Seville oranges, like grapefruit, contain compounds that inhibit the CYP3A4 enzyme, potentially increasing blood levels of certain calcium channel blockers and enhancing their effects.
Applies primarily to dihydropyridine CCBs like felodipine and nifedipine; less effect on non-CYP3A4 substrates.
Even small amounts in marmalade may interact; effect can last up to 72 hours.
Patients on chronic CCB therapy should avoid Seville oranges to prevent variability in drug levels.
Monitor for signs of overdose such as dizziness or excessive lowering of blood pressure.
Furanocoumarins in Seville oranges irreversibly inhibit intestinal CYP3A4, reducing the first-pass metabolism of CYP3A4 substrate calcium channel blockers (e.g., felodipine, nifedipine, verapamil), leading to elevated systemic drug concentrations.
Risk of exaggerated hypotensive effects, bradycardia, headache, flushing, or peripheral edema; severe cases may lead to hypotension or reflex tachycardia.
Avoid or limit consumption of Seville orange products; monitor blood pressure and heart rate if interaction occurs; consider alternative fruits; consult prescriber for dose adjustments.
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