Grapefruit–drug interactions (NICE) - research article/commentary/ilist of drug interactions including statins)

Issue 48 – April 2013


Research:  Overview: A pharmacokinetic interaction between grapefruit and certain drugs was first identified over 20 years ago. To date, more than 85 drugs have the possibility of interacting with grapefruit, many of which are widely prescribed for important or common medical conditions. The main interaction results from interference in the activity of the cytochrome P450 3A4 (CYP3A4) enzyme..........

 
Commentary:
"This review provides a comprehensive background to the pharmacokinetics of grapefruit-drug interactions. Of particular importance is the table listing the drugs with the potential to interact with grapefruit – a list that is wider than one may suspect. Also of interest to practitioners is the information on the amount of grapefruit that could cause a clinically significant effect and that all forms of grapefruit have the potential to cause the interaction.
"The true extent of grapefruit-drug interactions in clinical practice is not clear, and this review is not able to provide such data. Under-reporting of such interactions via adverse drug reaction reporting to the MHRA in day-to-day clinical practice is likely and the yellow card system provides a straightforward mechanism for reporting any suspected events."