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Interaction between drugs and foods Tips Guide

Two interactions to know

1. Beware of foods rich in vitamin K

Brassicaceae (cabbage, broccoli, spinach ...), avocado, parsley, lettuce, green tea and offal packed with vitamin K. They are to eat sparingly (no more than one serving "reasonable" daily, limiting consumption of sudden changes) if we take the same time oral anticoagulants (vitamin K antagonists in the long term) to thin the blood .

Decreasing the effectiveness of anticoagulants, these foods are at risk of thrombosis.

2. Attention to citrus

Grapefruit juice, one of Seville oranges and tangelos contains two flavonoids (naringin and naringenin) which inhibit:

- A cytochrome P450 isoenzyme, CYP3A4, very involved in the metabolism of many drugs,
- And intestinal protein (P-glycoprotein).

a - This inhibition results in increased blood concentrations of drugs such as cyclosporine (immunosuppressant used against transplant rejection) with a risk of kidney damage.

Note: a glass of grapefruit juice three levels of cyclosporine
b - It also increases the blood levels of some statins used for lowering blood cholesterol: simvastatin, atorvastatin to a lesser extent. The risk of myopathy cause profound because citrus remains theoretical in people treated. In general it is just muscle pain. Similarly, the risk of acute renal failure by grapefruit interaction / statin remains theoretical.

Note: A grapefruit juice taken with simvastatin can multiply that by 15 drug absorption.

c - The plasma concentration of certain antihypertensive calcium channel blockers may also increase (felodipine, nisoldipine, for example) with a risk of hypotension mainly.

Note: A glass of grapefruit juice increased the peak plasma concentration of felodipine on average 300% of nisoldipine on average 500%.
d - A glass of grapefruit juice can increase:

  • Levels of terfenadine (antihistamine) of 450%.
  • Levels of ethinyl estradiol (estrogen birth control pills)
  • Midazolam (benzodiazepine psycholeptic, sedative)

- Of the antiviral agent saquinavir.

In addition, citrus fruits (lemon, grapefruit, orange) should be avoided with anti-inflammatories or aspirin, otherwise increase or trigger heartburn or acid reflux.

Three practical advice

1 - avoid drinking grapefruit juice within two hours before the medication,

2 - limit consumption to less than a quarter of a liter per day

3 - swallow its anti-inflammatory in the middle of the meal.

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