Grapefruit and Nifedipine interaction

Grapefruit and Nifedipine: the Nifedipine prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Nifedipine label · effective 2026-02-05

Major

Grapefruit juice should be avoided by patients on nifedipine.

Precautionsnames GrapefruitView label on DailyMed
Moderate

…as ketoconazole, fluconazole, itraconazole, clarithromycin, erythromycin (Azithromycin, although structurally related to the class of macrolide antibiotic is void of clinically relevant CYP3A4 inhibition), grapefruit, nefazodone, fluoxetine, saquinavir, indinavir, nelfinavir, and ritonavir may result in increased exposure to nifedipine when co-administered.

Drug interactionsnames GrapefruitView label on DailyMed
Moderate

Dietary Supplements Grapefruit Juice: In healthy volunteers, a single dose co-administration of 250 mL double strength grapefruit juice with 10 mg nifedipine increased AUC and C max by factors of 1.35 and 1.13, respectively.

Precautionsnames GrapefruitView label on DailyMed
Moderate

Ingestion of repeated doses of grapefruit juice (5 × 200 mL in 12 hours) after administration of 20 mg nifedipine ER increased AUC and C max of nifedipine by a factor of 2.

Precautionsnames GrapefruitView label on DailyMed
Minor

The intake of grapefruit juice should be stopped at least 3 days prior to initiating patients on nifedipine.

Precautionsnames GrapefruitView label on DailyMed

Curated guidance for Grapefruit

Moderate

Grapefruit juice can raise blood levels of some calcium channel blockers used for blood pressure, which may cause excessive lowering of blood pressure.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.