A DOCS Education member seeks the faculty’s advice:

I have a patient who recently started taking grapefruit seed extract recommended by a holistic healer to relieve allergies. The patient has a chronic cough due to some sort of allergies. The patient says the grapefruit seed extract has really helped with the cough and he breathes easier. The allergist can't pinpoint any allergens, and pulmonologist states patient does not have COPD and cleared him for IV conscious sedation. The patient was observed to have a decreased cough since he recently started taking the grapefruit seed extract.

So, the question is: Does the grapefruit seed extract have the same potent CYP3A4 inhibition as the grapefruit itself?

Thanks


Dr. Jerome Wellbrock, DOCS Education faculty, responds:

Grapefruit juice is known as the "suicide inhibitor" and causes inhibition of the CYP3A4 enzymes by destroying those enzymes. This occurs primarily in the intestines and not in the liver. It would result in increased clinical sedation but would not increase the half life of the drug. The agent in grapefruit juice that is responsible for this is furanocoumarin. I am not certain if the grape seed extract contains furanocoumarin, but would assume that it does until proven otherwise. Your patient should be off of any grapefruit or grapefruit products for a minimum of four or more days as it takes the body two to three days after cessation of grapefruit to reestablish the CPY3A4 enzymes in the intestine.

Disclaimer

The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.

issue_no
1
The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
DOCS Membership

Upcoming Events
Streaming
May 17- 18, 2024
Atlanta, GA skyline
GA
August 23- 24, 2024
Streaming
October 04- 05, 2024

More Articles