I recently saw a short documentary with a case where someone had an overdose because of interaction with medicines and grapefruit juice.<p>This is apparently due to substances in grapefruit that interact with an enzyme used to metabolize some medicines.<p>Warning labels in the leaflet seems like a very inefficient solution. Why isn't the warning placed on products containing grapefruit?
In America, for as long as I remember grapefruit juice interactions are both listed on the bottle and on the pamphlet you receive every single time you get a prescription (renewed or new).<p>We can't put billboards up for everything. It is your health, and therefore your responsibility, to read the provided literature and raise any questions to your doctor. It's not obscured or hidden knowledge. In fact, it's usually one of the first things mentioned in big, bold text. In addition every pharmacy I've been to offers consulting on medications for free and in general doctors will always go over major interactions with medication (though I've had less luck with this).
Because what are you going to put on the grapefruit juice label, a list of thousands of drugs that can have interactions with it? If people don't read the leaflets to their medication that's really on them.<p>It's surprising that people would take any medication without reading the leaflet anyway, given that grapefruit is not the only thing that can interact with them, and it's usually pretty clearly written.
Someone prescribed a medicine is given given direction by the doctor, a consult from their pharmacist, and printed material explaining how to take their medication and what to be careful of while taking it. More information is available to them online and in popular home reference books for drugs.<p>Perhaps because of a life too inundated by data, or because they’re busy, or for whatever reason, they ignore all of these opportunities to understand the medicine they’ve been asked to take.<p>I can’t judge a person for doing that, as I’m sure I’ve done the same thing, but I certainly wouldn’t expect a new label on a jug of grapefruit juice that they barely glance at to finally make it across the finish line!<p>There are problems in the world that are just going to exist, and efforts to eradicate them can become costly and fruitless nuisances rather than further solutions. This feels like one of those to me.
I take a medication for which grapefruit juice is contraindicated.<p>I got no shortage of warning about from the medication side (doctor and pharmacist directly and verbally, plus in written form in the paperwork and labeling).<p>It seems far more reasonable and feasible to put the warnings on the medicine than on the food.
As the old saying goes, you can't fix stupid.<p>By the time someone has killed themselves by eating grapefruit, it means they've already plunged through two safety barriers:<p><pre><code> 1) The medical professional that prescribed failed in their duty to inform of interactions (which then begs the question as to whether they also failed to screen for interactions before prescribing).
2) You know, those little bits of magically folded paper that come in every single packet of pills. They're not just there for decoration. And if you can't read, then there's always the Pharmacist (or friends or family).
</code></pre>
Its a bit like that stupid warning the Californians put on wine bottles that it may cause issues with pregnancies. Well, that warning is a bit short, because they should have also told you about cirrhosis of the liver, drink driving, the dangers of broken glass, the fact you might stain your carpet ....
defensive and uncharitable comments..<p>Not common sense that grapefruit interacts with many meds. Signal to noise is important, but grapefruit interacts with enough to be notable. <i>Someone</i> would become aware that would've otherwise been ignorant:<p><a href="https://en.wikipedia.org/wiki/Defence_in_depth_(disambiguation)" rel="nofollow">https://en.wikipedia.org/wiki/Defence_in_depth_(disambiguati...</a><p>Even this thread itself raised some awareness, so thanks
Well, I need to be on statins forever. No doctor ever told me about interaction between statins and grapefruit. I totally googled at random one day about grapefruit and cholesterol and tangentially it was mentioned (the dreadful interactions with statins).
Grapefruit is a food that alone or with other foods poses basically no risk.<p>Medications have all kinds of complex interactions.<p>The vitamin K from any number of leafy greens in conjunction with prescription meds can kill you too.<p>If you are tuned within an inch of your life on prescription meds maybe you should read the leaflets.<p>Warnings on citrus fruit. What.
PSA: don't stop drinking grapefruit juice abruptly, if you are on meds. your effective dosage of medication will swing wildly as your liver enzymes adjust.<p>this has killed people before - someone will be on a carefully titrated dose of heart meds, stop consuming grapefruit, and die from their body suddenly having 3x more/less of their med.
If we start such warnings. What else should be covered? Alcohol by my understanding has interactions with those drugs that are broken down by liver at least. What should be threshold for warning to be present?
I think a more interesting question would be: should food that contains grapefruit have a warning? Any food with high levels of phenylalanine says “phenylketonurics: contains phenylalanine”. Perhaps food containing substantial amounts of grapefruit should carry a similar warning.<p>This is complicated by the fact that other citrus fruits may have similar interactions and, at least according to Wikipedia, the full set of problematic citrus fruits is not well characterized.
IMO, it would be perfectly reasonable to include a warning saying that grapefruit is known to interact with many medicines and should be taken with caution by medicated individuals.<p>That's more likely to prompt someone who's medicated into looking up if their drugs are affected by the fruit.<p>At worst, it causes a few companies to have to print an extra line of text and it gets disregarded by users.
The question is what is the level of risk you are trying to prevent. For me a far more underappreciated risk is the level of liver toxicity in acetaminophen (Tylenol) especially with even moderate amounts of alcohol--taking Tylenol for a hangover is a very bad idea.<p>You can be in liver failure (See <a href="https://www.mayoclinic.org/diseases-conditions/acute-liver-failure/symptoms-causes/syc-20352863" rel="nofollow">https://www.mayoclinic.org/diseases-conditions/acute-liver-f...</a> ) after one very large dose of acetaminophen, or after higher than recommended doses every day for several days.<p>From <a href="https://www.ucihealth.org/blog/2018/03/acetaminophen-liver-failure" rel="nofollow">https://www.ucihealth.org/blog/2018/03/acetaminophen-liver-f...</a>
About 1,600 U.S. cases of acute liver failure occur each year due to acetaminophen overuse. And some 500 people die each year from overdosing on the drug.
Why stop at grapefruit juice? I've heard citrus juice can have unpredictable effects on any drug.<p>Imagine you have a peanut allergy and have to check the labels on everything to see if it contains peanut or processed in a plant with peanuts.<p>Then you walk into the drinks aisle and see grapefruit juice box with a big red banner WARNING THIS PRODUCT CONTAINS GRAPEFRUIT JUICE.
Grapefruit will be mentioned in the ingredient list if it's present in significant amounts. Many allergens, such as peanuts, which can cause severe anaphylactic reactions <i>and</i> can affect many people, are prominently mentioned, including if the facility that produces a product also deals with them.<p>Beyond that, it's really on the consumer of food to make sure they are not ingesting anything that can cause harm to them. Ascertaining grapefruit presence in the food falls squarely in this category. If you can not be sure that grapefruit is absent in a juice, do not drink it. It's that simple. And if something says grapefruit prominently on the packaging (I imagine grapefruit juice in its original packaging would certainly fit the bill), then it's really the individual's responsibility.
CBD does the same as grapefruit. I don't know if it affects all the same medicines but I'm on a med affected by grapefruit and found out CBD has the same effect and my pharmacist confirmed what I found.
NO<p>You can of course, but you obviously need to print it on grapefruit too, no ?<p>Too much noise is bad even today. Try to about solutions which provide clarity and personalization.<p>Medical professional should be responsible for your care,
so he should provide you with link/printed brochure with comprehensive list of interactions for YOUR exact condition. it is more efficient and if something happens to you have piece of paper near you in your house with all interactions.
You need personalization of everything.
There are numerous interactions and precautions for most medications. The riskier ones are prescribed, and doctors (and pharmacists) should be going over the risks and interactions. The less risky (or grandfathered, or politically motivated) are available over the counter, and it's important to read the literature that comes with it. If people can't reasonably read or understand the risks and interactions, then that medication should be prescription.
Grapefruit juice has been thought to increase the effects of some drugs for some time. You can find many "recipes" of certain drugs taken with grapefruit juice on trip reports on Erowid.
A more relevant move would be to add warnings about monoamine oxidase inhibitors to various items that contain them, from coffee to tobacco.<p>You can’t avoid what isn’t on the packaging.
YES!!!!<p>They should.<p>-<p>My grandmother was an ER nurse her whole life (a candy-striper, etc, malpractice insurance investigations etc...)<p>she was on some medications and grapefruit was a staple morning breakfast for my grandmother and grandfather... Grapefruit, a small sprinkle of either sugar or salt and a glass of O.J. - every morning for like 40 years....<p>Nearly killed her after she was on some medication that had a poor interaction with grapefruit.<p>and these were medical experts!<p>So, _<i>YES</i>_<p>EDIT: The point is: that even if youre a medical expert, you're still susceptible to this problem, and SHE WAS AWARE but the thing was that a medication she took at like 75 years old, was NOT properly warned about...<p>Jeasus folks, even brilliant people miss shit like this at times.