Skip to main content
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1995 Aug;40(2):135–140.

Grapefruit juice-felodipine interaction: reproducibility and characterization with the extended release drug formulation.

D G Bailey 1, J M Arnold 1, J R Bend 1, L T Tran 1, J D Spence 1
PMCID: PMC1365172  PMID: 8562295

Abstract

1. Felodipine 10 mg extended release was administered with 250 ml regular-strength grapefruit juice or water in a randomized crossover manner followed by a second grapefruit juice treatment in 12 healthy men. The pharmacokinetics of felodipine and primary oxidative metabolite, dehydrofelodipine, were evaluated. 2. Initial grapefruit juice treatment increased felodipine AUC (mean +/- s.d.; 56.6 +/- 21.9 vs 28.1 +/- 11.5 ng ml-1 h; P < 0.001) and Cmax (8.1 +/- 2.5 vs 3.3 +/- 1.2 ng ml-1; P < 0.001) compared with water. Felodipine tmax (median; 2.8 vs 3.0 h) and t1/2 (7.3 +/- 3.7 vs 6.9 +/- 3.6 h) were not altered. 3. Readministration of felodipine with grapefruit juice produced mean felodipine AUC (61.5 +/- 32.2 ng ml-1 h) and Cmax (8.4 +/- 4.8 ng ml-1) which were similar to the initial grapefruit juice treatment 1-3 weeks previously. Felodipine AUC (r = 0.73, P < 0.01) and Cmax (r = 0.69, P < 0.02) correlated between grapefruit juice treatments among individuals. 4. The % increase in felodipine AUC with the initial grapefruit juice treatment compared with water correlated with the % increase in felodipine Cmax among individuals (r = 0.80, P < 0.01). Dehydrofelodipine AUC (74.7 +/- 28.7 vs 48.5 +/- 16.3 ng ml-1 h; P < 0.01) and Cmax (12.1 +/- 2.9 vs 7.9 +/- 2.6 ng ml-1; P < 0.01) were augmented with grapefruit juice compared with water.(ABSTRACT TRUNCATED AT 250 WORDS)

Full text

PDF
139

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahnoff M. Determination of felodipine in plasma by capillary gas chromatography with electron capture detection. J Pharm Biomed Anal. 1984;2(3-4):519–526. doi: 10.1016/0731-7085(84)80055-2. [DOI] [PubMed] [Google Scholar]
  2. Bailey D. G., Arnold J. M., Munoz C., Spence J. D. Grapefruit juice--felodipine interaction: mechanism, predictability, and effect of naringin. Clin Pharmacol Ther. 1993 Jun;53(6):637–642. doi: 10.1038/clpt.1993.84. [DOI] [PubMed] [Google Scholar]
  3. Bailey D. G., Arnold J. M., Spence J. D. Grapefruit juice and drugs. How significant is the interaction? Clin Pharmacokinet. 1994 Feb;26(2):91–98. doi: 10.2165/00003088-199426020-00002. [DOI] [PubMed] [Google Scholar]
  4. Bailey D. G., Arnold J. M., Strong H. A., Munoz C., Spence J. D. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther. 1993 Dec;54(6):589–594. doi: 10.1038/clpt.1993.195. [DOI] [PubMed] [Google Scholar]
  5. Bailey D. G., Spence J. D., Munoz C., Arnold J. M. Interaction of citrus juices with felodipine and nifedipine. Lancet. 1991 Feb 2;337(8736):268–269. doi: 10.1016/0140-6736(91)90872-m. [DOI] [PubMed] [Google Scholar]
  6. Blychert E., Edgar B., Elmfeldt D., Hedner T. A population study of the pharmacokinetics of felodipine. Br J Clin Pharmacol. 1991 Jan;31(1):15–24. doi: 10.1111/j.1365-2125.1991.tb03852.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ducharme M. P., Provenzano R., Dehoorne-Smith M., Edwards D. J. Trough concentrations of cyclosporine in blood following administration with grapefruit juice. Br J Clin Pharmacol. 1993 Nov;36(5):457–459. doi: 10.1111/j.1365-2125.1993.tb00395.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Edgar B., Bailey D., Bergstrand R., Johnsson G., Regårdh C. G. Acute effects of drinking grapefruit juice on the pharmacokinetics and dynamics of felodipine--and its potential clinical relevance. Eur J Clin Pharmacol. 1992;42(3):313–317. doi: 10.1007/BF00266354. [DOI] [PubMed] [Google Scholar]
  9. Guengerich F. P., Brian W. R., Iwasaki M., Sari M. A., Bärnhielm C., Berntsson P. Oxidation of dihydropyridine calcium channel blockers and analogues by human liver cytochrome P-450 IIIA4. J Med Chem. 1991 Jun;34(6):1838–1844. doi: 10.1021/jm00110a012. [DOI] [PubMed] [Google Scholar]
  10. Guengerich F. P. Characterization of human cytochrome P450 enzymes. FASEB J. 1992 Jan 6;6(2):745–748. doi: 10.1096/fasebj.6.2.1537465. [DOI] [PubMed] [Google Scholar]
  11. Haynes R. B., Sackett D. L., Gibson E. S., Taylor D. W., Hackett B. C., Roberts R. S., Johnson A. L. Improvement of medication compliance in uncontrolled hypertension. Lancet. 1976 Jun 12;1(7972):1265–1268. doi: 10.1016/s0140-6736(76)91737-2. [DOI] [PubMed] [Google Scholar]
  12. Kolars J. C., Schmiedlin-Ren P., Schuetz J. D., Fang C., Watkins P. B. Identification of rifampin-inducible P450IIIA4 (CYP3A4) in human small bowel enterocytes. J Clin Invest. 1992 Nov;90(5):1871–1878. doi: 10.1172/JCI116064. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lown K. S., Kolars J. C., Thummel K. E., Barnett J. L., Kunze K. L., Wrighton S. A., Watkins P. B. Interpatient heterogeneity in expression of CYP3A4 and CYP3A5 in small bowel. Lack of prediction by the erythromycin breath test. Drug Metab Dispos. 1994 Nov-Dec;22(6):947–955. [PubMed] [Google Scholar]
  14. Nifedipine, hypotension, and myocardial injury. Ann Intern Med. 1988 Feb;108(2):305–306. doi: 10.7326/0003-4819-108-2-305. [DOI] [PubMed] [Google Scholar]
  15. O'Mailia J. J., Sander G. E., Giles T. D. Nifedipine-associated myocardial ischemia or infarction in the treatment of hypertensive urgencies. Ann Intern Med. 1987 Aug;107(2):185–186. doi: 10.7326/0003-4819-107-2-185. [DOI] [PubMed] [Google Scholar]
  16. Rashid J., McKinstry C., Renwick A. G., Dirnhuber M., Waller D. G., George C. F. Quercetin, an in vitro inhibitor of CYP3A, does not contribute to the interaction between nifedipine and grapefruit juice. Br J Clin Pharmacol. 1993 Nov;36(5):460–463. doi: 10.1111/j.1365-2125.1993.tb00396.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Regårdh C. G., Edgar B., Olsson R., Kendall M., Collste P., Shansky C. Pharmacokinetics of felodipine in patients with liver disease. Eur J Clin Pharmacol. 1989;36(5):473–479. doi: 10.1007/BF00558072. [DOI] [PubMed] [Google Scholar]
  18. Shimada T., Yamazaki H., Mimura M., Inui Y., Guengerich F. P. Interindividual variations in human liver cytochrome P-450 enzymes involved in the oxidation of drugs, carcinogens and toxic chemicals: studies with liver microsomes of 30 Japanese and 30 Caucasians. J Pharmacol Exp Ther. 1994 Jul;270(1):414–423. [PubMed] [Google Scholar]
  19. Sigusch H., Hippius M., Henschel L., Kaufmann K., Hoffmann A. Influence of grapefruit juice on the pharmacokinetics of a slow release nifedipine formulation. Pharmazie. 1994 Jul;49(7):522–524. [PubMed] [Google Scholar]
  20. Soons P. A., Vogels B. A., Roosemalen M. C., Schoemaker H. C., Uchida E., Edgar B., Lundahl J., Cohen A. F., Breimer D. D. Grapefruit juice and cimetidine inhibit stereoselective metabolism of nitrendipine in humans. Clin Pharmacol Ther. 1991 Oct;50(4):394–403. doi: 10.1038/clpt.1991.156. [DOI] [PubMed] [Google Scholar]
  21. Wang S. X., Sutfin T. A., Bärnhielm C., Regårdh C. G. Contribution of the intestine to the first-pass metabolism of felodipine in the rat. J Pharmacol Exp Ther. 1989 Aug;250(2):632–636. [PubMed] [Google Scholar]
  22. Waters D. Proischemic complications of dihydropyridine calcium channel blockers. Circulation. 1991 Dec;84(6):2598–2600. doi: 10.1161/01.cir.84.6.2598. [DOI] [PubMed] [Google Scholar]
  23. Yee G. C., Stanley D. L., Pessa L. J., Dalla Costa T., Beltz S. E., Ruiz J., Lowenthal D. T. Effect of grapefruit juice on blood cyclosporin concentration. Lancet. 1995 Apr 15;345(8955):955–956. doi: 10.1016/s0140-6736(95)90700-9. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES