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Great news for those who would love to try a Reverb Crash or any of the other many tasty tropical drinks that contain grapefruit juice, but can't due to drug interaction concerns. You won't be able to use fresh-squeezed juice, and it might take some friendly pestering of the juice producers, but it's an important bit of progress:

Study finds how grapefruit juice affects drugs

Tue May 9, 12:25 PM ET

WASHINGTON (Reuters) - U.S. researchers said they have identified the compound in grapefruit juice that affects how some drugs are absorbed in the body and said on Tuesday it might be used to help lower dosages for some patients.

Grapefruit juice is known for its effects on drug metabolism and is avoided by some patients while other deliberately take their drugs with the juice.

The reason is an intestinal enzyme called CYP3A, which partially destroys drugs as they are absorbed. Grapefruit juice, like no other fruit juice, interferes with CYP3A, so the body ends up absorbing more of the drug.

Dr. Paul Watkins of the University of North Carolina at Chapel Hill and colleagues say they have identified the substance in grapefruit juice that is responsible -- furanocoumarin.

"It should now be possible to market the furanocoumarin-free grapefruit juice to patients who would otherwise need to avoid grapefruit," Watkins said in a statement.

"In addition, it should be possible to screen new foods for the potential for drug interactions by determining whether they contain furanocoumarins," Watkins said.

"Finally, it may be possible to add furanocoumarins to formulations of certain drugs that tend to be poorly or erratically absorbed to improve their oral delivery."

To test the theory that furanocoumarin was the responsible compound, Watkins and colleagues filtered it out grapefruit juice, which they discovered was then less bitter but otherwise unaltered.

Then they tested 18 men and women taking various drugs on a regular basis including aspirin and birth control pills.

Each fasted in the hospital and got a single dose of the blood pressure drug felopidine, sold under the brand name Plendil, along with either normal grapefruit juice, furanocoumarin-free juice or orange juice.

They then ate and drank normally and blood was taken regularly all day.

In each volunteer, the normal grapefruit juice made between 6 percent to 230 percent more Plendil available in the blood, the researchers reported in the American Journal of Clinical Nutrition. The furanocoumarin-free grapefruit juice and orange juice had no such effect, they reported.

See TiKi Central can save your life! I take blood pressure meds and know that I cannot drink grapefruit juice, I forgot that Reverb Crash has it! That could be bad! Thanks Humuhumu!


Mu doctor actually told me that a lot of meds are not affected by alcohol consumption but to never drink grapefruit while taking my meds. It's actually funny to hear that from your doctor. Drink booze not juice.

My sincerest sympathies to those who can't drink grapefruit juice. A Reverb Crash without fresh grapefruit juice is, well... I don't even want to think about it.



So, has anyone found furanocoumarin-free grapefruit juice yet? I really want to make the Zombie Punch recipe in Sippin' Safari, but can't due to interaction with my blood-pressure meds.

In the absence of some sort of magical new grapefruit juice, what other kinds of fruit juice might make an adequate substitute?


I thought I'd bring this back from the dead as I'm now a member of the "can't drink grapefruit juice" tribe. I didn't think it would be a big deal until it hit me: no navy grogs, no jet pilots. My two absolute favorite and go-to exotic cocktails. Not only that, but I'm close to completing my passport over at Ventiki and what have I saved for last, among others? Reverb Crash.

While I'm not the first one who has run into this issue, I've unfortunately not found any passable substitute over the years. I've scourged the internet and thus far have found nothing. Now while I'm sure 1/2 oz - 4 oz in a cocktail, occasionally, is different than a big ol' 12 oz glass of grapefruit juice in the morning, it's a bit early on in my Jynarque/tolvaptan to start rolling the dice.

I've checked out the "grapefruit substitute in a Navy Grog" thread, alas no solution either.

Truly a dilemma... I think you’re on the right track investigating how much of the incompatible compound is in 1/2 oz, 1 oz, etc.

Had someone along at a Hukilau many years ago with the same issue. He drank carefully and limited his grapefruit intake and did just fine along with the rest of us.

Fortunately there are many other cocktails you can fall in love with. They’re not a replacement but certainly a distraction.


On 2019-05-29 06:22, AceExplorer wrote:
Fortunately there are many other cocktails you can fall in love with. They’re not a replacement but certainly a distraction.

Distraction is absolutely the right word. For whatever reason I've gravitated to a Lapu Lapu. It works for now.

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