75-year-old Mao Uncle, who has been on the stent for many years, has been on the stent for regular follow-up visits and takes medicine on time, and his condition has been stable. However, recently I often feel dizzy, fatigue, muscle pain and discomfort, and I feel that my symptoms are getting worse and worse after resting in bed. With the company of his family, he found Huang Qi, deputy chief physician of the Department of Cardiology at the Municipal Red Cross Hospital. After examination, he found that both liver enzyme and muscle enzyme were significantly increased. Dr. Huang found clues after asking in detail...
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It turns out that Uncle Mao fell in love with a fruit recently. He likes to eat a few petals of grapefruit after meals. It is sour and sweet, which is very consistent with Uncle Mao’s taste. After careful examination, Dr. Huang suspected that the problem was most likely in grapefruit.
Why does grapefruit take the blame?
grapefruit, also known as grapefruit , is a relatively common fruit on the market. It is a citrus fruit, along with oranges, lime and grapefruit. The reason why patients with cardiovascular diseases need to treat grapefruit so special is that it contains the "furancoumarin" component. Originally, this is a substance evolved from grapefruit to protect itself and resist insect gnawing. It can inhibit the activity of the liver CYP3A4 enzyme, which is a highway for drug metabolism. Many drugs are metabolized by CYP3A4 enzyme. Therefore, after eating grapefruit, the activity of CYP3A4 enzyme in the liver is inhibited, and the rate of drug metabolism decreases, resulting in an increase in drug accumulation.
Simply put, taking grapefruit juice at the same time will lead to an increase in the concentration of the drug, resulting in an increase in the effect of the drug and an increase in the side effects of the drug by about 2-10 times. Although not all drugs will be affected, drugs such as the commonly used clinical practice of lowering blood pressure, lipid lowering, anti- arrhythmia and anti-platelet aggregation are affected.
If you take antihypertensive drugs, it may cause blood pressure to drop. In mild cases, dizziness, palpitations, , blackness, and even hypotension and shock. If the lipid-lowering medicine is taken together with grapefruit juice, the blood concentration will increase by 2.5 times, increasing the risk of liver damage and increased muscle enzymes. If it is an antiarrhythmic drug taken with grapefruit juice, it will increase the drug concentration by about 1 times, and the consequences may be very serious. Uncle Mao is a patient of this type. He has had many years of hypertension and and coronary heart disease. He has to take drugs that lower blood pressure, lipids and antiplatelet aggregation. So after taking the medicine and taking grapefruit, Uncle Mao will experience some symptoms such as dizziness, fatigue, liver enzymes and muscle enzymes.
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So how long is it more suitable to take medicine after taking grapefruit?
Because grapefruit inhibits liver CYP3A4 enzymes, enzyme activity can only be restored after about 72 hours. Therefore, patients who eat grapefruit need to be 3 days apart from taking the drug. Perhaps for most people, there are very few times when they need to take medicine, but for some patients with chronic diseases, regular treatment is required every day, so it is recommended to avoid eating grapefruit during the medication.
In addition, Dr. Huang reminds that grapefruit will also cause changes in the efficacy of some sleeping pills, anti-cancer drugs, birth control pills, painkillers, etc.
drugs that may be affected by grapefruit and other types of antihypertensive drugs: nifedipine , amlodipine , felodipine, racidipine , metoprolol, losartan , etc.;
lower blood lipids: lovastatin , simvastatin , atorvastatin, etc.;
antiarrhythmic drugs: dronedarone, amiodarone , verapamil , etc.;
antiplatelet aggregation: cilotazo, clopidogrel , ticarvastatin, etc.
Hangzhou.com Hangzhoutong client reporter Yang Wei Correspondent Wang Li Huang Qi
