Wechselwirkungen von Grapefruit

Concomitant intake of large quantities, more than 1.2 liters daily, of grapefruit juice is not recommended in patients taking amlodipine and atorvastatin tablets [see Drug Interactions (7.3) ]. (Fachinformation zu Amlodipin und Atorvastatin, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant intake of large quantities, more than 1.2 liters daily, of grapefruit juice is not recommended in patients taking LIPITOR [see Drug Interactions (7.1) ] . (Fachinformation zu Atorvastatin, Warnhinweise und Vorsichtsmaßnahmen)

Grapefruit or grapefruit juice may also increase axitinib plasma concentrations and should be avoided. (Fachinformation zu Axitinib, Arzneimittelwechselwirkungen)

Patients receiving buspirone should be advised to avoid drinking such large amounts of grapefruit juice. (Fachinformation zu Buspiron, Arzneimittelwechselwirkungen)

Avoid ingestion of foods (e.g., grapefruit, grapefruit juice) or nutritional supplements that are known to inhibit cytochrome P450 while taking COMETRIQ. (Fachinformation zu Cabozantinib, Arzneimittelwechselwirkungen)

Although the clinical significance of this interaction is unknown, grapefruit juice should be avoided. (Fachinformation zu Chinidin, Arzneimittelwechselwirkungen)

Grapefruit Juice Grapefruit and grapefruit juice affect metabolism, increasing blood concentrations of cyclosporine, thus should be avoided. (Fachinformation zu Ciclosporin, Arzneimittelwechselwirkungen)

CYP3A4 The concomitant use of colchicine capsules and CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole, grapefruit juice, erythromycin, verapamil, etc.) should be avoided due to the potential for serious and life-threatening toxicity [see Warnings and Precautions (5.3) and Clinical Pharmacology (12) ] . (Fachinformation zu Colchicin, Arzneimittelwechselwirkungen)

• Grapefruit juice: Avoid concomitant use. (Fachinformation zu Dronedaron, Arzneimittelwechselwirkungen)

Avoid food or drink containing grapefruit. (Fachinformation zu Elexacaftor, Tezacaftor und Ivacaftor, Arzneimittelwechselwirkungen)

Avoid co-administering erlotinib with strong CYP3A4 inhibitors (e.g., boceprevir, clarithromycin, conivaptan, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telithromycin, voriconazole, grapefruit or grapefruit juice) or a combined CYP3A4 and CYP1A2 inhibitor (e.g., ciprofloxacin). (Fachinformation zu Erlotinib, Arzneimittelwechselwirkungen)

Intervention: Avoid grapefruit juice when taking VYTORIN. (Fachinformation zu Ezetimib und Simvastatin, Arzneimittelwechselwirkungen)

Grapefruit juice may also increase plasma concentrations of imatinib; avoid grapefruit juice [see Clinical Pharmacology (12.3)] . (Fachinformation zu Imatinib, Arzneimittelwechselwirkungen)

Avoid food or drink containing grapefruit. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Avoid coadministration of VITRAKVI with strong CYP3A4 inhibitors, including grapefruit or grapefruit juice. (Fachinformation zu Larotrectinib, Arzneimittelwechselwirkungen)

Patients must avoid grapefruit juice ( 4 , 5.6 , 7.1 ). (Fachinformation zu Lomitapid, Arzneimittelwechselwirkungen)

…products Gemfibrozil Avoid with lovastatin Cyclosporine Danazol Do not exceed 20 mg lovastatin daily Diltiazem Dronedarone Verapamil Amiodarone Do not exceed 40 mg lovastatin daily Grapefruit juice Avoid grapefruit juice Immune-Mediated Necrotizing Myopathy There have been rare reports of immune-mediated necrotizing myopathy (IMNM), an autoimmune myopathy, associated… (Fachinformation zu Lovastatin, Warnhinweise)

•Avoid consumption of grapefruit or grapefruit juice during treatment with MOVANTIK [see Dosage and Administration (2.1) ] . (Fachinformation zu Naloxegol, Arzneimittelwechselwirkungen)

Grapefruit juice should be avoided by patients on nifedipine. (Fachinformation zu Nifedipin, Vorsichtsmaßnahmen)

Avoid grapefruit juice. (Fachinformation zu Nimodipin, Arzneimittelwechselwirkungen)

Avoid grapefruit or grapefruit juice during IBRANCE treatment. (Fachinformation zu Palbociclib, Arzneimittelwechselwirkungen)

Interaction with Food Patients should avoid grapefruit juice because it may inhibit the metabolism of pimozide by CYP 3A4. (Fachinformation zu Pimozid, Arzneimittelwechselwirkungen)

Intervention: Avoid grapefruit juice when taking ZOCOR. (Fachinformation zu Simvastatin, Arzneimittelwechselwirkungen)

Grapefruit Juice Because grapefruit juice inhibits the CYP3A4-mediated metabolism of sirolimus, it must not be taken with sirolimus [ see Clinical Pharmacology (12.3) ]. (Fachinformation zu Sirolimus, Arzneimittelwechselwirkungen)

Avoid food or drink containing grapefruit. (Fachinformation zu Suzetrigin, Arzneimittelwechselwirkungen)

Avoid grapefruit or grapefruit juice. (Fachinformation zu Tacrolimus, Arzneimittelwechselwirkungen)

Patients should avoid grapefruit juice beverages while taking SAMSCA [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Tolvaptan, Arzneimittelwechselwirkungen)

Grapefruit juice may also increase plasma concentrations of toremifene and should be avoided. (Fachinformation zu Toremifen, Arzneimittelwechselwirkungen)

Food or drink containing grapefruit should be avoided during treatment with RINVOQ/RINVOQ LQ. (Fachinformation zu Upadacitinib, Arzneimittelwechselwirkungen)

CYP450 Inhibitors Grapefruit juice, certain fluoroquinolone and macrolide antibiotics, azole antifungals, cimetidine Increased exposure of amiodarone. (Fachinformation zu Amiodaron, Arzneimittelwechselwirkungen)

Grapefruitsaft kann die Blutspiegel einiger Calciumkanalblocker erhöhen, die bei Bluthochdruck angewendet werden, was eine übermäßige Blutdrucksenkung verursachen kann. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Although specific interactions have not been studied, other CYP3A4 inhibitors, including grapefruit juice are likely to increase avanafil exposure. (Fachinformation zu Avanafil, Arzneimittelwechselwirkungen)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir), grapefruit juice CYP3A4 Inducers Clinical Impact: The concomitant use of Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules and CYP3A4 inducers can result in lower codeine levels, greater norcodeine levels,… (Fachinformation zu Butalbital, Paracetamol, Koffein und Codein, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4 or CYP2C19 Inhibitors of CYP3A4 Coadministration of strong (e.g., ketoconazole) and moderate (e.g., erythromycin, diltiazem and grapefruit juice) CYP3A4 inhibitors can increase exposure to cilostazol. (Fachinformation zu Cilostazol, Arzneimittelwechselwirkungen)

Therefore, give one third the recommended dosage of EMFLAZA when moderate or strong CYP3A4 inhibitors (e.g., clarithromycin, fluconazole, diltiazem, verapamil, grapefruit juice) are used concomitantly with EMFLAZA [see Dosage and Administration ( 2.5 ) and Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Deflazacort, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Desogestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Inhibitors of this isoenzyme (e.g., macrolide antibiotics, azole antifungal agents, protease inhibitors, serotonin reuptake inhibitors, amiodarone, cannabinoids, diltiazem, grapefruit juice, nefazadone, norfloxacin, quinine, zafirlukast) should be cautiously co-administered with dofetilide as they can potentially increase dofetilide levels. (Fachinformation zu Dofetilid, Arzneimittelwechselwirkungen)

Monitor for increased dronabinol-related adverse reactions when dronabinol oral solution is co-administered with inhibitors of CYP2C9 (e.g., amiodarone, fluconazole) and inhibitors of CYP3A4 enzymes (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir, erythromycin, grapefruit juice). (Fachinformation zu Dronabinol, Arzneimittelwechselwirkungen)

Concomitant administration of moderate or strong CYP3A4 inhibitors such as azole antifungals (e.g., ketoconazole, itraconazole, voriconazole, fluconazole), verapamil, macrolides (e.g., clarithromycin, erythromycin), diltiazem, and grapefruit juice can increase the plasma concentrations of the estrogen or the progestin or both. (Fachinformation zu Drospirenon und Ethinylestradiol, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4 such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice may increase plasma concentrations of estrogens and may result in side effects. (Fachinformation zu Estradiol, Arzneimittelwechselwirkungen)

…Systemic Exposure of COCs (enzyme inhibitors): Concomitant administration of moderate or strong CYP3A4 inhibitors like azole antifungals (for example, ketoconazole, itraconazole, voriconazole, fluconazole), verapamil, macrolides (for example, clarithromycin, erythromycin), diltiazem, and grapefruit increase the serum concentrations of both estradiol and dienogest. (Fachinformation zu Estradiol und Dienogest, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4 such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice may increase plasma concentrations of estrogens and result in adverse reactions. (Fachinformation zu Estradiol und Norethisteron, Arzneimittelwechselwirkungen)

Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin concentrations. (Fachinformation zu Etonogestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Grapefruitsaft erhöht die Blutspiegel von Arzneimitteln gegen Transplantatabstoßung. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Coadministration of CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, erythromycin, grapefruit juice, cimetidine) with felodipine may lead to several-fold increases in the plasma levels of felodipine, either due to an increase in bioavailability or due to a decrease in metabolism. (Fachinformation zu Felodipin, Arzneimittelwechselwirkungen)

No dosing adjustments are recommended in the presence of moderate CYP3A4 inhibitors (e.g., erythromycin, fluconazole, diltiazem, verapamil and grapefruit juice). (Fachinformation zu Fesoterodin, Arzneimittelwechselwirkungen)

Grapefruitsaft verändert die Menge dieser Arzneistoffe, die in den Blutkreislauf gelangt (bei den meisten erhöht er sie, bei Fexofenadin senkt er sie jedoch). (FDA, Grapefruit Juice and Some Drugs Don't Mix)

…telaprevir, telithromycin and conivaptan Examples of moderate CYP3A4 inhibitors Amprenavir, atazanavir, ciprofloxacin, diltiazem, erythromycin, fluconazole, fosamprenavir, verapamil, and grapefruit juice Clinical Implications The concomitant use of ADDYI with moderate or strong CYP3A4 inhibitors increases flibanserin exposure compared to the use of ADDYI alone. (Fachinformation zu Flibanserin, Arzneimittelwechselwirkungen)

Grapefruitsaft kann die Blutspiegel einiger Calciumkanalblocker erhöhen, die bei Bluthochdruck angewendet werden, was eine übermäßige Blutdrucksenkung verursachen kann. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Examples of moderate CYP3A4 inhibitors include diltiazem, verapamil, and grapefruit juice [ s ee Warnings and Precautions ( 5.3 ) and Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Ivabradin, Arzneimittelwechselwirkungen)

CYP3A inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice The effect of grapefruit juice on CYP3A4 enzymes (e.g., strong vs. moderate inhibition) depends on its brand, concentration, and preparation. , or ketoconazole may increase systemic exposure of the estrogen and/or progestin component of CHCs. (Fachinformation zu Levonorgestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Grapefruitsaft kann die Blutspiegel einiger Calciumkanalblocker erhöhen, die bei Bluthochdruck angewendet werden, was eine übermäßige Blutdrucksenkung verursachen kann. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Grapefruitsaft kann die Blutspiegel einiger Calciumkanalblocker erhöhen, die bei Bluthochdruck angewendet werden, was eine übermäßige Blutdrucksenkung verursachen kann. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Norelgestromin und Ethinylestradiol, Arzneimittelwechselwirkungen)

Substances increasing the systemic concentrations of HCs: Co-administration of certain HCs and strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase the systemic concentrations of progestins, including norethindrone. (Fachinformation zu Norethisteron, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Norgestimat und Ethinylestradiol, Arzneimittelwechselwirkungen)

Concomitant administration of CYP3A4 inhibitors such as itraconazole, fluconazole, grapefruit juice or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Norgestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Examples Clarithromycin, conivaptan, grapefruit juice, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, mibefradil, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, and voriconazole Intervention If a patient initiates or discontinues therapy with a strong CYP3A4 inhibitor, dose adjustment of Paricalcitol Injection may be necessary. (Fachinformation zu Paricalcitol, Arzneimittelwechselwirkungen)

In addition, grapefruit juice was also reported to produce a 1.6-fold increase in the C max and a 1.9-fold increase in the AUC of praziquantel. (Fachinformation zu Praziquantel, Arzneimittelwechselwirkungen)

Drugs that inhibit these CYP pathways (such as desipramine, paroxetine, ritonavir, sertraline for CYP2D6; ketoconazole, erythromycin, saquinavir, and grapefruit juice for CYP3A4; and amiodarone and tobacco smoke for CYP1A2) can be expected to cause increased plasma levels of propafenone. (Fachinformation zu Propafenon, Warnhinweise und Vorsichtsmaßnahmen)

Moderate CYP3A Inhibitors Limit the dose of ASPRUZYO Sprinkle to 500 mg twice daily in patients on moderate CYP3A inhibitors, including diltiazem, verapamil, erythromycin, fluconazole, and grapefruit juice or grapefruit-containing products [see Dosage and Administration (2.2), Clinical Pharmacology (12.3)]. (Fachinformation zu Ranolazin, Arzneimittelwechselwirkungen)

The recommended dose of BELSOMRA is 5 mg in subjects receiving moderate CYP3A inhibitors (e.g., amprenavir, aprepitant, atazanavir, ciprofloxacin, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, imatinib, verapamil). (Fachinformation zu Suvorexant, Arzneimittelwechselwirkungen)

Although specific interactions have not been studied, other CYP3A4 inhibitors, such as erythromycin, itraconazole, and grapefruit juice, would likely increase tadalafil exposure. (Fachinformation zu Tadalafil, Arzneimittelwechselwirkungen)

Dose adjustment is recommended with concomitant use of UBRELVY and moderate CYP3A4 inhibitors (e.g., cyclosporine, ciprofloxacin, fluconazole, fluvoxamine, grapefruit juice) [see Dosage and Administration ( 2.2 )] . (Fachinformation zu Ubrogepant, Arzneimittelwechselwirkungen)

…recommended not to exceed a single 5 mg dose of vardenafil hydrochloride tablets in a 24-hour period when used in combination with erythromycin. [See Dosage and Administration (2.4) and Warnings and Precautions (5) .] Although specific interactions have not been studied, other CYP3A4 inhibitors, including grapefruit juice would likely increase vardenafil exposure. (Fachinformation zu Vardenafil, Arzneimittelwechselwirkungen)

Grapefruit juice may significantly increase verapamil levels ( 7.3 ) (Fachinformation zu Verapamil, Arzneimittelwechselwirkungen)

…itraconazole, fluconazole, voriconazole ) , cimetidine, ciprofloxacin, clarithromycin, dalfopristin, danazol, dantrolene, delavirdine, diltiazem, erythromycin, fluoxetine, fluvoxamine, grapefruit juice, ibuprofen, isoniazid, loratadine, nefazodone, niacinamide, nicotinamide, olanzapine, omeprazole, oxybutynin, quinine, quinupristin, ticlopidine, troleandomycin, valproate,… (Fachinformation zu Carbamazepin, Arzneimittelwechselwirkungen)

Quinine sulfate may be taken with grapefruit juice. (Fachinformation zu Chinin, Arzneimittelwechselwirkungen)

Strong and moderate CYP3A inhibitors include, but are not limited to, atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, and verapamil. (Fachinformation zu Dextromethorphan und Chinidin, Warnhinweise und Vorsichtsmaßnahmen)

Less potent inhibitors include saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxamine, zileuton, and clotrimazole. (Fachinformation zu Dihydroergotamin, Warnhinweise)

Examples of less potent CYP 3A4 inhibitors include: saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice, fluvoxamine, zileuton, metronidazole, and clotrimazole. (Fachinformation zu Ergotamin und Koffein, Warnhinweise)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir), grapefruit juice. (Fachinformation zu Fentanyl, Arzneimittelwechselwirkungen)

Examples: Anti-fungals: itraconazole, posaconazole, voriconazole Antibiotics: erythromycin and clarithromycin Antiretrovirals: ritonavir Grapefruit juice CYP3A4 Inducers Clinical Impact: Hydrocortisone is metabolized by cytochrome P450 3A4 (CYP3A4). (Fachinformation zu Hydrocortison, Arzneimittelwechselwirkungen)

Examples of some of the strong CYP 3A4 inhibitors include saquinavir, grapefruit juice, nefazodone, macrolide antibiotics (e.g., troleandomycin, clarithromycin), HIV protease or reverse transcriptase inhibitors (e.g., ritonavir, indinavir, nelfinavir) or azole antifungals (e.g., ketoconazole, itraconazole, voriconazole). (Fachinformation zu Methylergometrin, Arzneimittelwechselwirkungen)

Some botanicals and foods can interact with warfarin sodium through CYP450 interactions (e.g., echinacea, grapefruit juice, ginkgo, goldenseal, St. (Fachinformation zu Warfarin, Arzneimittelwechselwirkungen)

The following have no clinically relevant effects on the pharmacokinetics of amlodipine: cimetidine, grapefruit juice, magnesium and aluminum hydroxide antacid, sildenafil. (Fachinformation zu Telmisartan und Amlodipin, Arzneimittelwechselwirkungen)