Grapefruit

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KEY POINTS

• This remedy has been used to treat several conditions. Studies in humans or animals have not proved that this remedy is safe or effective for all uses. Before using this remedy for a serious condition, you should talk with your healthcare provider.
• The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines. Natural remedies are not always safe.
• This remedy may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• This remedy affects your body and may interact with prescription medicines that you take. Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this remedy?

Type of medicine: natural remedy

Scientific names: Citrus paradisi, Citrus maxima

Common names: toronja, bioflavonoid concentrate, citrus grandis extract, citrus seed extract, CSE, grapefruit extract

What is grapefruit?

The grapefruit is a large, round citrus fruit. Both the fruit and the seeds are used medicinally.

Although grapefruit is very good for you, many medicines react with grapefruit juice and should not be taken with grapefruit juice.

What is it used for?

This remedy has been used to treat several conditions. Studies in humans or animals have not proved that this remedy is safe or effective for all uses. Before using this remedy for a serious condition, you should talk with your healthcare provider.

Grapefruit has been used to add vitamin C, fiber, and potassium to the diet. It has been taken by mouth to treat:

• Asthma
• Atherosclerosis (hardening of the arteries)
• High cholesterol
• Infections caused by bacteria, viruses, fungi, yeast, and parasites
• Obesity
• Psoriasis

Grapefruit seed has been used on the skin as a face cleanser and to treat acne and mild skin irritations. It has also been used as:

• Ear drops for ear infections
• A vaginal douche for yeast infections
• A throat gargle for sore throats
• A dental rinse to help keep gums healthy and keep breath fresh

This remedy does not appear to help treat or prevent cancer.

The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines.

How is grapefruit taken?

You can eat the fruit or drink the juice. When taking grapefruit to lower cholesterol, you must eat the fruit rather than drink the juice, because the pectin is in the pulp of the fruit. Grapefruit also comes in the form of tablets and capsules.

Grapefruit seed extracts may be taken by mouth or put on the skin.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Grapefruit, as the fruit or juice, is generally recognized as safe by the FDA. However, grapefruit affects MANY other medicines. Before taking grapefruit, talk with your healthcare provider if you take any other medicines.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Talk to your healthcare provider or pharmacist about any natural remedy that you are using or thinking about using. If your provider does not tell you how to take it, follow the directions that come with the package. Do not take more or take it longer than recommended. Ask about anything you do not understand. Remember:

• Natural remedies are not always safe.
• You should not take them if you are pregnant or breast-feeding without your healthcare provider's approval. They should not be taken by infants, children, or older adults without your provider's approval.
• They affect your body and may interact with prescription medicines that you take.
• Natural remedies are not standardized and may have different strengths and effects. They may be contaminated.

What are the possible side effects?

Along with its desirable effects, this remedy may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the remedy. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

No significant side effects have been reported from eating grapefruit or drinking the juice.

What products might interact with this remedy?

When you take this remedy with other medicines, it can change the way the remedy or the medicines work. Vitamins and certain foods may also interact. Using these products together might cause harmful side effects. Check with your healthcare provider or pharmacist before using this remedy if you take other medicines.

Some of the medicines that should NOT be taken with grapefruit juice are:

• Aliskiren (Tekturna) and aliskiren/hydrochlorothiazide (Tekturna HCT)
• Antianxiety medicines such as alprazolam (Xanax), buspirone, clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), and oxazepam
• Antiarrhythmic medicines (to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), dronedarone (Multaq), ivabradine (Corlanor), and propafenone (Rythmol)
• Antibiotics such as bedaquiline (Sirturo), erythromycin (E.E.S., Ery-Tab, Erythrocin), and telithromycin (Ketek)
• Antidepressants such as amitriptyline, duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• Antipsychotic medicines such as lurasidone (Latuda) and pimozide (Orap)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Antiviral medicines such as daclatasvir (Daklinza), elbasvir/grazoprevir (Zepatier), ledipasvir/sofosbuvir (Harvoni), ombitasvir/paritaprevir/ritonavir (Technivie), ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira), and rilpivirine (Edurant)
• Artemether/lumefantrine (Coartem)
• Bladder control medicines such as darifenacin (Enablex) and solifenacin (VESIcare)
• Blood pressure medicines such as amlodipine (Norvasc), amlodipine/benazepril (Lotrel), amlodipine/olmesartan (Azor), amlodipine/perindopril (Prestalia), amlodipine/telmisartan (Twynsta), amlodipine/valsartan (Exforge), nisoldipine (Sular), olmesartan/amlodipine/hydrochlorothiazide (Tribenzor), and trandolapril/verapamil (Tarka)
• Brexpiprazole (Rexulti)
• Bromocriptine (Cycloset, Parlodel)
• Buprenorphine (Buprenex, Butrans)
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Caffeine
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as bexarotene (Targretin), bosutinib (Bosulif), cabozantinib (Cometriq), ceritinib (Zykadia), cobimetinib (Cotellic), crizotinib (Xalkori), erlotinib (Tarceva), flutamide, gefitinib (Iressa), ibrutinib (Imbruvica), idelalisib (Zydelig), imatinib (Gleevec), irinotecan (Camptosar), lapatinib (Tykerb), nilotinib (Tasigna), olaparib (Lynparza), osimertinib (Tagrisso), palbociclib (Ibrance), panobinostat (Farydak), pomalidomide (Pomalyst), regorafenib (Stivarga), ruxolitinib (Jakafi), sunitinib (Sutent), tamoxifen, temsirolimus (Torisel), topotecan (Hycamtin), toremifene (Fareston), trabectedin (Yondelis), vandetanib (Caprelsa), and venetoclax (Venclexta)
• Carvedilol (Coreg)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor), ezetimibe/atorvastatin (Liptruzet), ezetimibe/simvastatin (Vytorin), lomitapide (Juxtapid), lovastatin (Altoprev), and simvastatin (Zocor)
• Cilostazol (Pletal)
• Cinacalcet (Sensipar)
• Clomipramine (Anafranil)
• Corticosteroids such as cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), and prednisone (Prednisone Intensol)
• Dextromethorphan, an ingredient in many allergy, cold, or cough medicines such as Robitussin-DM
• Doxepin (Silenor)
• Eliglustat (Cerdelga)
• Eplerenone (Inspra)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Etoposide
• Flibanserin (Addyi)
• Gout medicines such as colchicine (Colcrys) and probenecid
• Fexofenadine (Allegra)
• Haloperidol (Haldol)
• HIV medicines such as atazanavir/cobicistat (Evotaz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), and stavudine (Zerit)
• Hormonal birth control implants, IUDs, patches, pills, shots, and vaginal rings, and and hormones such as conjugated estrogens (Premarin), estradiol (Climara, Estrace, Estraderm, Vivelle), medroxyprogesterone (Depo-Provera, Provera), and norethindrone (Aygestin, Micronor)
• Immunosuppressants such as azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), mycophenolate (CellCept, Myfortic), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Isavuconazonium (Cresemba)
• Losartan (Cozaar)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• Maraviroc (Selzentry)
• Medicines to block or prevent stomach acid such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and pantoprazole (Protonix)
• Medicines to treat breathing or lung problems such as budesonide (Entocort, Rhinocort, Uceris), budesonide/formoterol (Symbicort), ciclesonide (Alvesco), mometasone (Asmanex, Nasonex), and mometasone/formoterol (Dulera)
• Medicines to treat pulmonary hypertension such as riociguat (Adempas), sildenafil (Revatio), and tadalafil (Adcirca)
• Methadone (Dolophine, Methadose)
• Methylprednisolone (Medrol, Solu-Medrol)
• Mifepristone (Korlym, Mifeprex)
• Migraine medicines such as dihydroergotamine (D.H.E. 45, Migranal), eletriptan (Relpax), and ergotamine (Ergomar)
• Naloxegol (Movantik)
• Nimodipine (Nymalize)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Praziquantel (Biltricide)
• Quinidine
• Sleeping pills such as ramelteon (Rozerem), suvorexant (Belsomra), and zolpidem (Ambien, Edluar, Intermezzo)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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Keep all natural remedies and medicines out of the reach of children.

This advisory includes select information only. The information was obtained from scientific journals, study reports, and other documents. The author and publisher make no warranty, expressed or implied, as to the information. The advisory may not include all side effects associated with a remedy or interactions with other medicines. Nothing herein shall constitute a recommendation for the use of any remedy. Ask your healthcare provider or pharmacist for more information.