Grapefruit Interactions with Medications

Cardiovascular Medications

• The American College of Cardiology recommends that verapamil should not be taken with grapefruit juice due to CYP3A4 inhibition and P-glycoprotein effects, in patients with cardiovascular disease 1, 2, 3, 4, 5, 6
• The American Heart Association advises that ivabradine must avoid grapefruit juice, as the combination is contraindicated, in patients with heart failure 1
• The American College of Cardiology suggests that amiodarone should not be combined with grapefruit juice due to its CYP3A4 substrate properties, in patients with arrhythmias 1, 7, 8, 3, 4, 6

Lipid-Lowering Agents

• The American College of Cardiology recommends that lomitapide must avoid grapefruit juice as it is a CYP3A4 substrate, in patients with hyperlipidemia 9