Grapefruit

What are other names for this remedy?

Type of medicine: natural remedy

Scientific names: Citrus paradisi, Citrus maxima

Common names for grapefruit: pomelo, toronja

Common names for grapefruit seed extract: 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?

Grapefruit has been used to:

• add vitamin C, fiber, and potassium to the diet
• lose weight
• reduce the risk of cancer
• reduce the cholesterol level in the body
• reverse atherosclerosis (when the walls of arteries become thick with fatty deposits)
• reduce wheezing in people with asthma
• treat muscle fatigue
• treat psoriasis

Grapefruit seed extract has been taken by mouth to treat infections caused by bacteria, viruses, fungi, yeast, and parasites.

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:

• an ear rinse for 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.

There is no evidence to show that grapefruit is effective as a way to treat 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.

Do not take grapefruit seed extract products that contain preservatives. These can cause serious side effects such as vomiting, seizures, collapse, and coma.

Do not get grapefruit seed extract in your eyes or nose. Do not use it on your genitals or rectum. It can cause severe irritation.

Females of childbearing age: If you are pregnant or breast-feeding, do not take large doses (4 or more glasses per day) of this remedy without your healthcare provider's approval. Do not use grapefruit seed extract. You may eat the fruit in normal amounts.

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.

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:

• antidepressants such as clomipramine (Anafranil), sertraline (Zoloft), citalopram (Celexa), fluvoxamine (Luvox), and paroxetine (Paxil)
• antifungal medicines such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• antihistamines such as fexofenadine (Allegra)
• anti-HIV medicines such as saquinavir (Invirase, Fortovase) and nelfinavir (Viracept)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, primidone (Mysoline), and phenytoin (Dilantin)
• benzodiazepines such as alprazolam (Xanax), diazepam (Valium), triazolam (Halcion), chlordiazepoxide (Librium), lorazepam (Ativan), and midazolam (Versed)
• birth control pills and hormones such as estradiol (Estrace, Estratab), and conjugated estrogens (Premarin)
• buspirone (BuSpar)
• caffeine
• calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan)
• carvedilol (Coreg)
• cholesterol-lowering medicines (statins) such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor)
• clomipramine (Anafranil)
• fexofenadine (Allegra)
• immunosuppressants such as azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), mycophenolate mofetil (CellCept), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• dextromethorphan (Robitussin DM)
• erythromycin (EES, E-mycin, PCE)
• etoposide (VePesid)
• haloperidol (Haldol)
• losartan (Cozaar)
• methadone
• methylprednisolone (Depoject, Medrol)
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Motrin IB, Advil, Nuprin), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), ketoprofen, nabumetone (Relafen), indomethacin (Indocin), ketorolac (Toradol), sulindac (Clinoril), piroxicam (Feldene), diclofenac (Voltaren, Cataflam), and oxaprozin (Daypro)
• praziquantel (Biltricide)
• proton pump inhibitors such as omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), and lansoprazole (Prevacid)
• quinidine
• scopolamine
• medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
• theophylline
• warfarin (Coumadin)
• wine

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.

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