0
Want this question answered?
Be notified when an answer is posted
Add your answer:
Earn +20 pts
Can the medication sporonox cause hair loss?
Does anyone know the answer to this question?
What kind of doctor should you see to treat nail fungus?
Onycholysis is when the nail separates from the pink part nail bed. There are several ways that this can be treated but first you will need to know what is causing it. If it is a fungal infection you will need to be treated with medication. If you think that you have onycholysis you should seek medical attention.
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. Dramatic inhibition of amiodarone metabolism induced by grapefruit juice. Br J Clin Pharmacol. 2000 Apr;49(4):373-8.21. Mitsunaga Y, Takanaga H, Matsuo H, Naito M, Tsuruo T, Ohtani H, Sawada Y. Effect of bioflavonoids on vincristine transport across blood-brain barrier. Eur J Pharmacol. 2000 May 3;395(3):193-201.22. Ozdemir M, Aktan Y, Boydag BS, Cingi MI, Musmul A. Interaction between grapefruit juice and diazepam in humans. Eur J Drug Metab Pharmacokinet. 1998 Jan-Mar;23(1):55-9.23. Singh BN. Effects of food on clinical pharmacokinetics. Clin Pharmacokinet. 1999 Sep;37(3):213-55. Review.24. Zhang H, Wong CW, Coville PF, Wanwimolruk S. Effect of the grapefruit flavonoid naringin on pharmacokinetics of quinine in rats. Drug Metabol Drug Interact. 2000;17(1-4):351-63. © D.McAuley, GlobalRPH.com 2001
