Tuesday, November 25, 2014

Patients taking which of the following drugs should be advised to avoid drinking grapefruit juice?

Patients taking which of the following drugs should be advised to avoid drinking grapefruit juice?


A. Amoxicillin
B. Aspirin
C. Atorvastatin
D. Prevacid
E. Sildenafil

The answer is C.  Grapefruit juice inhibits CYP3A4 in the liver, particularly at
high doses. This can cause decreased drug elimination via hepatic metabolism and increase
potential drug toxicities. Atorvastatin is metabolized via this pathway. Drugs that may enhance atorvastatin toxicity via this mechanism include phenytoin, ritonavir, clarithromycin,
and azole antifungals. Aspirin is cleared via renal mechanisms. Prevacid can cause
impaired absorption of other drugs via its effect on gastric pH. Sildenafil is a phosphodiesterase
inhibitor that may enhance the effect of nitrate medications and cause hypotension.

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