Harvard Heart Letter

Grapefruit, drug interactions

The potency of some cardiovascular and other drugs is affected by grapefruit, pomelo, and other juices. Some of the most common drugs affected by grapefruit are listed below. The University of Florida has set up a Web site (www.druginteractioncenter.org) where you can see if your medications interact with grapefruit.

Drugs that interact with grapefruit

Grapefruit and grapefruit juice can boost blood levels of various prescription medications. Keep in mind that each category contains several other medications that aren't affected by grapefruit.

Drug category (major uses)

Drugs affected

Statins (lowering cholesterol)

atorvastatin (Lipitor), lovastatin (Mevacor, Altoprev, Advicor), simvastatin (Zocor, generic)

Calcium-channel blockers (high blood pressure, angina)

diltiazem (Cardizem, others), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nisoldipine (Sular), verapamil (Covera, Verelan)

Other cardiovascular drugs

amiodarone (Cordarone, Pacerone), cilostazol (Pletal, generics), losartan (Cozaar, Hyzaar)

Immunosuppressants (prevent organ rejection)

cyclosporine (Gengraf, Neoral, others), tacrolimus (Prograf, Protopic)

Sedatives (anxiety, insomnia)

diazepam (Valium, Diastat, Dizac), midazolam (Versed), triazolam (Halcion)

Other neurological and psychiatric medications

buspirone (BuSpar), carbamazepine (Tegretol, Epitol, Carbatrol), sertraline (Zoloft)

Phosphodiesterase inhibitors (erectile dysfunction)

sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra)

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