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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by horridmonster on October 13, 2002, at 4:15:53
I read that while on lexapro one shouldn't drink grapefruit juice. I LOOOOOVE grapefruits and would like to go back to eating one a day. anyone have any info on this? Would one grapefruit (every day) be bad? Sounds like a ridiculis silly question but believe it or not i'm serious. Pharm rep? anyone?
While i'm here i also want to thank all of the folks who've been posting. I'm on my third week of lex (I also continue to take wellbutrin) and i don't think i would've given this drug a chance if i hadn't come across mystia's postings. I'm still feeling sluggish and a little queasy but i'll stick with it a couple of months to see if it helps my (SEVERE)pms. -horridmonster
Posted by Mystia on October 13, 2002, at 11:32:01
In reply to lexapro and grapefruit, posted by horridmonster on October 13, 2002, at 4:15:53
I'm really happy to hear that I helped someone out =)
About the grapefruits/grapefruit juice. With all the SSRI's I have ever taken, my doc has told me to stay away from grapefruits and grapefruit juice. He explained it to me by saying that the same part of your digestive system that digests grapefruits also digests the meds (there's some kind of enzyme that breaks both of them down). So, if you eat grapefruits, then you could overdose because you'd have a higher level of the meds in your bloodstream. I'm not sure how scientific that is, but it made sense to me. I have found a few websites about grapefruit interactions with meds, but I am not sure if we're allowed to post URLs here.Myst
Posted by Mystia on October 13, 2002, at 11:49:23
In reply to Re: lexapro and grapefruit, posted by Mystia on October 13, 2002, at 11:32:01
Ok, I read the FAQ and I don't *think* it's illegal to post URLs here. So, here you are!
http://www.powernetdesign.com/grapefruit/
http://www.holistic-online.com/Herbal-Med/_Herbs/grapefruit-interactions-home.htm
Posted by BeardedLady on October 13, 2002, at 12:25:34
In reply to lexapro and grapefruit, posted by horridmonster on October 13, 2002, at 4:15:53
You can eat grapefruits and drink grapefruit juice while taking a medicine; you just can't take the medicine with grapefruits or grapefruit juice.
This applies to a great deal of medications, including some antibiotics and pain relievers. It's best to take meds with a full glass of water, unless otherwise directed on the label.
beardy
Posted by SLS on October 18, 2002, at 15:44:26
In reply to Re: lexapro and grapefruit, posted by Mystia on October 13, 2002, at 11:49:23
Hi.
Grapefruit interactions do not extend to all of the SSRIs. Such a generalization is not justified.
Prozac, Zoloft, and Paxil do not react with grapefruit juice. The only SSRI I know of for which this is a problem is Luvox (fluvoxamine), whose main metabolic pathway uses CYP3A4. The culprit substance in grapefruit that affects the levels of many drugs is a cytochrome enzyme known as CYP3A4. Lexapro (escitalopram) does not use this enzyme exclusively for its metabolism.
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"After normalization for hepatic abundance, relative contributions to net intrinsic clearance were 37% for CYP2C19, 28% for CYP2D6, and 35% for CYP3A4"
[Escitalopram (S-citalopram) and its metabolites in vitro: cytochromes mediating biotransformation, inhibitory effects, and comparison to R-citalopram.]
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I think it would be a good idea to investigate this matter further by perhaps calling Forest Labs to get accurate information. From what I see, though, I don't think there should be a problem with combining Lexapro and grapefruit juice.
- Scott---------------------------------------------
"These findings suggest that there is a low potential for interactions between escitalopram and other agents that inhibit CYP3A4."http://www.nimh.nih.gov/ncdeu/abstracts2001/ncdeu3021.cfm
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"We investigated the inhibitory activity of the furanocoumarin derivatives from grapefruit juice to the drug metabolizing enzyme, cytochrome P450 (CYP) 3A4. Although two known furanocoumarin dimers GF-I-1 (1) and GF-I-4 (2) showed potent CYP3A4 inhibition with IC50 value of 0.07 microM, a semi-synthetic dihydroxybergamottin caproate (11), which was more stable and more simple than the dimers, exhibited comparable activity against CYP3A4."
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"Grapefruit juice, a beverage consumed in large quantities by the general population, is an inhibitor of the intestinal cytochrome P-450 3A4 system, which is responsible for the first-pass metabolism of many medications. Through the inhibition of this enzyme system, grapefruit juice interacts with a variety of medications, leading to elevation of their serum concentrations."
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This is the end of the thread.
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