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It is a dopamine receptor antagonist
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What are phenylbutylpiperadines?
The phenylbutylpiperadines are haloperidol (Haldol) and pimozide (Orap). They find primary use in control of Tourette's syndrome. Haloperidol has been extremely useful in controlling aggressive behavior.
Can you take Panadol and Zoloft?
As far as I understand, yes you can. You cannot take clotting medications or MAOI's whilst taking Zoloft. "Do not take Zoloft together with pimozide (Orap), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Zoloft. After you stop taking Zoloft, you must wait at least 14 days before you start taking an MAOI."** **http://www.drugs.com/zoloft.html
Can you take zithromax while on methadone?
ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking Methadone with azithromycin! Before using: Some medicines or medical conditions may interact with Azithromycin 500mg. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE AZITHROMYCIN 500mg if you are also taking dofetilide, nilotinib, propafenone, pimozide, or tetrabenazine. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking antiarrhythmics (eg, disopyramide), anticoagulants (eg, warfarin), arsenic, astemizole, carbamazepine, cisapride, digoxin, domperidone, maprotiline, METHADONE, nelfinavir, cyclosporine, ergot alkaloids (eg, ergotamine), paliperidone, phenytoin, quinolones (eg, levofloxacin), rifampin, terfenadine, theophylline, triazolam, tyrosine kinase inhibitors (eg, dasatinib), or medicines that may affect your heartbeat. Ask your doctor if you are unsure if any of the medicines you are taking may affect your heartbeat. Inform your doctor of any other medical conditions including irregular heartbeat, kidney problems, liver problems, myasthenia gravis, allergies, pregnancy or breastfeeding. Contact your doctor or pharmacist if you have any questions or concerns about taking Azithromycin 500mg.
Why is tobacco not a Schedule I substance even though it has a high chance of abuse and no medical purpose?
Money. It makes money for the government through taxes. That is the only reason it is legal...because of the huge amounts of money it brings in. And that is exactly why marijuana is illegal...because they would have no way of controlling the producers (tax payers).However, to be fair nicotine (consituent of tobacco) does have accepted medical potential. For example, nicotine patches are used to potentiate the effects of haloperidol and pimozide in patients suffering from tourette's syndrome. So it would be more fitting to label tobacco as schedule II (accepted medical use and highly addictive), the same class that includes methylphenidate (Ritalin), cocaine, methamphetamine (Desoxyn), morphine, etc. However, this is not the case.It is interesting to note that most Schedule I substances do have medical uses (whether generally accepted or not) but are considered too "addictive" or "dangerous" to give to the general public. For example, heroin has ample medical uses since it is broken down into morphine (schedule II) to be used by the body, but when injected this substance can be extremely habit-forming. Other schedule I examples include LSD or psilocybin (mushrooms) which can be used to treat cluster headaches (aka suicide headaches), but are relatively non habit-forming. In summary, the scheduling of substances does not reflect so much on how addictive a substance is or what medical potential exists. Instead, substance classifications are more of a reflection of social attitudes and taboos surrounding them.
What other prescribed medications have the same effect as adderall?
Adderall should not be taken if you have taken an MAO inhibitor within the last two weeks. MAO inhibitors include medications such as phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®). Adderall can also interact with the following drugs: •acetazolamide •alcohol containing beverages •bupropion •caffeine •furazolidone •guarana •insulin and other medicines for diabetes •levodopa •linezolid •lithium •medicines for colds, sinus, and breathing difficulties •medicines for high blood pressure and heart medicines •other medicines for mental depression or anxiety •medicines for mental problems and psychotic disturbances •some medicines for migraines (propranolol) •medicines to decrease appetite or cause weight loss •meperidine •melatonin •other stimulant medications (examples: dexmethylphenidate, methylphenidate, modafinil) •pimozide •propoxyphene •seizure (convulsion) or epilepsy medicine •selegiline •sodium bicarbonate •thyroid hormones This is not a complete list. Interactions between Adderall and some medications have not yet been identified.
What meds can you take and not take while on methadone?
Talk to your doctor. Talk to you pharmacist. Also see the related link below. Do not take this medicine with any of the following medications: •antibiotics like chloroquine, clarithromycin, erythromycin, grepafloxacin, pentamidine, sparfloxacin, troleandomycin •arsenic trioxide •cisapride •droperidol •halofantrine •haloperidol •medicines for irregular heart beat like amiodarone, bretylium, disopyramide, dofetilide, procainamide, quinidine, sotalol •pimozide •ranolazine •rasagiline •selegiline •sertindole •ziprasidone This medicine may also interact with the following medications: •alcohol •alfuzosin •antibiotics like gatifloxacin, gemifloxacin, levofloxacin, mefloquine, moxifloxacin, ofloxacin, telithromycin •antihistamines for allergy, cough and cold •desipramine •MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate •medicines for blood pressure •medicines for depression, anxiety, or psychotic disturbances •medicines for irregular heart beat like flecainide, propafenone •medicines for nausea or vomiting like dolasetron, ondansetron, palonosetron •medicines for seizures like carbamazepine, phenobarbital, phenytoin •medicines for sleep •medicines for sleep during surgery •medicines to numb the skin •muscle relaxers •narcotic medicines for pain •octreotide •peginterferon Alfa-2b •phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine •rifampin, rifapentine •some medcines for cancer like dasatinib, lapatinib, sunitinib •some medicines for HIV like delavirdine, didanosine, efavirenz, nevirapine •St. John's wort •tacrolimus •tramadol •vardenafil •vorinostat This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
Chronic motor tic disorder?
DefinitionChronic motor tic disorder involves quick, uncontrollable movements or vocal outbursts (but not both).Alternative NamesChronic vocal tic disorder; Tic - chronic motor tic disorderCauses, incidence, and risk factorsAbout 1 to 2% of the population has chronic motor tic disorder. The condition is more common than Tourette syndrome. However, it is not as common as transient tic disorder.Chronic tics may be forms of Tourette syndrome.SymptomsExcessive blinkingGrimaces of the faceQuick movements of the arms, legs, or other areasSounds (grunts, throat clearing, contractions of the abdomen or diaphragm)People can hold off these symptoms for a short period of time, but they feel a sense of relief when they carry out these movements. Patients typically describe them as responding to an inner urge and may have abnormal sensations in the area of the tic prior to the tic occurring.Tics may continue during all stages of sleep. They may get worse with:ExcitementFatigueHeatStressSigns and testsThe doctor can usually diagnose a tic during a physical examination. Tests are generally not needed.To be diagnosed with the disorder:You must have had the tics nearly every day for more than a yearYou have not had a tic-free period longer than 3 monthsTreatmentTreatment depends on how bad the tics are and how the condition affects you. Medicines and psychotherapy are used only when the tics have a major impact on daily activities, such as school and job performance.Drugs used to treat tics include dopamine blockers, such as fluphenazine, haloperidol, pimozide and risperidone. These medicines can help control or reduce tics, but they have side effects such as movement disorders and cognitive dulling.Botulinium toxin injections is used to treat certain form of dystonic tics.In recent years, brain stimulation using permanently implanted electrodes in the brain has shown promising results.Expectations (prognosis)Children who develop this disorder between ages 6 and 8 usually do very well. Symptoms may last 4 to 6 years, and then stop without treatment in early adolescence.When the disorder begins in older children and continues into the 20s, it may become a life-long conditionComplicationsThere are usually no complications.Calling your health care providerThere is usually no need to see the health care provider for a tic unless it is severe or disrupts your life.If you cannot tell whether your movements are a tic or something more serious (such as a seizure), call your health care provider.ReferencesJankovic J. Movement disorders. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 34.Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 434.
Can erythromycin help get rid of a bladder infection?
It depends on the bacteria causing the infection. Most common use is strep or staph; but LGV can cause LGV urethra infection that is caused by - Chlamydia trachomatis (or) UTI - Mycoplasma hominis -Erythromycin is an antibiotic approved to treat a wide range of infections caused by bacteria, such as streptococcal infections of the skin, ears, and sinuses, pneumococcal pneumonia, chlamydia, bronchitis; diphtheria; pneumonia; rheumatic fever;, certain venereal diseases, and other infections. UTI - Mycoplasma hominis -Lymphogranuloma venereum: (LGV). An uncommon genital or anorectal (affecting the anus and/or rectum) or urethra infection that is caused by Chlamydia trachomatis.Once LGV is diagnosed, it is usually treated with doxycycline 100 mg twice per day by mouth for 21 days. If this is not an option, for example, because of intolerance to the drug, erythromycin base 500 mg four times per day by mouth for 21 days can be used as an alternative.A person who has been sexually exposed to a person with LGV should be examined for signs or symptoms of LGV, as well as for chlamydial infection of the urethra, since the LGV and urethral strains (types) of Chlamydia trachomatis can co-exist. If exposure occurred within 30 days of the onset of their partner's symptoms of LGV, the exposed person should be treated.MRSA (Methicillin-Resistant Staphylococcus aureus) Infections - Drug-Induced Liver Disease - Strep Throat (Streptococcus bacteria) - Rheumatic Fever (streptococcal infection) - Whooping Cough (Bordetella pertussis) - Infectious Mononucleosis (strep A,mycoplasma, neisseria, and strep bacteria other than group A) - Pink Eye (Staphylococci and Streptococci) - diarrhea disease - CampylobacterErythromycin is an antibiotic approved to treat a wide range of infections caused by bacteria, such as streptococcal infections of the skin, ears, and sinuses, pneumococcal pneumonia, chlamydia, bronchitis; diphtheria; pneumonia; rheumatic fever; diarrhea disease - Campylobacter, certain venereal diseases, and other infections.ORIGINAL USES (ON-LABEL): Various bacterial infections BRAND NAME- Ilosone- GENERIC NAME Erythromycin - CHEMICAL CLASS - Macrolide derivativeTHERAPEUTIC CLASS - Antibiotic (macrolide) oral, topical, intravenous, eye.POTENTIAL SIDE EFFECTS Systemic: Irregular heart rate (ventricular arrhythmias, QT prolongation), headache, fever, seizures, rash, abdominal pain, cramping, nausea, oral yeast infection, vomiting, jaundice,CAUTIONS: Do not use if you have pre-existing liver disease and use with caution if you have reduced liver function. - Do not use concomitantly with ergot derivatives, pimozide, astemizole, or cisapride.- May aggravate myasthenia gravis.NEWLY DISCOVERED USES (OFF-LABEL)Acne, chancroid, cholera, diarrhea due to Campylobacter, gingivitis, granuloma inguinale, impetigo, Lyme disease, lymphogranuloma venereum (AKA UTI), periodontitis.FOOD INTERACTIONS: Avoid alcohol. The absorption of some erythromycin formulations are affected by food. Er. stearate should be taken at least two hours before or after a meal. Er. estolate, er. ethylsuccinate and erythromycin base may be taken without regard to meals.
Phenothiazine overdose?
DefinitionPhenothiazine is a medication used to treat serious mental and emotional disorders. This article discusses an overdose of phenothiazine. Overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of a certain substance.This article is for information only, NOT for use in treating or managing an actual overdose. If you have overdosed or been exposed to poison, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.Poisonous IngredientThe poisonous ingredient is phenothiazine, which may be found in a variety of medications.Where FoundAcetophenazineChlorpromazine (Thorazine)Chlorprothixene (Taractan)Clozapine (Clozaril)Fluphenazine (Prolixin)Haloperidol (Haldol)Loxapine (Loxitane)Mesoridazine (Serentil)Molindone (Moban)Perphenazine (Trilafon)Pimozide (Orap)Prochlorperazine (Compazine)Promazine (Sparine)Thioridazine (Mellaril)Thiothixene (Navane)Trifluoperazine (Stelazine)TriflupromazinePromethazine (Phenergan)Note: This list may not be all inclusive.SymptomsAirways and lungs No breathingRapid breathingShallow breathingBladder and kidneys Retention of urine (unable to empty bladder)Eyes, ears, nose, mouth, and throat Blurred visionCongested noseDroolingDry mouthSwallowing difficultiesUlcers in the mouth, on the tongue, or in the throatVision color changes (things look brownish)Yellow eyesHeart and blood High or severely low blood pressureIrregular heartbeatRapid heartbeatMuscles and joints Muscle spasms, particularly of the neck, face, and backMuscle stiffnessNervous system AgitationClumsinessComaConfusionConvulsionsDeep sleepDifficulty walking or shuffling gaitFaintingHallucinations (rare)IncoordinationIrritabilityNeeding to move, restlessnessTremorWeaknessSkin Rapid sunburn if exposed to the sunSkin discoloration, bluish (changing to purplish)Stomach and intestinal tract ConstipationLoss of appetiteNauseaOther Changes in menstrual pattern (in women, from chronic doses)FeverLow body temperature (hypothermia)Home TreatmentSeek immediate medical help.Do NOT make a person throw up unless told to do so by poison control or a health care professional.Before Calling EmergencyDetermine the following information:Patient's age, weight, and conditionThe name of the product (ingredients and strengths, if known)The amount swallowedThe time it was swallowedIf the medication was prescribed for the patientPoison Control, or a local emergency numberThe National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.Take the container with you to the hospital, if possible.See: Poison control center - emergency numberWhat to expect at the emergency roomThe health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:Activated charcoalBreathing supportFluids through a vein (IV)LaxativeMedication to help reverse the effect of the poisonTube through the mouth into the stomach to empty the stomach (gastric lavage)Expectations (prognosis)Recovery depends on the amount of damage. Survival past 2 days is usually a good sign. The most serious side effects are usually due to damage to the heart. If heart damage can be stabilized, recovery is likely.ReferencesNockowitz RA, Rund DA. Psychotropic medications. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 290.
The administration of neuroleptics may cause what?
Besides treating schizophrenia, bipolar disorder, delusional disorder, psychotic depression, etc....Antipsychotics (neuroleptics) are associated with a range of side effects. It is well-recognized that many stop taking them (around two-thirds of people in controlled drug trials) due in part to adverse effects. Extrapyramidal reactions include acute dystonias, akathisia, parkinsonism (rigidity and tremor), tardive dyskinesia, tachycardia, hypotension, impotence, lethargy, seizures, intense dreams or nightmares, and hyperprolactinaemia.From a subjective perspective, antipsychotics heavily influence one's perceptions of pleasurable sensations, causing a severe reduction in feelings of desire, motivation, pensive thought, and awe. This does not coincide with the apathy and lack of motivation experienced by the negative symptoms of schizophrenia. Detrimental effects on short term memory, which affect the way one figures and calculates (although this also may be purely subjective), may also be observed on high enough dosages. These are all the reasons why they are thought to affect "creativity". Also, for some individuals with schizophrenia, too much stress may cause "relapse".Following are details concerning some of the side effects of antipsychotics:Antipsychotics, particularly atypicals, appear to cause diabetes mellitus and fatal diabetic ketoacidosis, especially (in US studies) in African Americans.Antipsychotics may cause pancreatitis.The atypical antipsychotics (especially olanzapine) seem to cause weight gain more commonly than the typical antipsychotics. The well-documented metabolic side effects associated with weight gain include diabetes, which can be life-threatening.Clozapine also has a risk of inducing agranulocytosis, a potentially dangerous reduction in the number of white blood cells in the body. Because of this risk, patients prescribed clozapine may need to have regular blood checks to catch the condition early if it does occur, so the patient is in no danger.One of the more serious of these side effects is tardive dyskinesia, in which the sufferer may show repetitive, involuntary, purposeless movements often of the lips, face, legs, or torso. It is believed that there is a greater risk of developing tardive dyskinesia with the older, typical antipsychotic drugs, although the newer antipsychotics are now also known to cause this disorder.A potentially serious side effect of many antipsychotics is that they tend to lower an individual's seizure threshold. Chlorpromazine and clozapine, in particular, have a relatively high seizurogenic potential. Fluphenazine, haloperidol, pimozide and risperidone exhibit a relatively low risk. Caution should be exercised in individuals that have a history of seizurogenic conditions such as epilepsy, or brain damage.Deterioration of teeth due to a lack of saliva.[citation needed]Neuroleptic malignant syndrome, in which the drugs appear to cause the temperature regulation centers to fail, resulting in a medical emergency, as the patient's temperature suddenly increases to dangerous levels.Dysphoria.Sexual Dysfunction.Dystonia - a neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.There is evidence that exposure may cause demyelinating disease in laboratory animals.Following controversy over possible increased mortality (death) related to antipsychotics in indivdiuals with dementia, warnings have been added to packaging.Some people suffer few apparent side effects from taking antipsychotic medication, whereas others may have serious adverse effects. Some side effects, such as subtle cognitive problems, may go unnoticed.There is a possibility that the risk of tardive dyskinesia can be reduced by combining the anti-psychotics with diphenhydramine or benzatropine, although this remains to be established. Central nervous system damage is also associated with irreversible tardive akathisia and/or tardive dysphrenia.
Gilles de la Tourette syndrome?
DefinitionGilles de la Tourette syndrome is a disorder of the nervous system that causes a person to make repeated and uncontrolled (involuntary) rapid movements and sounds (vocalizations) called tics. The disorder is commonly called Tourette syndrome.See also:Chronic motor tic disorderFacial ticsTransient tic disorderAlternative NamesTourette syndromeCauses, incidence, and risk factorsTourette syndrome is named for Georges Gilles de la Tourette, who first described this disorder in 1885. There is strong evidence that Tourette syndrome is passed down through families, although the gene has not yet been found.The syndrome may be linked to problems in certain areas of the brain, and the chemical substances (dopamine, serotonin, and norepinephrine) that help nerve cells talk to one another.Tourette syndrome can be either severe or mild. About 10% of Americans have a mild tic disorder, but far fewer have more severe forms of Tourette syndrome. Many people with very mild tics may not be aware of them and never seek medical help.Tourette syndrome is four times as likely to occur in boys as in girls.SymptomsMost affected people first notice symptoms of Tourette syndrome during childhood, between ages 7 and 10.Symptoms of Tourette syndrome can range from almost unnoticeable minor movements (such as grunts, sniffling, or coughing) to continuing, uncontrollable movements and sounds (vocalizations).The symptoms tend to get better and worse. Symptoms usually get worse before the mid-teen years.The most common first symptom is a facial tic. Other tics may follow. A tic is a sudden, rapid, repeated movement or voice sound (vocalization). Tics can include:Arm thrustingEye blinkingJumpingKickingRepeated throat clearing or sniffingShoulder shruggingTics may occur many times a day, but they tend to improve or get worse at different times. The tics may change with time.Contrary to popular belief, use of curse words or other inappropriate words or phrases (coprolalia) occurs in only a small number of patients.Many patients say that the tics are not totally out of their control (involuntary), but that "things just would not feel right" if they did not do them. This is what makes Tourette syndrome different from obsessive-compulsive disorder (OCD) -- people with OCD feel as though they have to do the behaviors.Many people with the disorder can suppress the tic for periods of time, but find that when it is allowed to occur after that time, it is more dramatic for a few minutes.Signs and testsThere are no lab tests to diagnose Tourette syndrome. However, a health care provider should do an examination to rule out other causes of these symptoms.To be diagnosed with Tourette syndrome, a person must:Have had many motor tics and one or more vocal tics at some time, although not necessarily at the same timeHave tics that occur many times a day, nearly every day or on and off, for a period of more than 1 year; during this period, there must not be a tic-free period of more than 3 months in a rowHave started the tics before age 18Have no other brain problem that could be a likely cause of the symptomsTreatmentMany patients with Tourette syndrome have very minor symptoms. In this case, they are usually not treated, because the side effects of the medications may be worse than the symptoms of the condition.Drugs used to treat tics include dopamine blockers, such as fluphenazine, haloperidol, pimozide and risperidone. These medicines can help control or reduce tics, but they have side effects such as movement disorders and cognitive dulling. Antiseizure medications are also used sometimes.A blood pressure medicine called clonidine has been shown to help control tics. Another drug commonly used is tetrabenazine, but this drug is also linked to movement disorders as well as depression. Many other treatments have been tried with little or no improvement.Deep brain stimulation (DBS) has given encouraging results both for the main symptoms of Tourette syndrome and for the associated obsessive-compulsive mannerisms.Support GroupsTourette Syndrome Association - www.tsa-usa.orgExpectations (prognosis)Most patients improve in early adulthood. Although 1 in 4 patients may be symptom-free for a few years, only 8% of patients have symptoms completely go away without returning.People with Tourette syndrome have a normal life expectancy.ComplicationsConditions that may occur in people who have Tourette syndrome include:Anger control issuesAttention deficit hyperactivity disorder (ADHD)Impulsive behaviorObsessive-compulsive disorderPoor social skillsThese conditions need to be diagnosed and treated.Calling your health care providerMake an appointment with your health care provider if you have tics that are severe or persistent, or if they interfere with your daily life.PreventionThere is no known prevention.ReferencesJankovic J. Movement disorders. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 34.Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 434.Kuhn JTO. Deep brain stimulation for psychiatric disorders. Dtsch Arztebl Int. 2010. 107(7): 105-113.
Should you avoid drinking grapefruit juice while taking azithromycin?
Grapefruit has a lot of Vitamin C plus some enzymes that seem to speed up things . (For a while back in the 60's- grapefruit was thought to be a fat burner. ) Some antibiotics i.e. Erythromycin and other drugs which are in this class (the Not Pencillins) do not mix well at all, especially with Garpefruit. So those of you who take Erythromycin because of your pencillin allergies should be careful; especially when taking megadoses of Vitamin C or eating grapefruit. The end result is your liver gets a big buildup of drugs it cannot handle - you are actually poisoning your self because the drugs are not working properly. Here is the science: Erythromycin competes - It does the exact same thing as Vitamin C: it inhibits the cytochrome P450 system, particularly the CYP3A4 isozyme, which can cause it to affect the metabolism of many different drugs, not just Vitamin C. I am not the pharmacist- just a smart nutritionist student who knows biochemistry. When I graduate I will sign this. In the meantime you are provided with the following quoted directly from a professional source D.McAuley, with references GlobalRPH.com His site is a great study guide as well. Just always give him credit because he has copyrighted the site. " Grapefruit juice is a potent inhibitor of the intestinal cytochrome P-450 3A4 system (specifically: CYP3A4 - mediated drug metabolism) which is responsible for the first-pass metabolism of many medications. This interaction can lead to increases in bioavailability and corresponding increases in serum drug levels. In many cases, the increased serum drug levels can produce some readily observable symptoms. Here are a few examples of adverse effects that are possible when the following medications are taken concurrently with grapefruit. (1) Excessive sedation: benzodiazepines. (2) Increased risk of rhabdomyolyis: HMG-CoA reductase inhibitors (statins)-- there are some exceptions. (3) Symptomatic hypotension: dihydropyridine calcium antagonists (some exceptions exist). (4) QT interval prolongation: astemizole, cisapride, pimozide, terfenadine. "Drug interactions may be most apparent when patients are stabilized on the affected drug and the CYP3A4 inhibitor is then added to the regimen." 5 CONVERSELY THE VITAMIN C THAT IS FACILITATED BY THE ENZYMES IN GRAPEFRUIT IS NOT ALL BAD>>>> the problem is that the drugs you take work on the same enzyme activation sites or pathways and only one thing can work well at a time or in the case of some drugs like the heart medicines the heartbeat is sped up or slowed down which is NOT what the doctor ordered when he put you on the medication. There may be some pharmacological advantages to this interaction. If the interaction is taken into account during the initialization of drug therapy it is possible to decrease drug dosages. This concept can be applied to cyclosporine therapy. If a patient regularly consumes grapefruit, lower dosages of cyclosporine will be required, which will lead to lower drug costs. IN CONCLUSION Grapefruit juice is not the only inhibitor of this enzyme system. Other drugs which have a similar effect include: clarithromycin (Biaxin ®), erythromycin (E-Mycin ®, others), itraconazole (Sporonox ®), ketoconazole (Nizoril ®), nefazodone (Serzone ®), and ritonavir (Norvir ®). " References: 1. Bailey DG, Dresser GK. Grapefruit juice-lovastatin interaction. Clin Pharmacol Ther. 2000 Jun;67(6):6902. Bistrup C, Nielsen FT, Jeppesen UE, Dieperink H. Effect of grapefruit juice on Sandimmun Neoral absorption among stable renal allograft recipients. Nephrol Dial Transplant. 2001 Feb;16(2):373-7.3. Bramer SL, Brisson J, Corey AE. Effect of multiple cilostazol doses on single dose lovastatin pharmacokinetics in healthy volunteers. Clin Pharmacokinet. 1999;37 Suppl 2:69-77.4.Damkier P, Hansen LL, Brosen K. Effect of diclofenac, disulfiram, itraconazole, grapefruit juice and erythromycin on the pharmacokinetics of quinidine. Br J Clin Pharmacol. 1999 Dec;48(6):829-38.5. Dresser GK, Spence JD, Bailey DG. Pharmacokinetic-pharmacodynamic consequences and clinical relevance of cytochrome P450 3A4 inhibition. Clin Pharmacokinet. 2000 Jan;38(1):41-57.6. Dresser GK, Bailey DG, Carruthers SG. Grapefruit juice--felodipine interaction in the elderly. Clin Pharmacol Ther. 2000 Jul;68(1):28-34.7.Eagling VA, Profit L, Back DJ. Inhibition of the CYP3A4-mediated metabolism and P-glycoprotein-mediated transport of the HIV-1 protease inhibitor saquinavir by grapefruit juice components. Br J Clin Pharmacol. 1999 Oct;48(4):543-52.8. Evans AM. Influence of dietary components on the gastrointestinal metabolism and transport of drugs Ther Drug Monit. 2000 Feb;22(1):131-6.9. Fukuda K, Guo L, Ohashi N, Yoshikawa M, Yamazoe Y. Amounts and variation in grapefruit juice of the main components causing grapefruit-drug interaction. J Chromatogr B Biomed Sci Appl. 2000 May 12;741(2):195-203.10. Fuhr U. [Clinically significant" new drug interactions]. Med Klin. 2000 May;95(1 Spec No):18-22.11. Fuhr U, Maier-Bruggemann A, Blume H, Muck W, Unger S, Kuhlmann J, Huschka C, Zaigler M, Rietbrock S, Staib AH. Grapefruit juice increases oral nimodipine bioavailability. Int J Clin Pharmacol Ther. 1998 Mar;36(3):126-32.12. Garg SK, Kumar N, Bhargava VK, Prabhakar SK. Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy. Clin Pharmacol Ther. 1998 Sep;64(3):286-8.13.Kanazawa S, Ohkubo T, Sugawara K. The effects of grapefruit juice on the pharmacokinetics of erythromycin. Eur J Clin Pharmacol. 2001 Jan-Feb;56(11):799-803.14. Kane GC, Lipsky JJ. Drug-grapefruit juice interactions. Mayo Clin Proc. 2000 Sep;75(9):933-42.15. Lee AJ, Chan WK, Harralson AF, Buffum J, Bui BC. The effects of grapefruit juice on sertraline metabolism: an in vitro and in vivo study. Clin Ther. 1999 Nov;21(11):1890-9.16.Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice increases serum concentrations of atorvastatin and has no effect on pravastatin. Clin Pharmacol Ther. 1999 Aug;66(2):118-27.17.Lilja JJ, Kivisto KT, Backman JT, Lamberg TS, Neuvonen PJ. Grapefruit juice substantially increases plasma concentrations of buspirone. Clin Pharmacol Ther. 1998 Dec;64(6):655-60.18. Lilja JJ, Kivisto KT, Neuvonen PJ. Duration of effect of grapefruit juice on the pharmacokinetics of the CYP3A4 substrate simvastatin. Clin Pharmacol Ther. 2000 Oct;68(4):384-90.19. Lilja JJ, Kivisto KT, Backman JT, Neuvonen PJ. Effect of grapefruit juice dose on grapefruit juice-triazolam interaction: repeated consumption prolongs triazolam half-life. Eur J Clin Pharmacol. 2000 Aug;56(5):411-5.20. Libersa CC, Brique SA, Motte KB, Caron JF, Guedon-Moreau LM, Humbert L, Vincent A, Devos P, Lhermitte MA. 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