Juices & drugs don't mix

WASHINGTON - GRAPEFRUIT, orange and apple juices can harm the body's ability to 
absorb certain medications and make the drugs less effective, said a Canadian 
study released on Tuesday in the United States.

The research showed that these juices can decrease the effectiveness of certain 
drugs used to treat heart disease, cancer, organ-transplant rejection and 
infection, 'potentially wiping out their beneficial effects', it said.

David Bailey, a professor of clinical pharmacology with the University of 
Western Ontario and leader of the study, was the first researcher to identify 
grapefruit juice's potential to increase the absorption of certain drugs two 
decades ago, possibly turning some doses toxic.

The new findings came as part of his continuing research on the subject, and 
were presented at the 236th annual meeting of the American Chemical Society on 
Philadelphia, Pennsylvania.

'Recently, we discovered that grapefruit and these other fruit juices 
substantially decrease the oral absorption of certain drugs undergoing 
intestinal uptake transport', said Mr Bailey.

'The concern is loss of benefit of medications essential for the treatment of 
serious medical conditions'.

Healthy volunteers took fexofenadine, an antihistamine used to fight allergies, 
along with either a glass of grapefruit juice, a glass of water with naringin 
(which gives the bitter taste to grapefruit juice), or plain water. Those who 
drank the grapefruit juice absorbed only half the amount of fexofenadine, 
compared to those who drank plain water. Researchers said the water with 
naringin served to block 'a key drug uptake transporter, called OATP1A2, 
involved in shuttling drugs from the small intestine to the bloodstream'.

'Blocking this transporter reduces drug absorption and neutralises their 
potential benefits', the study said.

'By contrast, drugs whose levels are boosted in the presence of grapefruit 
juice appear to block an important drug metabolizing enzyme, called CYP3A4, 
that normally breaks down drugs'.

Among the drugs affected by consumption of grapefruit, orange and apple juices 
are: etoposide, an anticancer agent; beta blockers (atenolol, celiprolol, 
talinolol) used to treat high blood pressure and prevent heart attacks; and 
certain antibiotics (ciprofloxacin, levofloxacin, itraconazole).

The drug-lowering interaction also affected cyclosporine, a drug taken to 
prevent rejection of transplanted organs, and more drugs were expected to be 
added to the list as the research continued. Prof Bailey said patients should 
consult with a doctor about taking medications with juice, and stick to plain 
water when taking most medications.

'This is just the tip of the iceberg', Prof Bailey said. 'I'm sure we'll find 
more and more drugs that are affected this way'.

AFP
http://straitstimes.asia1.com.sg/Breaking%2BNews/Tech%2Band%2BScience/Story/STIStory_270074.html

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