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Q & A: Grapefruit pectin and clogged arteries

Q: I have heard that grapefruit pectin cleans out clogged arteries. Is this true?

A: Researchers at the University of Florida have conducted a series of studies to examine the ability of grapefruit pectin (Citrus paradisi) to help reduce cholesterol and protect against the development of atherosclerosis. Atherosclerosis is the hardening and narrowing of the arteries due to plaque build up, that causes conditions like heart attack and stroke.

Several studies done on animals have suggested that grapefruit pectin, the soluble fiber of the fruit, can prevent development of both high cholesterol and atherosclerosis in pigs. In addition, at least one human study suggests that this dietary supplement may offer the same protection against high cholesterol in people. The evidence overall, though, is not very strong.

There is also the potential for interactions between grapefruit and certain medications. (Medications that are affected by grapefruit are listed in the table below.) Specifically, grapefruit juice may lead to increased blood levels of some medications, and this can lead to an increased risk of side effects and other adverse events from these drugs. This effect is due to a substance in grapefruit called naringenin, which slows down the activity of the cytochrome P450 system in the liver. This system is responsible for breaking down drugs, which are then eliminated from the body through urine and feces. By slowing this system, the level of the drug builds up in the blood.

It is not entirely clear how much naringenin is in the pectin of grapefruit compared to the juice, but, if you take any of the medications listed below, or similar drugs, it is best to avoid grapefruit and supplements containing naringenin. If you do not take any of these medications, it shouldn't hurt to consider eating more grapefruit, drinking more grapefruit juice, or taking a pectin supplement to help protect yourself from developing high cholesterol or blocked arteries.

Be sure to discuss your interest in grapefruit with your doctor, particularly if you are taking any medications or herbs, even if they are not listed in the table below. Your doctor can tell you if the drug is metabolized through the P450 system, or if the herb contains coumarins (also know as furocoumarins), and, therefore, should not be taken with grapefruit. Another important consideration to discuss with your doctor is that there are some reports that too much grapefruit juice may increase the risk of developing kidney stones.

Type of medication Generic names (brand names)
AIDS medications indinavir (Crixivan)
nelfinavir (VIRACEPT)
ritonavir (Norvir)
saquinavir (Fortovase, Invirase)
Anti-anxiety medications, sleep aids alprazolam (Alprazolam Intensol, Xanax)
buspirone (BuSpar)
diazepam (Diastat, Diazepam Intensol, Dizac, Valium)
haloperidol (Haldol)
midazolam (Versed)
triazolam (Halcion)
zaleplon (Sonata)
zolpidem (Ambien)
Antibiotics clarithromycin (Biaxin)
erythromycin (Erythro, Erythrocin, Ilotycin, Ilosone, Wintrocin)
Antihistamines chlorpheniramine (Aller-Chlor, Chlo-Amine, Chlorate, Chlor-Trimeton, Gen-Allerate, Phenetron, Telachlor, Teldrin)
Asthma medication salmeterol (Serevent)
Cancer treatments paclitaxel (Paxene, Taxol)
vincristine (Oncovin, Vincasar PFS, Vincrex)
Carbamazepines, to treat epileptic seizures and trigeminal neuralgia carbamazepine (Atretol, Carbatrol, Epitol, Tegretol)
Cholesterol-lowering drugs atorvastatin (Lipitor)
lovastatin (Mevacor)
simvastatin (Zocor)
Coumarins warfarin (Coumadin)
Also found in certain herbs:
dong quai (Angelica sinensis)
angelica root (Angelica archangelica)
Heart medications, including high blood pressure medications amlodipine (Norvasc)
carvedilol (Coreg)
diltiazem (Cardizem, Dilacor-XR)
felodipine (Plendil)
nicardipine (Cardene)
nifedipine (Adalat, Procardia)
nimodipine (Nimotop)
nisoldipine (Sular)
quinidine (Cardioquin)
Hormones ethinyl estradiol (the estrogen component of many birth control pills)
testosterone
Immunosuppressive drugs cyclosporine (Neoral, Sandimmune, SangCya)
tacrolimus (Prograf)
Pain relievers fentanyl (Actiq, Duragesic)
alfentanil (Alfenta)
codeine
methadone (Dolophine, Methadose)
Steroids Glucocorticoids
hydrocortisone
Miscellaneous drugs caffeine
dapsone
dextromethorphan
sildenafil (Viagra)

Last reviewed: June 2001 by HealthGate Medical Review Board.



Item ID: mea13653   Source ID: 2

Description: Medical Encyclopedia Article: Q & A: Grapefruit pectin and clogged arteries

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Medical Encyclopedia Article: Q & A: Grapefruit pectin and clogged arteries



 
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