Grapefruit juice significantly increases felodipine blood levels by inhibiting its metabolism, potentially causing excessive blood pressure reduction and adverse effects.
Interaction can increase felodipine AUC by up to 300%, amplifying side effects.
Applies to many calcium channel blockers like felodipine; check specific medication.
Even small amounts (200-250 mL) of juice can cause significant effects.
Consult healthcare provider for alternatives if grapefruit consumption is desired.
Grapefruit juice contains furanocoumarins that irreversibly inhibit the CYP3A4 enzyme in the intestinal wall and liver, reducing first-pass metabolism of felodipine, a substrate of CYP3A4, leading to 2- to 8-fold increases in its bioavailability and plasma concentrations.
Enhanced hypotensive effects may result in severe dizziness, hypotension, tachycardia, headache, flushing, and peripheral edema; risk of overdose-like symptoms from routine juice intake.
Avoid grapefruit juice and related products (e.g., whole fruit, marmalade) during felodipine therapy; the interaction can persist for 24-72 hours after consumption. If ingested, monitor blood pressure closely and consider dose adjustment under medical supervision.
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