For cancer patients, there is nothing special to avoid, but from the perspective of treatment effect, during the period of taking targeted drugs, foods such as grapefruit , carambola , pomegranate , oranges, etc. Fruits containing furanocoumarins substances cannot be eaten as they may destroy the efficacy of the medicine.
Everyone may know that grapefruit is not good, but in fact, there are some hidden "targeted drug killers". Its furanocoumarins are higher than those of the fruits mentioned above!
1. Targeted drug killer - parsley
What is unexpected is that the content of furanocoumarins in parsley is as high as 23214.8ng/g, which is 1356.9 ng/g higher than the content in grapefruit. , is the hidden boss!
What is parsley? I have only heard of celery, is it the same thing?
Parsley (also known as French ) is native to the Mediterranean region of Europe and is an ingredient often used in Western food. For example, it can be seen on steaks, bread, and salads.
People mainly eat its fresh leaves and petioles, which are rich in aroma. It can be said to be the "cilantro" in the eyes of Westerners. And it is rich in nutrients and contains vitamins and minerals needed by the human body. In addition to its food value, it is also a good deodorant and can neutralize some pungent smells such as onions and garlic.
Although it is commonly used in Western food, it has long been spread all over the world. It is grown in Northeast my country, Inner Mongolia, Shandong and other regions. Therefore, although it is more common in Western food, it is not uncommon. With the improvement of people's living standards Lift, which can be purchased in many large supermarkets.
also looks a bit like coriander, so you have to identify it carefully and don't be confused.
In addition to Big Boss parsley and grapefruit, others with higher furanocoumarin content are lime . But not all citrus fruits have a strong impact on drug metabolism . For example, the close relatives of grapefruit, such as honey pomelo, red pomelo, and that we often eat, have a weak effect on drugs, but for safety reasons, they can be avoided from being taken together.
In addition to these vegetables and fruits, some drugs themselves contain furanocoumarins, such as Angelica dahurica . Therefore, when taking anti-cancer drugs, you should also avoid taking them with some traditional Chinese medicines. Therefore, furanocoumarins can be used as medicinal ingredients, but they are also the "public enemy" of medicines!
2. How does furanocoumarins affect targeted drugs?
So what exactly are furanocoumarins? Why can’t you take it while taking targeted drugs?
We all know that the absorption and metabolism of drugs require the participation of enzymes. These enzymes are collectively called cytochrome P450, or CYP for short, and are often called liver drug enzyme .
liver drug enzymes are a large family. They are mainly distributed in the liver and to a small extent in intestinal mucosal cells. Among them, CYP3A4 and CYP2CP are the two main members. They are involved in the metabolism of almost 60% of existing drugs.
When CYP3A4 encounters targeted drugs and takes them orally, some of the drugs will be decomposed by it. The decomposed products will then be excreted from the body, while the undecomposed ones will be absorbed into the bloodstream to achieve a therapeutic effect.
However, furanocoumarins will inhibit the action of liver drug enzymes, so the decomposition of the drug will be reduced, the drug will be absorbed in large quantities, and the drug concentration in the blood will rise sharply. You must know that the concentration of the drug in the blood is not higher. The better. targeted drugs need to maintain a certain concentration in the blood to ensure the therapeutic effect. Neither too high nor too low will work. If it is too high, adverse reactions due to drug overdose will occur.
Therefore, some anti-tumor drugs, such as crizotinib, sunitinib, etc., cannot be taken with foods high in furanocoumarins!
In addition, not only anti-tumor drugs, but also some antihypertensive drugs, lipid-lowering drugs , anti-allergic drugs , anticoagulants, etc. are not recommended to be taken with foods containing furanocoumarins, so if you have Patients with other diseases must first clarify whether there are any food taboos before taking medication. If you are really not sure whether certain foods can be eaten while taking medication, you can read the drug instructions or consult a professional doctor.
Reference:
[1] K. S. Lown et al., “Grapefruit juice increases felodipine oral availability in humans by decreasing intestinal CYP3A protein expression.,” J. Clin. Invest., vol. 99, no. 10, pp . 2545–2553, May 1997, doi: 10.1172/JCI119439.
