Drug interactions
Amiodarone + Grapefruit
Severity: Moderate
Amiodarone and Grapefruit: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Grapefruit juice inhibits intestinal CYP3A4 and can raise amiodarone concentrations. Higher exposure may increase bradycardia and QT prolongation, though it can also reduce formation of the active metabolite.
What this interaction means in plain words
Amiodarone and Grapefruit can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Grapefruit components inhibit intestinal CYP3A4, reducing first-pass metabolism of amiodarone.
What to do
Advise patients to avoid grapefruit and grapefruit juice while taking amiodarone. Monitor heart rate and ECG if intake is unavoidable.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Grapefruit?
MediHelp rates the interaction as moderate. Amiodarone and Grapefruit can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Grapefruit juice inhibits intestinal CYP3A4 and can raise amiodarone concentrations. Higher exposure may increase bradycardia and QT prolongation, though it can also reduce formation of the active metabolite.
How serious is the interaction between Amiodarone and Grapefruit?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid grapefruit and grapefruit juice while taking amiodarone. Monitor heart rate and ECG if intake is unavoidable.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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