Grapefruit Juice has 89 known drug interactions based on U.S. FDA drug labeling data. Of these, 11 are contraindicated combinations that should be avoided entirely. 21 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Amiodarone Hydrochloride, Budesonide, Elinzanetant. Patients taking Grapefruit Juice should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 89
- Contraindicated
- 11
- Major
- 21
- Moderate
- 56
- Minor
- 1
Contraindicated (11)
- Grapefruit Juice + Amiodarone Hydrochloride— CYP450 inhibitor that increases amiodarone exposure. Avoid concomitant use.
- Grapefruit Juice + Budesonide— Inhibits CYP3A4 activity, increasing systemic budesonide exposure. Avoid ingestion with budesonide.
- Grapefruit Juice + Elinzanetant— Strong CYP3A4 inhibitor that increases elinzanetant exposure, raising risk of adverse reactions. Avoid concomitant use.
- Grapefruit Juice + Finerenone— Avoid concomitant intake of grapefruit or grapefruit juice due to increased finerenone exposure.
- Grapefruit Juice + Lomitapide Mesylate— Strong CYP3A4 inhibitor that increases lomitapide exposure approximately 27-fold. Avoid during JUXTAPID treatment.
- Grapefruit Juice + Lovastatin— CYP3A4 inhibitor increases risk of myopathy by reducing lovastatin elimination.
- Grapefruit Juice + Methylergonovine Maleate— Strong CYP 3A4 inhibitor; rare reports of serious adverse events with ergot alkaloids including vasospasm leading to cer…
- Grapefruit Juice + Propafenone Hydrochloride— CYP3A4 inhibitor; simultaneous use with both CYP2D6 and CYP3A4 inhibitors should be avoided due to increased risk of pro…
- Grapefruit Juice + Rapamycin— Grapefruit juice inhibits CYP3A4-mediated metabolism of sirolimus and must not be taken with or used for dilution of sir…
- Grapefruit Juice + Tacrolimus— Strong CYP3A inhibitor that may increase tacrolimus concentrations and risk of serious adverse reactions including neuro…
- Grapefruit Juice + Tolvaptan— CYP3A inhibitor; patients should avoid grapefruit juice beverages while taking tolvaptan.
Major (21)
- Grapefruit Juice + Axitinib— May increase axitinib plasma concentrations and should be avoided.
- Grapefruit Juice + Butalbital, Acetaminophen, Caffeine And Codeine Phosphate— CYP3A4 inhibitor may increase codeine plasma concentrations and morphine levels, potentially causing fatal respiratory d…
- Grapefruit Juice + Cilostazol— Moderate CYP3A4 inhibitor increases cilostazol exposure. Requires cilostazol dose reduction to 50 mg twice daily.
- Grapefruit Juice + Colchicine— Toxicities reported when colchicine is administered with grapefruit juice, a CYP3A4 inhibitor. Serious and life-threaten…
- Grapefruit Juice + Deflazacort— Moderate or strong CYP3A4 inhibitor; reduce EMFLAZA dose to one third of recommended dosage when used concomitantly.
- Grapefruit Juice + Erlotinib— Strong CYP3A4 inhibitor increases erlotinib exposure, raising risk of exposure-related toxicity. Avoid co-administration…
- Grapefruit Juice + Erlotinib Hydrochloride— Strong CYP3A4 inhibitor that increases erlotinib exposure and risk of exposure-related toxicity. Avoid concomitant use.
- Grapefruit Juice + Ezetimibe And Simvastatin— Avoid grapefruit juice due to increased simvastatin plasma levels and myopathy risk.
- Grapefruit Juice + Felodipine— CYP3A4 inhibitor resulting in more than 2-fold increase in AUC and Cmax of felodipine without prolongation in half-life.
- Grapefruit Juice + Fentanyl— CYP3A4 inhibitor that increases fentanyl plasma concentration, resulting in increased or prolonged opioid effects, respi…
- Grapefruit Juice + Fentanyl Citrate— CYP3A4 inhibitor that increases fentanyl plasma concentration, resulting in increased or prolonged opioid effects and re…
- Grapefruit Juice + Fentanyl Transdermal— CYP3A4 inhibitor; concomitant use can increase plasma concentration of fentanyl, resulting in increased or prolonged opi…
- Grapefruit Juice + Ivabradine— Moderate CYP3A4 inhibitor that increases ivabradine plasma concentrations; avoid concomitant use.
- Grapefruit Juice + Larotrectinib— Strong CYP3A4 inhibitor; coadministration may increase larotrectinib plasma concentrations and increase adverse reaction…
- Grapefruit Juice + Palbociclib— Avoid grapefruit or grapefruit juice during palbociclib treatment due to CYP3A inhibition.
- Grapefruit Juice + Paricalcitol— Strong CYP3A inhibitor increases paricalcitol exposure. Dose adjustment may be necessary; monitor intact PTH and serum c…
- Grapefruit Juice + Propafenone— CYP3A4 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia ris…
- Grapefruit Juice + Regorafenib— Strong CYP3A4 inhibitor that increases regorafenib plasma concentrations and may lead to increased toxicity.
- Grapefruit Juice + Simvastatin— Avoid grapefruit juice due to increased simvastatin plasma levels and risk of myopathy and rhabdomyolysis.
- Grapefruit Juice + Sufentanil Citrate— CYP3A4 inhibitor that increases sufentanil plasma concentration, resulting in increased or prolonged opioid effects incl…
- Grapefruit Juice + Tacrolimus Extended-Release Capsules— Strong or moderate CYP3A inhibitor may increase tacrolimus concentrations and risk of serious adverse reactions includin…
Moderate (56)
- Grapefruit Juice + Alprazolam— Possible drug interaction with alprazolam based on clinical studies in other benzodiazepines. Caution recommended.
- Grapefruit Juice + Bexarotene— Concomitant grapefruit juice could increase bexarotene plasma concentrations through CYP3A4 inhibition, though increases…
- Grapefruit Juice + Cabozantinib— Grapefruit juice may increase exposure of cabozantinib, increasing risk of exposure-related adverse reactions. Avoid coa…
- Grapefruit Juice + Carbamazepine— CYP3A4 inhibitor that increases carbamazepine plasma levels. Close monitoring of carbamazepine levels and dosage adjustm…
- Grapefruit Juice + Colchicine Tablets 0.5 Mg— Grapefruit juice increases exposure to colchicine. Advise patients to avoid grapefruit juice when taking colchicine.
- Grapefruit Juice + Conjugated Estrogens And Medroxyprogesterone Acetate— CYP3A4 inhibitor may increase plasma concentrations of estrogens and may result in side effects.
- Grapefruit Juice + Crizotinib— Grapefruit juice may increase plasma concentrations of crizotinib, increasing risk of adverse reactions. Avoid concomita…
- Grapefruit Juice + Cyclosporine— Affects cyclosporine metabolism, increasing blood concentrations. Should be avoided.
- Grapefruit Juice + Desogestrel And Ethinyl Estradiol And Ethinyl Estradiol— CYP3A4 inhibitor that may increase plasma hormone concentrations of desogestrel and ethinyl estradiol.
- Grapefruit Juice + Dihydroergotamine Mesylate— Moderate CYP3A4 inhibitor; administer with caution due to potential vasospasm risk.
- Grapefruit Juice + Dronabinol— CYP3A4 inhibitor may increase dronabinol systemic exposure and adverse reactions; monitor for increased dronabinol-relat…
- Grapefruit Juice + Dronedarone— Avoid concomitant use. May increase dronedarone exposure.
- Grapefruit Juice + Drospirenone And Ethinyl Estradiol— Can increase plasma concentrations of estrogen or progestin or both.
- Grapefruit Juice + Drospirenone, Ethinyl Estradiol And Levomefolate Calcium And Levomefolate Calcium— CYP3A4 inhibitor that can increase plasma concentrations of estrogen or progestin or both.
- Grapefruit Juice + Drospirenone/Ethinyl Estradiol/Levomefolate Calcium And Levomefolate Calcium— Can increase plasma concentrations of estrogen or progestin through CYP3A4 inhibition.
- Grapefruit Juice + Encorafenib— Strong CYP3A4 inhibitor that increases encorafenib plasma concentrations and may increase adverse reactions. Avoid coadm…
- Grapefruit Juice + Estradiol— CYP3A4 inhibitor that may increase plasma concentrations of estradiol and may result in side effects.
- Grapefruit Juice + Estradiol Acetate— CYP3A4 inhibitor may increase estradiol acetate plasma concentration and result in side effects.
- Grapefruit Juice + Estradiol And Levonorgestrel— CYP3A4 inhibitor that may increase plasma concentrations of estrogens and may result in adverse reactions.
- Grapefruit Juice + Estradiol And Norethindrone Acetate— CYP3A4 inhibitor that may increase plasma concentrations of estrogens and result in adverse reactions.
- Grapefruit Juice + Estradiol And Progesterone— CYP3A4 inhibitor may increase plasma concentrations of estrogen or progestin, resulting in adverse reactions.
- Grapefruit Juice + Estradiol Gel 0.1%— CYP3A4 inhibitor that may increase estradiol plasma concentrations and result in adverse reactions.
- Grapefruit Juice + Estradiol Transdermal— CYP3A4 inhibitor that may increase estradiol plasma concentrations and result in adverse reactions.
- Grapefruit Juice + Estradiol Valerate— CYP3A4 inhibitor that may increase plasma concentrations of estradiol valerate and result in side effects.
- Grapefruit Juice + Estradiol/Norethindrone Acetate Transdermal System— CYP3A4 inhibitor that may increase plasma concentrations of estrogens and result in side effects.
- Grapefruit Juice + Estrogens, Conjugated— CYP3A4 inhibitor may increase plasma concentrations of estrogens and result in side effects.
- Grapefruit Juice + Etonogestrel— Strong CYP3A4 inhibitor that may increase serum concentrations of etonogestrel.
- Grapefruit Juice + Etonogestrel And Ethinyl Estradiol— May increase plasma estrogen and/or progestin concentrations through CYP3A4 inhibition.
- Grapefruit Juice + Etonogestrel And Ethinyl Estradiol Vaginal Ring— CYP3A4 inhibitor may increase plasma estrogen and/or progestin concentrations.
- Grapefruit Juice + Fesoterodine Fumarate— Moderate CYP3A4 inhibitor. No dosing adjustments recommended in the presence of this substance.
- Grapefruit Juice + Hydrocortisone— CYP3A4 inhibitor may increase serum hydrocortisone concentrations and risk of adverse reactions; may require dose decrea…
- Grapefruit Juice + Ifosfamide— CYP3A4 inhibitor may decrease metabolism of ifosfamide to its active alkylating metabolites, potentially decreasing effe…
- Grapefruit Juice + Imatinib— Grapefruit juice may increase plasma concentrations of imatinib; avoid concomitant use.
- Grapefruit Juice + Imatinib Mesylate— Grapefruit juice may increase plasma concentrations of imatinib; avoid grapefruit juice.
- Grapefruit Juice + Levonorgestrel And Ethinyl Estradiol And Ethinyl Estradiol Tablets— Grapefruit juice, a CYP3A4 inhibitor, may increase plasma hormone concentrations of COCs.
- Grapefruit Juice + Levonorgestrel And Ethinyl Estradiol And Ferrous Fumarate— CYP3A4 inhibitor may increase plasma hormone concentrations.
- Grapefruit Juice + Levonorgestrel/Ethinyl Estradiol And Ethinyl Estradiol— CYP3A inhibitor that may increase systemic exposure of estrogen component.
- Grapefruit Juice + Mifepristone— CYP3A4 inhibitor that may increase mifepristone serum concentrations. Use with caution in patients currently or recently…
- Grapefruit Juice + Nifedipine— Grapefruit juice approximately doubles nifedipine AUC and Cmax with no change in half-life.
- Grapefruit Juice + Nimodipine— Inhibits CYP3A4 and increases nimodipine plasma concentration. Ingestion of grapefruit/grapefruit juice is not recommend…
- Grapefruit Juice + Norelgestromin And Ethinyl Estradiol— CYP3A4 inhibitor that may increase plasma hormone concentrations.
- Grapefruit Juice + Norethindrone— May increase systemic concentrations of norethindrone.
- Grapefruit Juice + Norethindrone Acetate, Ethinyl Estradiol And Ferrous Fumarate— CYP3A4 inhibitor that may increase plasma hormone concentrations.
- Grapefruit Juice + Norethindrone Acetate/Ethinyl Estradiol— CYP3A4 inhibitor may increase plasma concentration of estrogen or progestin and may result in adverse reactions.
- Grapefruit Juice + Norethindrone And Ethinyl Estradiol— CYP3A4 inhibitor that may increase plasma hormone concentrations of norethindrone and ethinyl estradiol.
- Grapefruit Juice + Norgestimate And Ethinyl Estradiol— CYP3A4 inhibitor that may increase plasma hormone concentrations of ethinyl estradiol and norgestimate.
- Grapefruit Juice + Norgestrel And Ethinyl Estradiol— CYP3A4 inhibitor may increase plasma hormone concentrations.
- Grapefruit Juice + Pexidartinib Hydrochloride— Moderate or strong CYP3A inhibitor that may increase pexidartinib concentrations, increasing incidence and severity of a…
- Grapefruit Juice + Praziquantel— Reported to produce 1.6-fold increase in Cmax and 1.9-fold increase in AUC of praziquantel. Safety effects not systemati…
- Grapefruit Juice + Ranolazine— CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.
- Grapefruit Juice + Rydapt— Strong CYP3A4 inhibitor (with certain preparations) that may increase midostaurin concentrations. Effect varies by brand…
- Grapefruit Juice + Segesterone Acetate And Ethinyl Estradiol— CYP3A4 inhibitor that may increase systemic exposure of estrogen and/or progestin component.
- Grapefruit Juice + Suvorexant— Moderate CYP3A inhibitor; recommended suvorexant dose is 5 mg, may increase to 10 mg if needed.
- Grapefruit Juice + Triazolam— Coadministration increased maximum plasma concentration by 25%, area under curve by 48%, and half-life by 18%.
- Grapefruit Juice + Ubrogepant— Moderate CYP3A4 inhibitor. Dose adjustment recommended with concomitant use.
- Grapefruit Juice + Verapamil Hydrochloride— May significantly increase verapamil concentrations (AUC increased 28-36%, Cmax increased 40-57%), though clinical conse…
Minor (1)
- Grapefruit Juice + Prasugrel— CYP3A inhibitor not expected to have significant effect on prasugrel active metabolite pharmacokinetics.