Chloesterol and citrus

[deepee]

I am using Lipitor (atorvastatin calcium) to reduce my cholesterol levels and have been told that consuming grapefruit interferes with my medication and has possible dangerous side effects. Now I cannot find out what it is in grapefruit that is the problem ingredient and whether this ingredient could possibly show up in some of the Asian citrus varieties. Those big Pomellos or "som oh" as the Thais call them are very grapefruit like, even the fruit of the kaffir lime I find similar in taste.
I'm expecting the producers of Lipitor to have little knowledge of other than mainstream western citrus varieties so there could be risks with local stuff. I have spoken to Thais who use Lipitor and nearly all are unaware of the grapefruit risk let alone any other problems with Lipitor. I have seen where it lists people of Asian background as not suited to using Lipitor also, again I cannot get to the fine detail on this.

[MrPlum]

It's just a suggestion but have you ever considered ditching the Lipitor and eating more grapefruit? You will get all the benefits of the fruit and none of the risks of the drug.

[PeteC]

This Wiki article has a very large list about grapefruit and drug interactions. It mentions Pomelo as well. Pete

http://en.wikipedia.org/wiki/List_of_dr ... grapefruit

[E-Dork]

Sorry but this is nothing to do with the thread.

Pete, I have always wondered for many a year now what your user name stands for. Is it....

Prepared and
Ready
Currently
Sitting on a
Comfortable
Couch about to
Type ??

... or am I way off?

[sargeant]

I dont know if this will help but i was on lipitor
I am now on simvastatin the cost saving from 64Bt a tab down to 7 Bt a tab
After every morning bike ride i am greeted by my new ladies mid morning snack of pineapple with lime juice squeezed over it

It has done wonders for me

[deepee]

Mr Plum,
I'd love to keep my distance from Lipitor but even tho my chloresterol levels are down around the 3's I have looked at risks v benefits and due a poor family health heritage I will go with my minimal dosage for now.BTW my diet is pretty good .
And thanks for your info Pete as it gives me an answer or two.

[Siani]

I dont know if this will help but i was on lipitor
I am now on simvastatin the cost saving from 64Bt a tab down to 7 Bt a tab
After every morning bike ride i am greeted by my new ladies mid morning snack of pineapple with lime juice squeezed over it

It has done wonders for me

I am so glad you posted that. My husband has just returned from the chemist an hour ago who gave him a price for Lipitor, he almost had a heart attack! I take Simvastatin, but think I may have some side effects e.g. cramp at night and occassional muscle ache. Anyway, think the cost of 7Bt a tab is a lot better Thanks for the post.

[littlebird]

Grapefruit does indeed interact with some drugs by reducing their potential.
Email the pharmaceutcal who makes them and they will advise. Found this on google
The pomelo (also called shaddock, pumelo, pommelo, and Chinese grapefruit) is the largest citrus fruit, ranging from the size of a cantaloupe to that of a large watermelon. Botanists believe that crosses between pomelo and wild orange created grapefruit. Pomelo mixes the sweet taste of orange with the tang of lemon. Its lineage means that pomelo contains many of the same compounds as grapefruit.

One or more substances in grapefruit and grapefruit juice block the action of an enzyme called cytochrome P-450 3A4 (CYP3A4). This enzyme breaks down a wide array of medications, including atorvastatin (Lipitor). (For an extensive list of drugs affected by grapefruit juice, visit health.harvard.edu/165.) Knocking CYP3A4 out of action means higher blood levels of these medications. One glass of grapefruit juice, or eating half a grapefruit, is enough to suppress CYP3A4 activity by half, and the effect lasts up to 24 hours. The accumulation of active statin in the bloodstream could cause muscle or liver problems.

From the handful of studies on the effects of pomelo on drug metabolism, it looks like pomelo and pomelo juice act much like grapefruit and grapefruit juice.

Grapefruit and pomelo aren't the only fruits that affect drug metabolism. Lab studies suggest that black mulberry juice, wild grape juice, pomegranate juice, and black raspberry juice also interfere with CYP3A4.

You have two basic options. One is to avoid eating pomelo and drinking juice made from it. The other is to keep enjoying it but talk with your doctor about switching to a statin that isn't affected by grapefruit, such as fluvastatin (Lescol), pitavastatin (Livalo), pravastatin (Pravachol), or rosuvastatin (Crestor).

[MrPlum]

Grapefruit juice appears to enhance the effects of certain drugs, which can increase side effects. It's not just Lipitor.

It may be nothing to worry about but if I was taking any of the following, I would check with my Doctor...

Medications That are Affected by Grapefruit Juice Use

Statins (Cholesterol Lowering Drugs):
Baycol (Cerivastatin)
Mevacor (Lovastatin)
Lipitor (Atorvastatin)
Zocor (Simvastatin)


Antihistamines: Ebastine
Seldane (Terfenadine, taken off the U.S. market)

Calcium Channel Blockers (Blood Pressure Drugs):
Nimotop (Nimodipine)
Nitrendipine
Plendil (Felodipine)
Pranidipine
Sular (Nisoldipine)

Psychiatric Medications:
Buspar (Buspirone)
Halcion (Triazolam)
Tegretol (Carbamazepine)
Valium (Diazepam)
Versed (Midazolam)

Intestinal Medications:
Propulsid (Cisapride, taken off the U.S. market)

Immune Suppressants:
Neoral (Cyclosporine)
Prograf (Tacrolimus)


Pain Medications:
Methadone

Impotence Drug:
Viagra (Sildenafil)

Miscellaneous
Losartan (for lowering blood pressure) - Grapefruit juice inhibits the body's ability to absorb the drug.
Digoxin (for treating congestive heart failure) - Grapefruit juice inhibits the body's ability to absorb the drug.

[richard]

I’m on warfarin (rat poison) to thin my blood

This is what I was told by doctors at the Bumrungrad to avoid

Foods high in vitamin K (green leafy vegetables (broccoli, Brussels sprouts, turnip greens, kale, spinach, beet greens), Cauliflower , legumes, mayonnaise, canola and soybean oils),

Caffeinated beverages (cola, coffee, tea, hot chocolate, chocolate milk).

As long as alcohol intake does not exceed 3 drinks daily, clotting times should not be affected. This amount of alcohol is present in 12 ounces of table wine or three 12 ounce beers. (Acute binges can raise INR. Chronic alcohol ingestion may decrease INR. )

Spices (garlic, ginger and chili)

Herbal teas: green tea, buckeye, horsechestnut, tonka, bean, meliot, and woodruff, feverfew, garlic, and ginseng.

Fruit is OK except no grapefruit, tomatoes, mango and papaya and cranberries

So pretty much stuffed

Bounced it off my doctor here and in the UK and they said all were OK in moderation (whats that?)

Best bet I reckon is get 2 opinions from separate doctors

[Roel]

Richard, I think if two separate doctors tell you you can have three drinks a day that does not mean you can have six.

[richard]

Oh shucks

[margaretcarnes]

I know that many people do have to depend on medication, but it seems increasingly apparent that 'essential' medications are often at odds with what we have always considered to be healthy foods!
And even 'healthy' foods these days carry the 'moderation' warning labels. Without wanting to provide Mr P with material for too much of a rant doesn't it all seem a bit A about F?
Is our food these days so processed/old/contaminated that we don't get what we need from it - or have we just lost the ability to instinctively know what fuel we need?

[deepee]

Yes Mags,
Trying to work out what is good or bad with food is becoming increasingly more difficult in these times. Take things like clever marketing, reduced diversity within food types and a total trust in a system which is surely going to look after us, or so we are led to believe.
This aside, probably the fact that we are living longer than the last few generations means our bodies are not keeping up with us and are programed to wear out and fail. Medications may prop us to get along with one problem, getting us on for another few years while we are just exposing ourselves to the next failing in our bodies.
It is unnerving to realize our forbears died much younger than we do now and with younger bodies too. We are sailing in new waters here me thinks.

[MrPlum]

I would say the number 1 cause of sickness is industrialized food.

Gardeners know good soil produces healthy plants and poor soil produces sickly plants. Likewise healthy food produces healthy people, while nutrient-poor food produces sick people.

This article talks about how the Hunzas went from healthy old age to western diseases, within an 80 year period... http://www.associatedcontent.com/articl ... n_the.html