CALCIUM-CHANNEL BLOCKERS AND GRAPEFRUIT JUICE
Grapefruit juice very markedly increases the bioavailability of felodipine and nisoldipine, and alters their haemodynamic effects. The bioavailability of nicardipine, nifedipine, nimodipine or nitrendipine is increased without significantly altering haemodynamic effects, whereas the bioavailability of amlodipine, diltiazem and verapamil is only minimally affected. However, with verapamil some ECG changes were seen.
The manufacturers of felodipine say that it should not be taken with grapefruit juice. It has been suggested that whole grapefruit or products made from grapefruit
peel such as marmalade should also be avoided in patients taking felodipine. The manufacturers of lercanidipine, nifedipine, nimodipine, nisoldipine and verapa- mil also contraindicate grapefruit juice, although this interaction is normally of little relevance with most calcium-channel blockers in the majority of patients.
The manufacturers of felodipine say that it should not be taken with grapefruit juice. It has been suggested that whole grapefruit or products made from grapefruit
peel such as marmalade should also be avoided in patients taking felodipine. The manufacturers of lercanidipine, nifedipine, nimodipine, nisoldipine and verapa- mil also contraindicate grapefruit juice, although this interaction is normally of little relevance with most calcium-channel blockers in the majority of patients.