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KMID : 1145720150030010027
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Korean Herbal Medicine Informatics
2015 Volume.3 No. 1 p.27 ~ p.39
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Interactions between Antihypertensive Agents and Grapefruit
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Yang Chang-Sop
Kim Young-Eun
Kim Ick-Tae
Yea Sang-Jun
Kim Chul
Song Mi-Young
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Abstract
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This study aimed to point out interactions between grapefruit and antihypertensive agents by reviewing published journal articles. Eight electronic databases were searched to identify literatures. Clinical and experimental studies on grapefruit interaction with antihypertensive drugs were selected by two independent researchers. Data were extracted by synergism/inhibition, relevant substances and mechanisms, and adverse events. Furanocoumarins, cytochrome P450 inhibition were analyzed to check out grapefruit-drug interactions. Fifty nine studies on interactions between grapefruit and 16 drugs were analyzed. Evident interactions were reported among grapefruit and most calcium channel blockers or beta blockers. Reversible inhibition of bergamottin and 6',7'-dihydroxybergamottin on cytochrome P450, P-glycoprotein, organic anion transporting polypeptide were mechanisms of interactions. Age-specific and genetic differences of clinical outcomes and adverse events were observed. Grapefruit interacts with antihypertensive agents and its results could induce negative clinical outcome. Furanocoumarins regulate drug absorption pathway that result citrus-drug interactions. Medical professionals should give information about food-drug interactions to their patients and caregivers.
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KEYWORD
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Grapefruit, Grapefruit juice-drug interaction, Antihypertensive agents, Hypertension, Safety
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