Currently,
a large quantity of pomelo fruits are on the market, including Shatian pomelo,
grapefruit, grapefruit, and so on
The sweet and sour, juicy "pomelo" is loved by many people
It should be noted that consuming "pomelo" while taking certain medications may cause the efficacy of the medication to become "uncontrollable" and even pose health risks.
When eating pomelo, be aware of these things
Pomelo, especially grapefruit, contains furanocoumarins, which can inhibit an enzyme in the liver (a drug-metabolizing enzyme called CYP3A4, which is also found in the small intestinal mucosa). Many of the medications we take rely on this enzyme for metabolism and decomposition. When the enzyme is inhibited, the drug cannot be metabolized normally and accumulates in the bloodstream, which is equivalent to "overdosing," naturally increasing the risk of side effects significantly.
It should be noted that the fruit with the most clear and substantial evidence of affecting drug metabolism is "grapefruit", not the commonly seen "pomelo/honey pomelo/mandarin pomelo/satian pomelo".
When eating pomelo properly, you need to pay attention to
Read the name carefully: When writing the instructions for a medicine labeled "pomelo/grapefruit" or "grapefruit juice", be sure to strictly avoid it; "pomelo/honey pomelo" is not "pomelo".
If in doubt, treat it as "grapefruit": Some fruit juice/beverages on the market are not clearly labeled. If you cannot confirm, it is safer to avoid them based on the criteria for "grapefruit".
Be even more cautious during medication: The effects of grapefruit can last for 24 to 72 hours, and simply staggering the intake by a few hours may not necessarily prevent interactions entirely.
These types of medications should never be taken together with "grapefruit/pomelo"
(1) Antihypertensive drugs (some calcium channel blockers): May cause dizziness/unsteadiness when blood pressure is too low.
Nifedipine (Xintongding, Bayentong, etc.)
Felodipine (Plendil, etc.)
Amlodipine (part of the compound contains this ingredient, with individual differences, monitor under doctor's advice)
Taking it with grapefruit may lead to increased blood drug concentration, sudden drop in blood pressure, dizziness, fatigue, palpitations, etc.
(2) Lipid-lowering drugs (some statins): May increase the risk of myopathy/liver injury.
Atorvastatin (Lipitor)
Simvastatin (Zocor)
Lovastatin (Mevacor)
These drugs inherently carry risks of muscle pain and liver damage. When taken with grapefruit, the drug concentration increases, and the risks double: muscle soreness, weakness, and even rhabdomyolysis may occur, while the burden on the liver also increases. Discuss alternatives with your doctor: pravastatin and rosuvastatin, which are less affected by metabolic enzymes.
(3) Some antiallergic drugs (mainly old drugs): May significantly increase the risk of somnolence/cardiac arrhythmia.
Terfenadine (Mentholatum)
Astemizole (currently the mainstream "Xisimin" drug on the market, its generic name has been updated to "Loratadine", which is relatively safer, but still need to be cautious with the old drug)
This type of medicine may inherently cause drowsiness. When taken with grapefruit, the efficacy is enhanced, and the feeling of drowsiness will be significantly aggravated, making it extremely dangerous to drive or operate machinery.
(4) Immunosuppressants: Highly sensitive to concentration, fluctuations can lead to severe consequences.
Cyclosporine (Neoral, etc.)
Tacrolimus (Prograf, etc.)
Taking the drug with grapefruit can significantly alter its concentration in the body, with too high a concentration increasing nephrotoxicity/neurotoxicity, and too low a concentration leading to insufficient immunosuppression. It is recommended to strictly avoid grapefruit and its products.
(5) Sedative-hypnotic/pre-anesthetic medication: Possible "oversleeping" or even respiratory depression.
Midazolam (short-term sleep aid/pre-anesthetic sedation)
Diazepam (Valium, may be affected)
Taking it with grapefruit can delay metabolism and prolong the duration of action, posing a higher risk for the elderly or those with poor respiratory function.
Three reminders to help you avoid risks
"Two checks" before taking medicine:
Check the "Drug Interactions" section in the instructions to see if it specifies to avoid "grapefruit/pomelo"; then check the generic name of the drug to see if it belongs to the high-risk drug category mentioned earlier.
If you are unsure, just "ask":
If you are unsure whether what you have eaten is "grapefruit" or "pomelo", or whether your medication has been affected, consult a doctor/pharmacist immediately.
A safer alternative:
Individuals who have a strong preference for grapefruit flavor but are currently taking high-risk medications (not all medications are affected by grapefruit, primarily involving oral medications that are strong CYP3A4 substrates and have significant first-pass metabolism) should consult a doctor/pharmacist if unsure. In terms of diet, they can choose safer fruits such as oranges, tangerines, and apples.
Q&A on common misunderstandings
Q: How to prevent mosquito bites? Do grapefruit-flavored drinks/jam/yogurt count?
A: Most of them can. As long as they contain grapefruit extract or juice, they may cause interactions; processing does not necessarily eliminate the effects.
Q: Is it safe to consume grapefruit after a few hours apart?
A: Not necessarily. Because it is a "mechanistic inhibition", the effect can last for 24 to 72 hours, and simply staggering the time is not reliable.
Source: Health Science Popularization on People's Daily Online