Re: Is Plavix Really Better Than Aspirin?
From: Zee (zwalanga_at_yahoo.com)
Date: 01/28/05
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Date: 27 Jan 2005 18:18:09 -0800
Don Kirkman wrote:
> It seems to me I heard somewhere that Zee wrote in article
> <1106791328.581648.38590@f14g2000cwb.googlegroups.com>:
>
> >There were haemorragic strokes in people too in one of the trials.
And
> >then, we do not know, you are right. But I have heard Peter's story
> >over and over and over.
>
> >And Plavix and a statin together?
>
> >Here. Just for you Jim.
>
> [Major snippage has happened]
>
> >Grapefruit statins, P450 (other drugs, foods, illness and
conditions)
> >Further on the impaired metabolism of drugs, including statins
> >(excepting pravastatin).
>
> >Nurses Study
>
>http://firstword.pslgroup.com/sn.do?pu=1&id=F674F5FE75F118C185256F1D00135BCC&mainsrc=/LoadMedicalNews.do?contentid=1080998
>
> >DGNews
> >Grapefruit Juice and Medication Can Be a Deadly Mix
> >ROCHESTER, NY -- January 18, 2005 -
>
> >-----snip-------
>
> >Amy Karch, R.N., M.S., of the School of Nursing at the
> >University of Rochester Medical Center reported on a man from a
> >northern climate who moved to Florida for the winter -- one of tens
of
> >thousands of "snowbirds" who head south each winter -- and began
> >drinking two to three glasses of grapefruit juice each day. Two
months
> >later the man
> >died, the victim of a deadly interaction between grapefruit juice
and
> >his
> >cholesterol-lowering medication.
>
> >The patient profiled in Karch's article had high
> >cholesterol and other risk factors for cardiac disease. The doctor
put
> >the
> >patient on atorvastatin (Lipitor), and the patient began dieting and
> >exercising. Two months after the patient went to Florida for the
> >winter, he
> >suddenly had muscle pain, fatigue and fever, and went to the
emergency
> >room. The patient ended up going into kidney failure and ultimately
> >died.
>
> >Karch, an expert on drug interactions, explains that
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >grapefruit juice is one of the foods most likely to cause problems
with
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >drugs,
> >because it is metabolized by the same enzyme in the liver that
breaks
> >down many drugs. The cytochrome P-450 3A4 enzyme breaks down
grapefruit
>
> >juice into useful components for body, just like it breaks down
dozens
> >of medications. Karch says when the system is overloaded, the
> >grapefruit
> ^^^^^^^^^^^^^^^^^^
> >juice can "swamp" the system, keeping the liver busy and blocking it
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >from
> >breaking down drugs and other substances.
>
> >Drugs that use the same pathway and interact with
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >grapefruit juice target some of the most common health problems
doctors
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >see today. The list consists of more than 50 medications, including
> >some drugs used to treat high cholesterol, depression, high blood
> >pressure, cancer,
> >pain, impotence, and allergies.
>
> [. . .]
>
> >~~~~~~~~~~
> >"The interaction: As little as 250 mL of grapefruit juice can change
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >the metabolism of some drugs.3 This drug-food interaction occurs
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >because of a common pathway involving a specific isoform of
cytochrome
> >P450 - CYP3A4 - present in both the liver and the intestinal wall.
> >Studies suggest that grapefruit juice exerts its effect primarily at
> >the level of the intestine.4
>
> [. . .]
>
> >What to do: Much of the data obtained on grapefruit juice-drug
> >interactions involved measuring serum drug concentrations in small
> >numbers of healthy volunteers. Because of the limited data and only
> >occasional case reports,10 it is difficult to quantify the clinical
> >significance for individual patients. One may assume that the
> >interaction occurs primarily with oral medicines, and only with
those
> >that share the CYP3A4 metabolism pathway, with the consequence being
> >increased oral bioavailability, higher serum drug concentrations and
> >associated adverse effects.
>
> As has been discussed before in smc and in the media, grapefruit and
> grapefruit juice can be dangerous when taken with some medications.
> This article explains the danger and reinforces the warnings that are
> already out in public.
Indeed it does Donny me boy. The purpose of posting it *now*, in all
its redundancy, was to show Chinnis Esq. that there are many things
that can come between your statin and your busy, busy P450; including
any of those drugs you may be taking concurrently. With, or without,
grapefruit, Seville oranges, tangelos, pomelos, and maybe kumquats.
And because the article was new, and several posters to the group are.
Too. I thought to post it. All.
Zee
> --
> Don
> "I do not feel obliged to believe that the same God who has endowed
> us with senses, reason, and intellect has intended us to forgo their
> use. --Galileo Galilei
- Next message: Zee: "have a look at this"
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