sugawara K. The effects of grapefruit juice on the pharmacokinetics of erythromycin. Eur J Clin Pharmacol 2001;56(11):799-803.
  51. Kantola T, Kivisto KT, Neuvonen PJ. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther 1998;Apr, 63(4):397-402. Comment in: Clin Pharmacol Ther 2000;Jun, 67(6):690.
  52. Kawakami M, Suzuki K, Ishizuka T, et al. Effect of grapefruit juice on pharmacokinetics of itraconazole in healthy subjects. Int J Clin Pharmacol Ther 1998;Jun, 36(6):306-308.
  53. Keevil JG, Osman HE, Reed JD, Folts JD. Grape juice, but not orange juice or grapefruit juice, inhibits human platelet aggregation. J Nutr 2000;Jan, 130(1):53-56.
  54. Kivisto KT, Lilja JJ, Backman JT, Neuvonen PJ. Repeated consumption of grapefruit juice considerably increases plasma concentrations of cisapride. Clin Pharmacol Ther 1999;Nov, 66(5):448-453.
  55. Kumar N, Garg SK, Prabhakar S. Lack of pharmacokinetic interaction between grapefruit juice and phenytoin in healthy male volunteers and epileptic patients. Methods Find Exp Clin Pharmacol 1999;Nov, 21(9):629-632.
  56. Kupferschmidt HH, Fattinger KE, Ha HR, et al. Grapefruit juice enhances the bioavailability of the HIV protease inhibitor saquinavir in man. Br J Clin Pharmacol 1998;Apr, 45(4):355-359.
  57. Lane HY, Jann MW, Chang YC, et al. Repeated ingestion of grapefruit juice does not alter clozapine's steady-state plasma levels, effectiveness, and tolerability. J Clin Psychiatry 2001;Oct, 62(10):812-817.
  58. Lee M, Min DI. Determination of sildenafil citrate in plasma by high-performance liquid chromatography and a case for the potential interaction of grapefruit juice with sildenafil citrate. Ther Drug Monit 2001;Feb, 23(1):21-26.
  59. Lee TH. Ask the doctor: does grapefruit pectin powder unclog arteries? Are there any side effects? Harv Heart Lett 2002;Feb, 12(6):8.
  60. Libersa CC, Brique SA, Motte KB, et al. Dramatic inhibition of amiodarone metabolism induced by grapefruit juice. Br J Clin Pharmacol 2000;Apr, 49(4):373-378.
  61. Lilja JJ, Backman JT, Laitila J, et al. Itraconazole increases but grapefruit juice greatly decreases plasma concentrations of celiprolol. Clin Pharmacol Ther 2003;Mar, 73(3):192-198.
  62. Lilja JJ, Kivisto KT, Neuvonen PJ. Duration of effect of grapefruit juice on the pharmacokinetics of the CYP3A4 substrate simvastatin. Clin Pharmacol Ther 2000;Oct, 68(4):384-390.
  63. Lilja JJ, Kivisto KT, Backman JT, Neuvonen PJ. Effect of grapefruit juice dose on grapefruit juice-triazolam interaction: repeated consumption prolongs triazolam half-life. Eur J Clin Pharmacol 2000;Aug, 56(5):411-415.
  64. Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice increases serum concentrations of atorvastatin and has no effect on pravastatin. Clin Pharmacol Ther 1999;Aug, 66(2):118-127.
  65. Lilja JJ, Kivisto KT, Backman JT, et al. Grapefruit juice substantially increases plasma concentrations of buspirone. Clin Pharmacol Ther 1998;Dec, 64(6):655-660.
    66. Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice-simvastatin interaction: effect on serum concentrations of simvastatin, simvastatin acid, and HMG-CoA reductase inhibitors. Clin Pharmacol Ther 1998;Nov, 64(5):477-483.
  66. Maish WA, Hampton EM, Whitsett TL, et al. Influence of grapefruit juice on caffeine pharmacokinetics and pharmacodynamics. Pharmacotherapy 1996;Nov-Dec, 16(6):1046-1052.
  67. Marinucci P. Risk of torsades de pointes with non-cardiac drugs: grapefruit juice is source of potentially life threatening adverse drug reactions. BMJ 2001;Jan 6, 322(7277):47. Comment in: BMJ 2000;Apr 29, 320(7243):1158-1159.
  68. Min DI, Ku YM, Perry PJ, et al. Effect of grapefruit juice on cyclosporine pharmacokinetics in renal transplant patients. Transplantation 1996;Jul 15, 62(1):123-125.
  69. Min DI, Ku YM, Geraets DR, Lee H. Effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of quinidine in healthy volunteers. J Clin Pharmacol 1996;May, 36(5):469-476.
  70. Mouly S, Paine MF. Effect of grapefruit juice on the disposition of omeprazole. Br J Clin Pharmacol 2001;Aug, 52(2):216-217. Comment in: Br J Clin Pharmacol 1998;Aug, 46(2):101-110. Br J Clin Pharmacol 1999;Oct, 48(4):543-552. Br J Clin Pharmacol 2000;Feb, 49(2):139-144.
  71. Nagy J, Schipper HG, Koopmans RP, et al. Effect of grapefruit juice or cimetidine coadministration on albendazole bioavailability. Am J Trop Med Hyg 2002;Mar, 66(3):260-263.
  72. Oesterheld J, Kallepalli BR. Grapefruit juice and clomipramine: shifting metabolitic ratios. J Clin Psychopharmacol 1997;Feb, 17(1):62-63.
  73. Ozdemir M, Aktan Y, Boydag BS, et al. Interaction between grapefruit juice and diazepam in humans. Eur J Drug Metab Pharmacokinet 1998;Jan-Mar, 23(1):55-59.
  74. Ozdemir V, Kalow W, Okey AB, et al. Treatment-resistance to clozapine in association with ultrarapid CYP1A2 activity and the C-->A polymorphism in intron 1 of the CYP1A2 gene: effect of grapefruit juice and low-dose fluvoxamine. J Clin Psychopharmacol 2001;Dec, 21(6):603-607.
  75. Penzak SR, Acosta EP, Turner M, et al. Effect of Seville orange juice and grapefruit juice on indinavir pharmacokinetics. J Clin Pharmacol 2002;Oct, 42(10):1165-1170.
  76. Penzak SR, Gubbins PO, Gurley BJ, et al. Grapefruit juice decreases the systemic availability of itraconazole capsules in healthy volunteers. Ther Drug Monit 1999;Jun, 21(3):304-309.
  77. Pisarik P. Blood pressure-lowering effect of adding grapefruit juice to nifedipine and terazosin in a patient with severe renovascular hypertension. Arch Fam Med 1996;Jul-Aug, 5(7):413-416.
  78. Proppe DG, Hoch OD, McLean AJ, Visser KE. Influence of chronic ingestion of grapefruit juice on steady-state blood concentrations of cyclosporine A in renal transplant patients with stable graft function. Br J Clin Pharmacol 1995;Mar, 39(3):337-338.
  79. Rashid J, McKinstry C, Renwick AG, et al. Quercetin, an in vitro inhibitor of CYP3A, does not contribute to the interaction between nifedipine and grapefruit juice. Br J Clin Pharmacol 1993;Nov, 36(5):460-463.
  80. Rau SE, Bend JR, Arnold MO, et al. Grapefruit juice-terfenadine single-dose interaction: magnitude, mechanism, and relevance. Clin Pharmacol Ther 1997;Apr, 61(4):401-409.
  81. Reif S, Nicolson MC, Bisset D, et al. Effect of grapefruit juice intake on etoposide bioavailability. Eur J Clin Pharmacol 2002;Oct, 58(7):491-494. Epub 2002;Sep 03.
  82. Robbins RC, Martin FG, Roe JM. Ingestion of grapefruit lowers elevated hematocrits in human subjects. Int J Vitam Nutr Res 1988;58(4):414-417.
  83. Schubert W, Eriksson U, Edgar B, et al. Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17 beta-estradiol. Eur J Drug Metab Pharmacokinet 1995;Jul-Sep, 20(3):219-224.
  84. Shelton MJ, Wynn HE, Hewitt RG, DiFrancesco R. Effects of grapefruit juice on pharmacokinetic exposure to indinavir in HIV-positive subjects. J Clin Pharmacol 2001;Apr, 41(4):435-442.
  85. Sigusch H, Henschel L, Kraul H, et al. Lack of effect of grapefruit juice on diltiazem bioavailability in normal subjects. Pharmazie 1994;Sep, 49(9):675-679.
  86. Sigusch H, Hippius M, Henschel L, et al. Influence of grapefruit juice on the pharmacokinetics of a slow release nifedipine formulation. Pharmazie 1994;Jul, 49(7):522-524.
  87. Soons PA, Vogels BA, Roosemalen MC, et al. Grapefruit juice and cimetidine inhibit stereoselective metabolism of nitrendipine in humans. Clin Pharmacol Ther 1991;Oct, 50(4):394-403.
  88. Spahn-Langguth H, Langguth P. Grapefruit juice enhances intestinal absorption of the P-glycoprotein substrate talinolol. Eur J Pharm Sci 2001;Feb, 12(4):361-367.
  89. Takanaga H, Ohnishi A, Murakami H, et al. Relationship between time after intake of grapefruit juice and the effect on pharmacokinetics and pharmacodynamics of nisoldipine in healthy subjects. Clin Pharmacol Ther 2000;Mar, 67(3):201-214.
    90. <
  90. Taniguchi S, Kobayashi H, Ishii M. Treatment of psoriasis by cyclosporine and grapefruit juice. Arch Dermatol 1996;Oct, 132(10):1249.
  91. Trinchieri A, Lizzano R, Bernardini P, et al. Effect of acute load of grapefruit juice on urinary excretion of citrate and urinary risk factors for renal stone formation. Dig Liver Dis 2002;Sep, 34(Suppl 2):160-163.
  92. van Agtmael MA, Gupta V, van der Graaf CA, van Boxtel CJ. The effect of grapefruit juice on the time-dependent decline of artemether plasma levels in healthy subjects. Clin Pharmacol Ther 1999;Oct, 66(4):408-414.
  93. Vanakoski J, Mattila MJ, Seppala T. Grapefruit juice does not enhance the effects of midazolam and triazolam in man. Eur J Clin Pharmacol 1996;50(6):501-508.
  94. Vandel S, Netillard C, Perault MC, Bel AM. Plasma levels of clozapine and desmethylclozapine are unaffected by concomitant ingestion of grapefruit juice. Eur J Clin Pharmacol 2000;Jul, 56(4):347-348.
  95. Varis T, Kivisto KT, Neuvonen PJ. Grapefruit juice can increase the plasma concentrations of oral methylprednisolone. Eur J Clin Pharmacol 2000;Sep, 56(6-7):489-493.
  96. Vincent J, Harris SI, Foulds G, et al. Lack of effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of amlodipine. Br J Clin Pharmacol 2000;Nov, 50(5):455-463.
  97. Weber A, Jager R, Borner A, et al. Can grapefruit juice influence ethinylestradiol bioavailability? Contraception 1996;Jan, 53(1):41-47.
  98. Xiao Dong S, Zhi Ping Z, Zhong Xiao W, et al. Possible enhancement of the first-pass metabolism of phenacetin by ingestion of grape juice in Chinese subjects. Br J Clin Pharmacol 1999;Oct, 48(4):638-640.
  99. Xu J, Go ML, Lim LY. Modulation of digoxin transport across Caco-2 cell monolayers by citrus fruit juices: lime, lemon, grapefruit, and pummelo. Pharm Res 2003;Feb, 20(2):169-176.
  100. Yasui N, Kondo T, Furukori H, et al. Effects of repeated ingestion of grapefruit juice on the single and multiple oral-dose pharmacokinetics and pharmacodynamics of alprazolam. Psychopharmacology (Berl) 2000;Jun, 150(2):185-190.
  101. Yasui N, Kondo T, Suzuki A, et al. Lack of significant pharmacokinetic interaction between haloperidol and grapefruit juice. Int Clin Psychopharmacol 1999;Mar, 14(2):113-118.
  102. Zaidenstein R, Soback S, Gips M, et al. Effect of grapefruit juice on the pharmacokinetics of losartan and its active metabolite E3174 in healthy volunteers. Ther Drug Monit 2001;Aug, 23(4):369-373.
  103. Zaidenstein R, Dishi V, Gips M, et al. The effect of grapefruit juice on the pharmacokinetics of orally administered verapamil: A. Eur J Clin Pharmacol 1998;Jun, 54(4):337-340.



Last updated July 14, 2005


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