Grapefruit juice significantly increases blood levels of cyclosporine, an immunosuppressant, potentially leading to toxicity and serious side effects.
Completely avoid grapefruit juice and related products (e.g., fresh fruit, marmalade) to prevent interaction.
Even small amounts can cause a significant increase in cyclosporine levels.
Inform healthcare providers of all dietary habits for optimal dose management.
Regular therapeutic drug monitoring is essential for patients on cyclosporine.
Grapefruit juice contains furanocoumarins that irreversibly inhibit the CYP3A4 enzyme in the intestinal mucosa, reducing the first-pass metabolism of cyclosporine and resulting in elevated systemic concentrations.
Heightened risk of cyclosporine toxicity, including nephrotoxicity, hypertension, neurotoxicity (e.g., tremors, headaches), hepatotoxicity, and increased infection risk due to excessive immunosuppression.
Avoid consumption of grapefruit juice or any grapefruit products while taking cyclosporine. If ingested, monitor cyclosporine blood levels closely and adjust dosage as needed under medical supervision. The interaction effect may persist for up to 72 hours after a single serving.
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