Core Viewpoint - The article highlights the health risks associated with consuming grapefruit, particularly its interaction with various medications, which can lead to increased drug levels in the bloodstream and potential overdose effects [3][4][5]. Summary by Sections Grapefruit Overview - Grapefruit, known for its rich aroma and refreshing taste, is popular among all age groups and is currently in season [2]. Health Risks - Grapefruit contains a compound called "furanocoumarin," which inhibits the activity of the CYP3A4 enzyme in the liver, essential for metabolizing many medications [4]. - This inhibition can lead to an accumulation of drugs in the bloodstream, resulting in overdose-like symptoms and increased side effects [4][5]. Affected Medications - A variety of medications are affected by grapefruit, including common antihypertensives, antibiotics, pain relievers, and medications for special conditions like cancer and insomnia [8]. - It is noted that over 85 medications are known to interact with grapefruit, with about half of these potentially causing severe adverse reactions [9]. Specific Drug Examples - The article lists several categories of drugs that are significantly impacted by grapefruit, including: - Antihypertensives (e.g., amlodipine, nifedipine) [6] - Cholesterol-lowering drugs (e.g., atorvastatin, simvastatin) [10] - Anticancer medications (e.g., erlotinib, lapatinib) [10] - Pain medications (e.g., oxycodone, fentanyl) [11] Recommendations - It is advised to avoid grapefruit entirely during medication use, as even consuming it hours apart does not mitigate the risk due to the prolonged enzyme inhibition [13][14]. - Grapefruit-flavored products, such as drinks or jams, should also be avoided if they contain grapefruit extract [15]. - Other citrus fruits like oranges and lemons also contain furanocoumarin but in lower amounts, thus should be consumed with caution [16][18].

Core Viewpoint - The article emphasizes the health risks associated with consuming grapefruit, particularly in relation to certain medications, highlighting the need for caution when combining grapefruit with specific drugs due to potential adverse effects on drug metabolism [4][3]. Group 1: Health Risks of Grapefruit - Grapefruit, especially varieties like grapefruit juice, contains furanocoumarins that inhibit the CYP3A4 enzyme in the liver, which is crucial for metabolizing many medications [4][6]. - The most significant interactions are noted with grapefruit, rather than other types of pomelo or citrus fruits [4][3]. Group 2: Medications to Avoid with Grapefruit - Certain antihypertensive medications (e.g., nifedipine, felodipine, amlodipine) can lead to dangerously low blood pressure when taken with grapefruit [8]. - Statins (e.g., atorvastatin, simvastatin, lovastatin) may increase the risk of muscle pain and liver damage when combined with grapefruit, necessitating discussions with healthcare providers about safer alternatives [9]. - Some antihistamines (e.g., terfenadine, astemizole) can cause increased drowsiness and heart rhythm issues when taken with grapefruit [10]. - Immunosuppressants (e.g., cyclosporine, tacrolimus) can have dangerously fluctuating concentrations in the body when combined with grapefruit, leading to severe health consequences [11]. - Sedatives and anesthetics (e.g., midazolam, diazepam) may have prolonged effects and increased risks of respiratory depression when taken with grapefruit [12]. Group 3: Practical Advice for Consumers - Consumers should carefully read medication labels for warnings about grapefruit interactions and identify if their medications fall into high-risk categories [13]. - If uncertain about the type of grapefruit or its effects on medications, consulting a healthcare professional is advised [13]. - Safer fruit alternatives, such as oranges, tangerines, and apples, are recommended for those on high-risk medications [13].