are grapefruit ok?

[minismom]

Not sure if this is where this thread belongs, but I figured I'd get a better response here.  If it needs to be moved, i understand.  My question is:
are grapefruit ok to eat?  What about drinking grapefruit juice?  Mini is on kaletra, susteva, and zerit.  I don't remember reading anything about it in the papers that come with her meds and the bottles don't have a warning sticker on them.  What do grapefruit do?  Are other citrus fruits/juices ok? I'm asking because someone gave her a bag with oranges and grapefruit in it and she wants to eat them for breakfast.  I told her I'd ask her friends for her .

Thanks!
mum

[Matty the Damned]

Hey Mum,

I think that grapefruit juice + saquinavir (Invirase) is a no-no, that drug isn't approved for use in kiddies. It may apply to other protease inhibitors too.

Perhaps other more knowledgeable members and/or our Drug Lessons can give further insights here.

MtD

[Miss Philicia]

I know grapefruit/juice does interfere with some medications (cholesterol ones are notable), though as for HIV specific ones I don't know which it does or doesn't.  Ask your doctor -- that's what they should know.

I just avoid the question by rarely buying it, though if I feel like eating a grapefruit I don't run in horror.  In fact, I bought one today, but that said I probably don't eat one more than once each month and I never buy the juice as the size I would buy would be a large container which is more than one serving. 

There is no issue with other fruit/juices that I know of, so that should make your question easier.  Still, I'd advise you to ask your doctor.

[minismom]

Thx matty and phiily.  I read the lessons and didn't see anything about not having grapefruit.  I did learn that kaletra needs to be increased if it's being used with susteva (which it is for mini) and that all her meds cause the same side effects which pretty much sucks for her.  When, and IF, her PID ever comes out of hiding AND if she won't change her to something less toxic, we'll definatly talk about the need to increase her kaletra - but i'd rather her get off it all together.

Thx again and sleep well!
Mum

[Oceanbeach]

Hi Mum,

The first time I was put on Lipitor for Cholesterol, I was told not to eat grapefruit or drink the juice.  So much for Salty Dogs at Sunday Brunch.

Recently, I was put back on Lipitor for Cholesterol (different doctor, different clinic).  I asked about grapefruit juice and was told it was OK... My HIV meds are Sustiva and Trizivir.  However comma I hate grapefruit juice without vodka as I hate water without scotch.  Mini should not be having that problem for a long time  Have the best day
Michael

[vokz]

The problem with concentrated grapefruit juice is that it reduces absorption (i.e. it boosts the blood levels and increases side effects) of most protease inhibitors, SSRI antidepressants and some cholesterol drugs; so it is best to avoid drinking it at the same time as (or within a few hours of) taking drugs.

A little of the actual fruit shouldn’t be much a of problem (you have to eat a fair bit of grapefruit to get the equivalent of a glass of concentrated grapefruit juice), but you may just want to play it safe and keep it clear of medication times.

As far as I am aware, other citrus fruits and their juices are fine .. although there is something in the back of my mind about the old style of ddI (didanosine, Videx) and orange juice and/or grapefruit juice, but I can’t for the life of me remember what that is.

[cjc]

Hello, MM. I take Atripla, Truvada and Sustiva , and from what i understand Grapefruit is a big no-no. It affects the absorption of the meds so I just don't drink or eat it. wish Newt were here, he know all that kind of stuff.    Other citrus are okay, just something about the grapefruit. Put it away, give her the oranges and ask your doctor about the grapefruit, just to be safe. Not much help to you but I want to try.   Cristy

[vokz]

Cristy,

Whilst adverse grapefruit juice interactions with efavirenz (Sustiva & Atripla) and nevirapine (Viramune) are THEORETICALLY possible, you would have to drink vast amounts of the stuff (as in several pints a day) for the interaction to even register.

I suspect that whoever told you to avoid grapefruit juice with Atripla was simply taking the easy option and telling people not to drink it with any antiretroviral.

[pozguy75]

I am on Atripla, and I know from reading the drug interaction section for Sustiva, it specifically states to stay away from grapefruit on the labeling...but I don't like it in any form, so that was an easy on for me...

[vokz]

I am on Atripla, and I know from reading the drug interaction section for Sustiva, it specifically states to stay away from grapefruit on the labeling

On the official package / patient information leaflet?

Can you give me the number / date of the leaflet?

My package leaflets certainly don’t mention it. I can find nothing in any of the current prescribing or patient information, for either Sustiva or Atripla, that advises against drinking grapefruit juice. Nor can I find a single reputable online source saying it.

[aztecan]

Hey MM,

Yes, grapefruit are a no-no for those of us on PIs. or NNRTIs. I used to do as Philly does, eat one occasionally, but my doc told me to stop because the enzyme-busting ingredient in grapefruit lingers in the body for quite a while.

Here is a link discussing it:

http://www.poz.com/articles/159_447.shtml

Other citrus is fine, just my beloved grapefruit, especially the pink, is verboten.

HUGS,

Mark

[Miss Philicia]

Other citrus is fine, just my beloved grapefruit, especially the pink, is verboten.

HUGS,

Mark

Oh, Miss Thing!  The one I bought yesterday is a PINK one.

But seriously, I swear I've not been warned by a doctor about any of this since like 2001 and due to insurance changes and relocating to another city I've gone through four HIV doctors since then.  Not a one after that year has said a thing.

I still can't imagine having ONE every two months is going to adversely effect me. 

Oh, and btw honey, your link specifically mentions the juice, not the actual fruit.  I think like vokz stated that there's a huge difference due to the concentration in the juice one finds at the store.  I never buy the juice.

[Dragonette]

Other citrus is fine, just my beloved grapefruit, especially the pink, is verboten.

I just bought a bunch of pink ones and ate one every day this week, and I am on Invirase. Just had no clue. Thanks Minismum for raising this

[Jnm594]

I am on Norvir, Reyataz, Truvada and Epzicom and my ID told me to not eat ANY grapefruit or drink any grapefruit juice. something about an enzyme in it affected absorption. She then said I could probably eat half a grapefruit every now and then after taking my meds so many hours beofore and not take them so many hours later, yadda, yadda but the concentration of enzyme in the juice was a big no no. I always err on the side of caution so now I don't eat any grapefruit which bites because I love them but that's something I chose to do.

My 2 cents, ask your ID doc before she has them. They don't spoil fast!

 

[cjc]

I am on Atripla, and I know from reading the drug interaction section for Sustiva, it specifically states to stay away from grapefruit on the labeling...but I don't like it in any form, so that was an easy on for me...

                                                                                               I ,too, remember reading that on my information packet that comes with my Atripla. Whether it's on the packet from the pharmacy or the company packet, I can't remember.                                   Even if it's only Atripla, I would err on the side of caution and not give her any. But that's just me.        Cristy

[minismom]

Thank you so much everyone for your posts and links!  We decided to err on the side of caution and gave them away to ds2's birthday party guests!  Most thought it was really cool   We explained to her that she could have all the other fruit she wanted, just not the grapefruit.  Since she'd never had one, she isn't missing it.  If/when her PID ever comes out of hiding, we'll be sure to ask her.

Thanks again!

Mum