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Mixing Grapefruit Juice With Pills Could Kill

At least 85 drugs on the market, including opioid painkillers, could cause an adverse reaction when mixed with seemingly harmless grapefruit juice.

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By Chrisanne Grise

11/28/12

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Scientists have long thought that grapefruit juice can cause harmful reactions when mixed with certain medications. Now a study has found that the number of drugs on the market with that risk—including opioid painkillers like oxycodone—has greatly increased since 2008. "Many of the drugs that interact with grapefruit are highly prescribed and are essential for the treatment of important or common medical conditions," write the authors in the study, published in the Canadian Medical Association Journal. "Recently, however, a disturbing trend has been seen." Researchers found that from 2008-2012, the number of meds with the potential for serious negative reactions with grapefruit rose from 17 to 43. "This increase is a result of the introduction of new chemical entities and formulations," they write. There are at least 85 drugs in total that can cause reactions with grapefruit juice.

Grapefruit—along with the Seville orange used to make marmalade, pomelos and limes—carries risks because it contains a chemical called furanocoumarins, which can change the way a drug is absorbed in the gastrointestinal tract, causing more of the drug to enter the bloodstream. With certain drugs, this can cause kidney damage, GI tract bleeding, respiratory failure, bone-marrow suppression and death. And the juice can have this effect even if the pills are taken hours later—so eating just one grapefruit a day while on these meds can be harmful. "Taking one tablet with a glass of grapefruit juice is like taking 20 tablets with a glass of water," says author David Bailey. "This is unintentional overdosing. So it's not surprising that these levels go from what we call therapeutic to toxic." Aside from oxycodone, other drugs that carry this risk include Zocor, Lipitor, Nifediac and some anti-infective, cardiovascular and urinary tract infection medications. Experts recommend checking with your doctor or pharmacist, along with reading information included with the medication, to find out whether ingesting grapefruit is safe.

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