December #42 : Beyond Grapefruit Juice - by Lark Lands, PhD

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The Age of Ignorance

Reboot Your System

POZ Annual Givers Guide

POZ Annual Givers Guide, Part 2

A Happy Convert

Working Mom

Money Man

You Can Take It With You

LifeStyle Change

Mom Knows Best

Foul Ball


To the Editor


Don't Ask, Do Tell?

In Your Wildest Steams

Boys in Green

When This You See

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Pirate of Penance

Show and Tell

hiv and Me

How Am I?

A Bite of the Apple

Down-and-Dirty Markups

Grow Your Own Bacteria

The Rx Files

Beyond Grapefruit Juice

Douching Dangers

Therapeutic Vaccine in the Works

A B.i.d. for Easier Adherence

Nevirapine for Best Head

Strong in the Tooth

Buyers Clubs

Where to Find It

Pair of Aces

Aunt Evelyn's Letters

POZ Picks

Letter from Sri Lanka: Island Fever

Wrong Way on the ADA

Mann of the Hour


Talk to the Hand

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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December 1998

Beyond Grapefruit Juice

by Lark Lands, PhD

Foods that mess with combos

Word’s out about the dangers of taking some other meds while on antiretroviral combos. Some foods, too, can wreak havoc on an HIV drug’s effectiveness—you’ve likely been warned to avoid grapefruit juice, which can inhibit the ability of a crucial enzyme (cytochrome P450 3A, or CYP3A) to break down both protease inhibitors and non-nucleoside reverse transcriptase inhibitors. Well, the bad news is, grapefruit juice is just one culprit. There are hundreds of fruits and vegetables that contain CYP3A-inhibiting compounds (and so may increase a drug’s toxicity and side effects). But the good news is that of those studied so far, few harbor levels high enough to alarm.

According to chemist and nutrition researcher Chester Myers, PhD, pill-poppers should be wary of garlic, blackberries, black cherries, broccoli, elderberries, cocoa, kale, onions, red wines, tea, blueberries and apples. Not that you have to purge these from your diet immediately and entirely. “If you’re having drug side effects,” Myers says, “avoid large servings of any of these foods. And don’t combine more than a couple at any meal.” And stay tuned: Future research may augment or diminish these culinary cautions. One final worry for your list: The opposite effect—inducing, or speeding up, CYP3A’s work—can also limit a drug’s effectiveness by clearing antiretrovirals from the body too quickly. But so far, the only food-derived compounds that have been found to do this are in licorice and one of its components, glycyrrhizin.  

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