Renal Diet Podcast 065 – Grapefruit, Kidney Disease, Medications

Grapefruit, Kidney Disease and Your Medications

Podcast #65 Released on January 18, 2018

There are medications that have interactions with Grapefruit or Grapefruit juice. It is important that we understand how medications react to our food.

I know that a lot of you take a variety of medications for different conditions. Typically, kidney disease isn't the only thing that you're working on so when you are starting medications of the interactions that they probably didn't tell you about is an interaction with grapefruits or grapefruit juice. I want to go over that with you it's because I think it's really important that you understand how your medications and your food interact.

A lot of times we see this kind of benign or nonreactive but foods can be significant in their their effect on you whether it's grapefruit thing I'm talking about or its just generally eating more organic, more healthy less fat all that type of things that can cause you to be healthier.

I got the questions about grapefruit and grapefruit juice and how does that affect my kidney disease and I've known for a long time as a Registered Dietitian that grapefruit does interact with kidney disease medications. That's one of the reasons why I did not put grapefruit or grapefruit juice when I write menus for hospitals just because it interacted with so many medications.

It is important to understand that whether you're trying to be careful or not, you might think grapefruit juice is healthy and it can be as long as it's not interacting with your medications so I just want you to be aware of this condition and potential interaction that could happen.

It said it in has about 43 medications that are known to cause serious adverse effects and that can be things like sudden death, acute kidney failure, respiratory failure,  gastrointestinal bleeding, bone marrow suppression, kidney toxicity and other serious side effects and those are pretty big deals and I want to explain to you what happens that causes this to be a problem. I always wanted you to talk to your doctor about any sort of medications that you're concerned with. Never should you stop taking a medicine or change significantly the amount that you're taking or anything like that until you talk to your doctor and that can be as simple as calling their office so this is not like you have to make an appointment and wait three weeks and whatever. Call the office and ask the specific question if they think you need to come in they'll work you in.

If you have a medication that you take that affects is affected by grapefruit juice, you may think to take the medications in the earlier part of the day and then take the medicines that interact with grapefruit later. What I learned from reading this article and understanding is that the interaction can occur later in the day. It may be 5-6 hours apart, 8 hours apart and it can still affect you and even a small amount of grapefruit juice like 4 ounces can affect how much your absorption is changed.

Let me tell you what happens. When you take a medicine, whatever it is – generic, whatever- your body absorbs percentage of that medication. Your body for example with glucophage. If you're getting a 200 mg pill [these are just made up numbers] then your body may only absorb a hundred milligrams but your doctor knows to prescribe you 200 because 100 is going to be absorbed and that's basically what they're basing their condition on. When they prescribed they know how much the amount is absorbed.

What can happen with grapefruit juice is that it interacts with an enzyme that's in your body that affects your absorption of medications and it actually negatively affects that enzyme that slows down the absorption and it causes you to absorb more of the medication. That's where your kidney toxicity and your acute kidney failure and all that other stuff. If you took a medication that your doctor prescribed to you, the amount based on the expectation of a certain level of absorption.

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