Food and medicine interaction
Grapefruit juice and amiodarone (Pacerone, Cordarone), a heart rhythm medicine
EstablishedEvidence level: established. Shown in drug labeling or in controlled studies in people.
Last reviewed
What can happen
Grapefruit juice changes how the body handles amiodarone. In 11 healthy volunteers, it raised amiodarone exposure by 50 percent and peak levels by 84 percent, and it fully blocked the drug's main breakdown product. That also changed the drug's effects on the heart tracing.
- Why it happens
- Grapefruit blocks CYP3A4, the enzyme that converts amiodarone to its main metabolite, N-desethylamiodarone.
- At ordinary food amounts
- The study used three 300 mL glasses in a day, but MedlinePlus gives no safe amount: it says not to drink grapefruit juice at all with this drug.
What to do
MedlinePlus says not to drink grapefruit juice while taking amiodarone. Ask your pharmacist about other citrus juices, and do not stop or change amiodarone without your prescriber.
Never stop or change a prescribed medicine without talking to the prescriber.
Common questions
Can I have grapefruit juice while taking heart rhythm medicines?
MedlinePlus says not to drink grapefruit juice while taking amiodarone. Ask your pharmacist about other citrus juices, and do not stop or change amiodarone without your prescriber. The study used three 300 mL glasses in a day, but MedlinePlus gives no safe amount: it says not to drink grapefruit juice at all with this drug.
Sources
- MedlinePlus (U.S. National Library of Medicine). Amiodarone: drug information.
- U.S. Food and Drug Administration. Grapefruit Juice and Some Drugs Don't Mix (consumer update).
- Libersa CC, et al. Dramatic inhibition of amiodarone metabolism induced by grapefruit juice. Br J Clin Pharmacol. 2000. PMID 10759694.
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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