You should not drink grapefruit juice while taking a variety of medications, including heart medications. As of August 2011, metoprolol succinate is not listed among heart medications known to cause problems when combined with grapefruit juice or other grapefruit products. Many medications remain untested for interactions with grapefruit. Always check with your doctor -- and read prescription bottle warnings -- before drinking grapefruit with metoprolol succinate or any other medication.
Beta Blocker
The U.S. Food and Drug Administration approved a new label for the brand name of the drug metoprolol succinate in March 2010. The new label included no warnings about combining metoprolol succinate with grapefruit juice or any other grapefruit products. Additionally, metoproplol succinate, a beta blocker, is not part of a category of heart medications known to cause adverse side effects with grapefruit. Beta blockers block your epinephrine hormone, otherwise known as adrenaline. Blocking your body from being able to pump out epinephrine causes your heart to beat more slowly, which, in turn, reduces your blood pressure. Metoprolol succinate is typically prescribed to treat high blood pressure and chest pains known as angina, caused by not enough blood getting to your heart.
Heart Drugs and Grapefruit Juice Interactions
If you take other heart-related medications, including calcium channels and statins, do not drink grapefruit juice with them. Calcium channel blockers, which, like metoprolol succinate, are prescribed to treat high blood pressure and angina, can cause adverse side effects if consumed with grapefruit or grapefruit juice. Calcium channel blockers known to cause dangerous interactions if consumed with grapefruit include felodipine and nifedipine. If you combine grapefruit with calcium channel blockers, your blood pressure may drop too low. If you combine grapefruit or grapefruit juice with statins, prescribed to treat high cholesterol, you increase your risk of side effects such as muscle damage. Additionally, the antiarrhythmic drug amiodarone and the drug quinidine, prescribed in the treatment of abnormal heart rhythms, should not be consumed with grapefruit or grapefruit juice.
Reason for Drug Interactions
Grapefruit and grapefruit juice can cause dangerous side effects with some heart medications -- as well as other medications -- because grapefruit can inhibit your body's CYP34A enzyme from metabolizing drugs. If your drugs aren't metabolized properly, an excess gets into your bloodstream. This essentially elevates the effectiveness and dosage of your medication, putting you at risk for serious, sometimes fatal, side effects, including heart attacks and strokes. Other drugs known to react adversely with grapefruit and grapefruit juice include oral contraceptives, antidepressants and immunosuppressants, among others.
Grapefruit Juice and Heart Benefits
You can include grapefruit in a heart-healthy diet if you do not take medications that interact negatively with them. Shela Gorinstein, of the Hebrew University of Jerusalem, led a study that found grapefruit -- especially red grapefruit -- helpful in lowering triglycerides. Triglycerides can clog your arteries and make you more susceptible to heart disease. In Gorinstein's study, 57 men and women with high blood pressure consumed grapefruit for 30 days. At the end of the study, all participants realized a reduction in the triglyceride levels, and red grapefruit proved the most helpful. Since grapefruit juice isn't known to react with negatively metoprolol succinate, consuming it with your medication might actually benefit your heart. But check with your doctor about making any changes to your diet if you take metroprolol succinate.
References
- The People's Pharmacy; Graedons' Guide to Grapefruit Interactions; 2002
- Access Data, Food and Drug Administration; Toprol XL Label; March 2010
- "Journal of Agricultural and Food Chemistry"; Red Grapefruit Positively Influences Serium Triglyceride Level in Patients Suffering From Coronary Atherosclerosis: Studies in Vitro and in Humans; Shela Gorinstein, et al.; March 2006
- MayoClinic.com: Angina; June 2011
- The Harvard Medical School Family Health Guide; Grapefruit and Medication: A Cautionary Note; February 2006
- MayoClinic.com; Amiodarone -- Oral Route; July 2011
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