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How to double your on time!!
I think I need help with this one. Two days ago I took a 50mg dose of Stavelo, together with my normal meds of rasagiline, amantadine, and trihexyphenidy at 8-00am. I switched on at 8-30am. Everything normal, but I then stayed on and on, until 3-00pm, when I switched off. That is 6.5 hours from one 5omg tablet!! I normally only get 2 to 3 hours,
What caused it, well I remembered taking a glass of fruit juice, namely grapefruit. I was aware of the restrictions of drugs and grapefruit juice but nothing generally affects me. I duplicated the experiment yesterday and again got exactly the same result. The only negative point is safety. There are about 50 drugs which interact with grapefruit, but are any PD drugs on the list? I did a quick search, and did not find any, but we need a very careful search. Apparently grapefruit juice and certain drugs both use ther same enzyme to break down. If it is safe, this would be a huge step forward. Ron |
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http://www.parkinsonswellness.org/nutrition.html someone likes orange juice, stomach acidity http://www.centralohioparkinson.org/...e=doc&id=10098 |
Worth trying
Ron-
I did a little looking (but not in depth). It seems that there are two or three ways for grapefruit juice to affect the apple cart- 1) It can influence the actions of certain enzymes (e.g. cytochrome P450) and affect serum levels of medications that are broken down by those enzymes. Depending on the medication, those levels can increase or decrease. 2) It can increase bioavailability of drugs that are absorbed from the small intestine by increasing the permeability of that barrier. This is the one that intrigues me for obvious reasons. 3) There are hints of a similar effect at your old friend the BBB, too. Bottom line is a bit of trial and error, but it looks darned promising. -Rick Food-drug interactions: grapefruit juice. Diaconu CH, Cuciureanu M, Vlase L, Cuciureanu R. Rev Med Chir Soc Med Nat Iasi. 2011 Jan-Mar;115(1):245-50. PMID: 21682192 [PubMed - indexed for MEDLINE] Related citations 2. Effect of grapefruit juice in relation to human pharmacokinetic study. Uno T, Yasui-Furukori N. Curr Clin Pharmacol. 2006 May;1(2):157-61. Review. PMID: 18666368 [PubMed - indexed for MEDLINE] Related citations 3. [Grapefruit juice and drugs: a hazardous combination?]. Lohezic-Le Devehat F, Marigny K, Doucet M, Javaudin L. Therapie. 2002 Sep-Oct;57(5):432-45. Review. French. PMID: 12611197 [PubMed - indexed for MEDLINE] Related citations 4. Grapefruit-drug interactions. Seden K, Dickinson L, Khoo S, Back D. Drugs. 2010 Dec 24;70(18):2373-407. doi: 10.2165/11585250-000000000-00000. Review. PMID: 21142260 [PubMed - indexed for MEDLINE] Related citations 5. Grapefruit juice and drug interactions. Exploring mechanisms of this interaction and potential toxicity for certain drugs. Bressler R. Geriatrics. 2006 Nov;61(11):12-8. Review. PMID: 17112309 [PubMed - indexed for MEDLINE] Related citations 6. The effects of fruit juices on drug disposition: a new model for drug interactions. Dresser GK, Bailey DG. Eur J Clin Invest. 2003 Nov;33 Suppl 2:10-6. Review. PMID: 14641551 [PubMed - indexed for MEDLINE] Related citations 7. Interactions between grapefruit juice and cardiovascular drugs. Bailey DG, Dresser GK. Am J Cardiovasc Drugs. 2004;4(5):281-97. Review. PMID: 15449971 [PubMed - indexed for MEDLINE] Related citations 8. Undesirable effects of citrus juice on the pharmacokinetics of drugs: focus on recent studies. Saito M, Hirata-Koizumi M, Matsumoto M, Urano T, Hasegawa R. Drug Saf. 2005;28(8):677-94. Review. PMID: 16048354 [PubMed - indexed for MEDLINE] Related citations 9. Drug interactions with grapefruit juice. Extent, probable mechanism and clinical relevance. Fuhr U. Drug Saf. 1998 Apr;18(4):251-72. Review. PMID: 9565737 [PubMed - indexed for MEDLINE] Related citations 10. [Grapefruit juice interactions with psychotropic drugs: advantages and potential risk]. Pawełczyk T, Kłoszewska I. Przegl Lek. 2008;65(2):92-5. Review. Polish. PMID: 18663908 [PubMed - indexed for MEDLINE] Related citations 11. The effect of grapefruit juice on drug disposition. Hanley MJ, Cancalon P, Widmer WW, Greenblatt DJ. Expert Opin Drug Metab Toxicol. 2011 Mar;7(3):267-86. Epub 2011 Jan 22. Review. PMID: 21254874 [PubMed - indexed for MEDLINE] Related citations 12. Grapefruit juice enhances intestinal absorption of the P-glycoprotein substrate talinolol. Spahn-Langguth H, Langguth P. Eur J Pharm Sci. 2001 Feb;12(4):361-7. Review. PMID: 11231102 [PubMed - indexed for MEDLINE] Related citations 13. [Grapefruit juice: potential drug interaction]. Palumbo G, Bacchi S, Palumbo P, Primavera LG, Sponta AM. Clin Ter. 2005 May-Jun;156(3):97-103. Review. Italian. PMID: 16048029 [PubMed - indexed for MEDLINE] Related citations 14. Food-drug interaction: grapefruit juice augments drug bioavailability--mechanism, extent and relevance. Dahan A, Altman H. Eur J Clin Nutr. 2004 Jan;58(1):1-9. Review. PMID: 14679360 [PubMed - indexed for MEDLINE] Related citations 15. Fruit juice inhibition of uptake transport: a new type of food-drug interaction. Bailey DG. Br J Clin Pharmacol. 2010 Nov;70(5):645-55. doi: 10.1111/j.1365-2125.2010.03722.x. Review. PMID: 21039758 [PubMed - indexed for MEDLINE] Free PMC Article Related citations 16. Inhibition of cytochrome P450 by furanocoumarins in grapefruit juice and herbal medicines. Guo LQ, Yamazoe Y. Acta Pharmacol Sin. 2004 Feb;25(2):129-36. Review. PMID: 14769198 [PubMed - indexed for MEDLINE] Related citations 17. Review article: cytochrome P450 enzyme, and transport protein mediated herb-drug interactions in renal transplant patients: grapefruit juice, St John's Wort - and beyond! Nowack R. Nephrology (Carlton). 2008 Jun;13(4):337-47. Epub 2008 Mar 17. Review. PMID: 18363644 [PubMed - indexed for MEDLINE] Related citations 18. Grapefruit juice-drug interactions. Bailey DG, Malcolm J, Arnold O, Spence JD. Br J Clin Pharmacol. 1998 Aug;46(2):101-10. Review. PMID: 9723817 [PubMed - indexed for MEDLINE] Free PMC Article Related citations 19. Drug interactions with grapefruit juice. Ameer B, Weintraub RA. Clin Pharmacokinet. 1997 Aug;33(2):103-21. Review. PMID: 9260034 [PubMed - indexed for MEDLINE] Related citations 20. The grapefruit: an old wine in a new glass? Metabolic and cardiovascular perspectives. Owira PM, Ojewole JA. Cardiovasc J Afr. 2010 Sep-Oct;21(5):280-5. Review. PMID: 20972517 [PubMed - indexed for MEDLINE] Free Article Related citations 21. Grapefruit juice-drug interaction studies as a method to assess the extent of intestinal availability: utility and limitations. Gertz M, Davis JD, Harrison A, Houston JB, Galetin A. Curr Drug Metab. 2008 Oct;9(8):785-95. Review. PMID: 18855612 [PubMed - indexed for MEDLINE] Related citations 22. Medicinal importance of grapefruit juice and its interaction with various drugs. Kiani J, Imam SZ. Nutr J. 2007 Oct 30;6:33. Review. PMID: 17971226 [PubMed - indexed for MEDLINE] Free PMC Article Related citations 23. Influence of dietary components on the gastrointestinal metabolism and transport of drugs. Evans AM. Ther Drug Monit. 2000 Feb;22(1):131-6. Review. PMID: 10688276 [PubMed - indexed for MEDLINE] Related citations 24. Interaction of grapefruit juice and calcium channel blockers. Sica DA. Am J Hypertens. 2006 Jul;19(7):768-73. Review. PMID: 16814135 [PubMed - indexed for MEDLINE] Related citations 25. Analysis of drug interactions involving fruit beverages and organic anion-transporting polypeptides. Greenblatt DJ. J Clin Pharmacol. 2009 Dec;49(12):1403-7. Epub 2009 Sep 29. Review. PMID: 19789373 [PubMed - indexed for MEDLINE] Related citations 26. Grape fruit juice-drug interactions. Arayne MS, Sultana N, Bibi Z. Pak J Pharm Sci. 2005 Oct;18(4):45-57. Review. PMID: 16380358 [PubMed - indexed for MEDLINE] Related citations 27. Influence of dietary substances on intestinal drug metabolism and transport. Won CS, Oberlies NH, Paine MF. Curr Drug Metab. 2010 Nov;11(9):778-92. Review. PMID: 21189136 [PubMed - indexed for MEDLINE] Free PMC Article |
Coincidently, I started about a month ago to drink grapefruit juice after a break of almost 6 years. I had stopped when I was put on statins.
I have not noticed an effect that I can directly attribute to grapefruit. However, the last few weeks have been good for me. I had put this down to more exercise, both normal and forced. Regarding the literature, see the blog of D. J. Kroll: http://scienceblogs.com/terrasig/200...a_drug_boo.php "Grapefruit juice as a 'drug booster': don't try this at home" Linking this to another current thread there are comments on the impact of grapefruit juice on DXM. John |
grapefrtuit juice
Hi Rick,
If that is a short literature search, gosh!! I would love to know if anyone else experiences the boost in on time. However, take it carefully, interactions with certain drugs are very bad. Certainly I tried it for 2 days and had no bad symptoms or side effects. I don't think big pharma will be too pleased, probably why it is not widely known. There is a list of 50 drugs where grapefruit juice intereacts with them, but I have not managed to find it yet. Thanks again for your mamouth list of refs. Ron |
grapefruit juice as a drugs booster
Hi Johnt,
Thanks for your link, it gives one explanation as to the mechanism of this boost to drugs. "). So, taking felodipine while drinking grapefruit juice was essentially the same as taking a higher dose of the drug because its elimination from the body was slowed. Today's WSJ article and blog post discuss the experimental and commercial approach to using CYP3A4 inhibitors as "dose boosters" to minimize the dose one needs to take of some very expensive drugs. I did say big pharma would not be amused!! Before we get into this, is there a clinical trial somewhere in ther literature? If there is, it is quite likely that it has been suppressed for reasons given above. Levodpa is a cheap drug, but with over 5 million sufferers worldwide, half of the market being lost would be horrendous for the suippliers. From our point of view, halving your sinemet would delay the onset of dyskinesia, or reduced dyskinesia in more advanced patients. Ron Quote:
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http://www.drugbank.ca/drugs/DB00323 click on enzymes at the top. |
I checked a few drug interaction lists and PD drugs aren't mentioned in the ones I saw. So I tried grapefruit juice with my Sinemet and Mirapex today with no effect. I used Ruby Red grapefruit juice, 100% juice, no sugar added. I wonder if the type of grapefruit juice makes a difference or maybe it's the different meds we're taking. Or like everyone keeps saying, we're all different. Hope it keeps working for you, Ron.
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Grapefruit booster effect
Hi Wendy,
Sorry you got no effect, but it may be the type of juice used or when you take it. I did not use red grapefruit It was a carton from a local supermarket marked as 100% grapejuice from concentrate. I don't know the optimum time to take it but I took the juice about an hour after taking my meds. There was no warning on the carton about it's effect on drugs. Ron |
Ron,
The more I read about this the more it sounds like an episode of the (USA) TV program "House". Scary to mess with our personal drug factory that is the human body. I'm going to try some grapefruit juice, but VERY cautiously! Mike Quote:
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Grapefruit Juice
Rick,
Your first explanaton as to how this interaction works seems to be the main one. see It turns out that grapefruit juice can directly or indirectly interact in important ways with a number of medications. This is especially important since grapefruit juice is consumed by approximately one fifth of Americans for breakfast - a time of the day when medications also are commonly taken. Grapefruit juice blocks special enzymes in the wall of the small intestine that actually destroys many medications and prevents their absorption into the body. Thus, smaller amounts of the drugs get into the body than are ingested. When the action of this enzyme is blocked, more of the drugs get into the body and the blood levels of these medications increase. This can lead to toxic side effects from the medications. There are over 1 million Americans with PD and if 20% of them take grapefruit juice, it looks fairly safe. The explanation that it blocks the enzyme that breaks down levodopa in the body, before it can get to the brain, explains why i got a boost. As one of your references said, it's effect is like taking a higher dose of Sinemet. Has anyone else tried it, and got a boost? Ron |
I haven't tried grapefruit juice. Now as much as I dislike the taste of it I will have to try it. I have used orange juice to get my Sinemet working quicker from mouth to brain.
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thanks Ron
I tried(just this morning) the fresh squeezed ruby red grapefruit by tropicana - did not seem to extend my on time however i did feel a faster onset however i did not take the fava juice - so far fava juice and quercitin are helping me extend that time to 6 hours/pill. (I take usually 2 doses/ day, 1 pill of either 25/100 OR 10/100 generic sinemet) will stay with the grapefruit juice and give it a chance to see. thanks for the thread Ron. my "offs" and "ons" don't really have clear boundaries so its a bit hard to make an immediate assessment
md |
Didn't do anything for me - tried 3 mornings.
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PD Alchemy is alive and well.
H |
worth exploring
I'm thinking grapefruit juice will be useful. My strategy today is to take it 3 hours or so after the sinemet to see if it has a boost effect....seems like it did yesterday. also, will try the bottled white grapefruit juice next!
salut, md Quote:
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It's a phytochemical
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I think it may have to due with how volatile it is. Seems to inhibit or enhance drug metabolism, but I don't see how they could formulate something for us because think of how many differing interactions they would need to list. Way too much liability involved. The compound that current researchers name responsible for the "grapefruit effect" is bergamottin, a plant compound that works in a plants defense as in having a bitter taste or toxic leaf. Just look at the root "bergamot"; this is what gives Earl Grey tea its heavenly scent and unusual taste. I am just wondering if a cup of Earl Grey may have a similar effect for some? It seems promising because it comes from the fruit of the plant so that bergamottin goes into the tea. Oh, and one citation it is neuroprotective. Cell signaling pathways in the mechanisms of neuroprotection afforded by bergamot essential oil Well, no grapefruit juice, but I will have a cup of Earl Grey in the morning... |
I drank about 6 oz of grapefruit juice with meds at 7:00 am yesterday morning.. I had dyskinesia for about 3- 4 hours which is highly unusual for me, but, my on time lasted untill 10 pm.. That is four extra hours of on time
So I decided to try it again today, only this time I drank the juice 30 minutes before meds I will report back later........... |
grapefruit juice as a drugs booster
Hi Steven,
Thank goodness someone has duplicated my experience. Do I understand right that you had one dose at 7.00am which gave you an on until 10.00pm.? Assuming you switched on at 8.00am, that would mean 14 hours on time from one dose!! You had no other doses during the day? What size dose of levodopa did you take, and did you take any other drugs in your 7.00am dose? I am not surprised you got dyskinesia, the grape juice acts as if you had taken a larger dose than you actually did. Thanks for your input Ron |
Soccertese,
I was wondering this as well. According to research, the responsible component of grapefruit is the phytochemical bergamottin. This is perhaps why Ron had such an extra long duration. It boosts the amount of levodopa in our bloodstreams and then it enhances the COMT inhibition leaving more dopamine up there working for us? Maybe if we are not on entacapone we do not get the extended on time? Just a guess. Oh, and our genes play a role. I don't know how many have done this but 23 andMe tests for our genetic dispositions with the COMT gene. The Val/Met SNP also informs how well we respond to COMT inhibitors. 23andme will tell you what alleles you have by looking up SNP rs43680 in browse raw data then see abstract for your response to COMT inhibitors at the pubmed link: The COMT Val158Met polymorphism affects the response to entacapone in Parkinson's disease: a randomized crossover clinical trial. Laura |
[QUOTE=Conductor71;829786]Soccertese,
I was wondering this as well. According to research, the responsible component of grapefruit is the phytochemical bergamottin. This is perhaps why Ron had such an extra long duration. It boosts the amount of levodopa in our bloodstreams and then it enhances the COMT inhibition leaving more dopamine up there working for us? Maybe if we are not on entacapone we do not get the extended on time? Just a guess. Oh, and our genes play a role. I don't know how many have done this but 23 andMe tests for our genetic dispositions with the COMT gene. The Val/Met SNP also informs how well we respond to COMT inhibitors. 23andme will tell you what alleles you have by looking up SNP rs43680 in browse raw data then see abstract for your response to COMT inhibitors at the pubmed link: The COMT Val158Met polymorphism affects the response to entacapone in Parkinson's disease: a randomized crossover clinical trial. Laura[/QUOTE what i find interesting is that if your detoxifying enzyme activity is inhibited by grapefruit juice and basically l-dopa is absorbed in just a small area of your small intestine via active transport, then i assume you have to have a higher concentration of l-dopa in your tissues and blood, and maybe that translates to a higher concentration in the brain but doesn't seem so, just a longer affect. so as an aside, it seems that the concentration of l-dopa in your brain must reach an equilibrium fairly quickly? i.e., the active transport into the brain gets saturated quickly and somehow shuts down until the concentration in the brain decreases? of course normally it's tyrosine that your brain uses to mfg dopamine but life's too short to research that pathway. amazingly complicated system, wonder how the kidneys look a l-dopa, how much l-dopa ends up in the urine? and how much better are comt inhibitors vs selegiline and rasagiline, which gives the bigger bang for the buck? have too much time on my hands. |
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Fishing is very challenging, and as of yesterday, I had gone out three days in a row..Getting any ontime past 7:00 pm, even after taking a teaspoon of Zandopa with my regular meds is unheard of for me....... I went out fishing today, and took my 3 Stalevos, and a teaspoon of Zandopa..I hauled 25 traps on Thursday, 30 traps on Friday, 20 traps yesterday, and 38 traps today..I havent fished 4 days in a row, in atleast 3-4 years, so you can imagine how tired, and fatigued I am right now I took my pd meds..(Stalevo 200 mg, and Amantadine 100 mg)..at 7:00 am, this morning, and it usually takes 45 minutes to one hour get on..and I usually go off at about 6:00 pm..Days that I work, I have to take a teaspoon of Zandoa, to insure that I wont go off, while I am working, and I usually, but not always, go off at about 6:30 - 7:00 pm when I take some Zandopa I dont eat breakfast, because it interferes with my pd meds, but I do have a cup of caffinated coffee I wish I could get 14 hours out of one dose, but I am thrilled with another 3 or 4 hours of on time I drank about 6 oz's of pure grapefruit juice and 6:30 am this morning, took pd meds at 7:00, and was on about 7:40 am I had only had about 5 minutes of dyskinesia, when my meds kicked in this morning, and have had none during the day so far .It is 5:00 pm here now, so we'll see how long I can stay on today I took my usual drug regimen yesterday, and today |
This is probably pre-mature, but..today was day 4 of drinking about 6 ozs of grapefruit juice 1/2 hour before morning meds
I stuck to my regular med regimen..no Zandopa today I had one day that I was on for an extra 4 extra hours, the other 3 days I went off at about 6:30 - 7:00 pm..Usual off time begins at 5:30 - 6:00 pm What is different the past few days, especially today/tonight is I started to get dyskinetic at around 6:00 pm, and meds began to wear off..By 6:30 I was off..At 7:30 I got dyskinetic again, which is very rare for me..When the dyskinesia stopped, I was in a semi on/off state..No shuffling, a minmum of freezing episodes, and I could walk fairly well..It is 11:45 now, and I have more movement than usual..Im not on, but Im not off like I usually am at this time of the night Last night I had a similar experience, only it didnt last as long Through the past 2 years, since Ive been on Stalevo, my on/off time was pretty predictable..Meds at 7:00 am, and on 45 minutes to one hour later 2nd dose at 10 am..3rd dose at 1:00 pm..Off between 5:00 - 6:00 pm..and when I went off, I stayed off..I cant take 4 doses of Stalevo, because all I get is 2-3 hours of non stop dyskinesia Now, Im not very well versed in science, chemistry or biology, but I do know that the amount of medication that is absorbed, in the small intestine, and avoids geting metabolized, basically has alot to do with the amount of l-dopa that reaches the brain I also know from experience, that what I ingest into my gastro system, prior to taking my morning meds, has alot to do with the amount of time it will take for my pd meds to kick in, and how much dyskinesia I will endure to get there I have gerd..( acid reflux )..and I was taking 20 mgs of Omeprazole every morning with my pd meds, and I would shake and bake for 45 mins to an hour before my meds kicked in Then, I happened to find and read a clinical study online one night, and it said that the patients were told not to take any anti-acid meds with their pd meds, because the two drugs will compete for absorbtion, and the anti-acid drug usually wins..When I stopped taking Omeprazole in the morning, and took it at night after my pd meds had worn off, the morning dyskinesia was minimal, and occasionally, I had none at all Anyway, I am going to continue the grapefruit juice every morning, and see what happens |
This grapefruit "assist" is very interesting. I'm experimenting with different timing - today I drank a small glass an hour after my first dose at 7:00 a.m. I went five hours between doses in the afternoon instead of my usual three, so that's promising. I wonder if a significant amount once a day is better, or several smaller amounts - so many variables.
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Hey Ron, here's my results...
I am taking 1 1/2 generic sinemet 25/100 tabs every 2 hours. The meds don't even make it dose to dose and then in the afternoon I have to decrease that or I will get dyskinesia around 2 or 3 in the afternoon that is severe.
On Tuesday morning 12/6, approx 7 in the morning, I drank about 10 ounces of Minute Maid grapefruit juice, not from concentrate and plain grapefruit, not red or pink. I then took my morning dose 1 1/2 tabs. I ate my normal breakfast of cold cereal and milk trying not to otherwise alter my routine. Normally I would expect to have to take a second dose at around 8:30. I have rarely if ever made it to the next dose without feeling some degree of off, perhaps not totally but I can feel it coming on. I was able to maintain an "on" state until around 1 pm in the afternoon! In fact having to monitor how I was feeling so that I would not go to an "off" state did not even come to mind I was moving about so well. It worked for me and beyond the having to drink grapefruit juice it was an enlightening experiment. Best of luck to all. |
Grapefruit Juice
Well it seems to work for most people most of the time. We must be careful and try to get more evidence that it is safe with PD meds. It does seem to be fairly mild so far. Several of us have taken grapejuice with our meds for days without any ill effects.
Wendy is right, there are a lot of variables, iit does not work every time. I have had just one failure, when it did not take effect. We need to build up experience to know do we take the juice before or after the meds. does one glass of juice last all day, or must it be taken throughout the day in small doses. What is the optimum dose level. Yesterday, I tried taking a glass of juice in the middle of the regime at 11-00am when I take a 50mg Stavelo, which normally lasts until 2-00pm, This time I switched off at 4-00pm, so an extra 2 hours. I took the juice at 11-30am, ie half an hour after taking the Stavelo. It works more often than it fails, but it will be very interesting to find out why it fails on some occasions. Ron |
Most days it has worked for me too Ron..The only problems is morning meds take about 15 - 20 mins longer to kick in, and the evening off period is a bit brutal for about an hour with dyskiesia, and musle cramps in my right leg, but the good news is that I bounce back into a semi on/off state..Im not on, but not off either..Freezing periods have been minimal all night, and my last dose of Stalevo is at 1:00 pm in the afternoon, as it has been for quite some time..I feel like the pd clock has been set back a couple of years
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Grapefruit
Doing a literature search, there is a massive amount of research on this booster effect. See Rick's list!!! I could not find any adverse effect on PD patients, but that does not mean there isn't any. I just may not have found it. The mechanism, at least with Sinemet is that grapefruit attacks an enzyme that breaks up levodopa in the bloodstream. The overall effect is as if you had takern a larger dose of Sinemet.
Coincidentally, a full page article was published yesterday on the effect, in the UK Daily Mail. It works with other fruit such as cranberries, some citrus fruits. With an agonist like cabergoline, see the abstract below. Effect of grapefruit juice on cabergoline pharmacokinetics in patients with Parkinson's disease M. Nagai MD, PhD1, A. Nakatsuka1, H. Yabe MD1, T. Moritoyo MD, PhD1 and M. Nomoto MD, PhD1 1Clinical Pharmacology and Therapeutics, Ehime University School of Medicine, Touon, Ehime, Japan Top of page Abstract Background: Cabergoline is one of the synthetic ergoline dopamine agonists, which is widely used for the treatment of Parkinson's disease (PD). Cytochrome P-450 (CYP) 3A4 contributes to metabolize Cabergoline. It has been well known that grapefruit juice inhibits CYP3A4 enzyme located in the gut wall. To investigate whether grapefruit juice influences the pharmacokinetics of cabergoline, plasma level of cabergoline in patients of PD was evaluated. Methods: Five patients with PD treated with cabergoline were enrolled. Plasma concentrations of cabergoline before and after coadministration of grapefruit juice were evaluated. The plasma concentration of cabergoline was determined using a LC/MS/MS. Results: The plasma concentration of cabergoline increased approximately 1.7 times, when grapefruit juice was taken together with cabergoline. Adverse events were not observed during this trial. Conclusions: Coadministration of grapefruit juice with cabergoline increases bioavailability of cabergoline. A relatively large therapeutic window of cabergoline may allow the concomitant treatment with grapefruit juice, and this combination treatment may augment the antiparkisonian effect of cabergoline. I have not tried any more tests at present until I do more searches, but it appears to have real promise of giving a huge boost to our normal drugs. It could enable you to half your regime . We need to find out what is best for us, drinking a fruit juice with half our normal drugs intake, or taking double that level of drugs. Ron |
Gets interesting
Just did a search for cyp3a4 plus turmeric. Turned up a lot of hits:
"It appears that Curcumin from Turmeric and Piperine from Black Pepper (commonly taken together) both inhibit a number of Cytochrome P450 enzymes. P450's such as CYP3A4 and CYP2D6 are responsible for a large amount of drug metabolism and the use of Curcumin and Piperine might explain some of the reactions people are experiencing upon co-administration with drugs such as Benzodiazepines and Amphetamine type drugs... Interesting stuff and something people, especially those using this forum, should be aware of. http://www.bluelight.ru/vb/threads/5...yme-Inhibition |
...a bit off topic, but...
Wow!, stevem53. Congrats on being able to stay so active. Very impressive, & truly inspirational. Whatever you're doing, keep it up. Dean.
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