Food and medicine interaction
Orange, apple and grapefruit juice and fexofenadine (Allegra), an allergy medicine
EstablishedEvidence level: established. Shown in drug labeling or in controlled studies in people.
Last reviewed
What can happen
Fruit juice can make fexofenadine work less well, the opposite of most grapefruit interactions. In a controlled study, grapefruit, orange and apple juice cut the amount of fexofenadine reaching the blood to 30 to 40 percent of the amount absorbed with water.
- Why it happens
- Compounds in these juices block OATP transporters in the gut that carry fexofenadine into the body, so less of the dose is absorbed.
- At ordinary food amounts
- The drug label says simply not to take it with fruit juices, and MedlinePlus names orange, grapefruit and apple juice. Eating whole fruit is not what the label addresses.
What to do
Take fexofenadine with water, as the label says. Ask your pharmacist how long to leave between the tablet and a glass of juice, and talk to them or your prescriber if your allergy medicine seems not to be working.
Never stop or change a prescribed medicine without talking to the prescriber.
Common questions
Can I have orange, apple and grapefruit juice while taking antihistamines?
Take fexofenadine with water, as the label says. Ask your pharmacist how long to leave between the tablet and a glass of juice, and talk to them or your prescriber if your allergy medicine seems not to be working. The drug label says simply not to take it with fruit juices, and MedlinePlus names orange, grapefruit and apple juice. Eating whole fruit is not what the label addresses.
Sources
- U.S. Food and Drug Administration. Grapefruit Juice and Some Drugs Don't Mix (consumer update).
- MedlinePlus (U.S. National Library of Medicine). Fexofenadine: drug information.
- Dresser GK, et al. Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine. Clin Pharmacol Ther. 2002. PMID 11823753.
Related
- RemedyGrapefruit: the full evidence pageA healthy fruit with one serious catch: it changes how the body handles certain medicines. It is the best-documented food-drug interaction there is. The fat-burning claims are not supported.
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