Quote Originally Posted by big_paul_ski View Post
Re: Oral steroids- Ways of Increasing Bioavailability
Now unfortunately for the fine print. Who didn’t see this one coming?


Unfortunately our oral steroids aren’t the only thing that grapefruit juice will have this effect on here is a direct copy of a list (even this is not complete) of things grapefruit juice will have the same effect on:
https://secure.pharmacytimes.com/lessons/200303-02.asp




Table 2. Potential Interactions Between Grapefruit Juice and CYP3A4 Substrates
Drug ClassDrugs(s) with Significant Grapefruit Juice InteractionDrug(s) with Negligible Grapefruit Juice InteractionFindings with Significant InteractionImplications with Significant Interaction
Anti-arrhythmicsAmiodarone Increases AUC by 50% and peak plasma concentration by 84%. Both PR and QRS intervals were not significantly altered and systolic arterial pressure decreased slightly.42Watch for arrhythmias and toxicity.
Quinidine Delays absorption of quinidine and inhibits the metabolism of active metabolite.43Clinical significance is unknown.
Anti-convulsantCarbamazepine Increases AUC, peak and trough concentrations by 40%.44Watch for signs of toxicity such as dizziness, ataxia, drowsiness, nausea, vomiting, tremor, and agitation. Monitor blood levels.
Anti-depressantSertraline Trazodone Nefazodone Clomipramine Increases plasma concentrations.Watch for increases in side effects.
Anti-histamineFexofenadineDesloratadineMay decrease oral absorption and blood levels by inhibiting the organic anion transporting polypeptide.24 Clinical significance is unknown.
Anti-hypertensiveCarvedilol Increases bio-availability of a single dose by 16%.Clinical significance is unknown
Losartan May reduce the AUC of the major active metabolite.May reduce effectivness of losartan but further studies are needed to determine significance.
Anxiolytics & hypnoticsDiazepam Midazolam Triazolam Buspirone AlprazolamIncreased plasma concentrations.Watch for possible increase in sedation.
Caffeine Decreases caffeine clearance.45,46Watch for possible increase in side effects such as nervousness or insomnia.
Calcium channel blockersFelodipine Nicardipine Nifedipine Nimodipine Isaradipine VerapamilAmlodipine DiltiazemIncreased plasma concentrations.47Watch for toxicity, such as flushing, headache,t achycardia, and hypotension.
Cortico-steroidsMethylprednisolone, oralPrednisoneIncreased plasma concentrations.Consumption of large amounts of grapefruit juice may increase the risk of adverse effects.
Budesonide Increases ora absorption.lWatch for hypercorticism.
EstrogensEthinyl estradiol Increased plasma concentration.Clinical significance is unknown.
HMG-CoA reductase inhibitorsAtorvastatin Lovastatin Simvastatin Fluvastatin PravastatinIncreased plasma concentrations.Increased toxicity such as GI complaints and muscle pain.
Immune modulators (immuno-suppressants)Cyclosporine Increased plasma concentrations of cyclosporine.48Watch for signs of toxicity such as hepatotoxicity, renal toxicity, and increased immunosuppression.
Tacrolimus Possible increases in plasma concentrations.Watch for signs of toxicity such as nephrotoxicity, and increased immunosuppression.
Macrolide antibiotics ErythromycinIncreased plasma concentration.Clinical significance is unknown.
Protease inhibitorsRitonavir Nelfinavir SaquinavirIndinavir Amprenavir Increases plasma concentrations.Watch for possible increased side effects.
OthersSildenafil Increased bioavailability.49
AUC = area under the curve; PR = pulse rate; GI = gastrointestinal.




NOTE: This will increase the potential for side effects for serious medications from blood pressure lowering medications to mood stabilizers. It will also increase the potency of caffeine and the ED drugs Viagra and Cialis so something very important to keep in mind since Priapism can occur and while you may think it is funny to have an erection for longer than 4 hours it can cause serious nerve damage and be extremely painful. Also keep in mind liver toxicity so please remember to use ALA and NAC while attempting any of this.














And as usual for my writeups:


Now for the disclaimer: I am an MD, but I cannot and will not give medical advice. Any advice given is simply what I would do with the information I have on the situation, I do not pretend to have all the answers I am just a knowledgeable source who has done a LOT of research on many different topics. Any help I give directly or otherwise is just that, help from one person to another, if you want medical advice I ADVISE you as a PERSON who cares about other people to see your Doctor, as they will be able to perform the proper tests and deal with you face to face. It is unethical for me to think that I could help anyone without seeing them and I will not bend my rules no matter what the circumstances.




Some references for everyone since I have been better about posting them with my information these days, some of these were posted in the write up but I wanted to throw them on the end as well for easy reference:


ScienceDirect - 44
Metabolism of anabolic steroids in humans: synthesis of 6 beta-hydroxy metabolites of 4-chloro-1,2-dehydro-17 alpha-methyltestosterone, fluoxymeste... - PubMed - NCBI
https://secure.pharmacytimes.com/lessons/200303-02.asp
10. Enzymatic Reactions of Anabolic Steroids
http://www.nutritionj.com/content/6/1/33/
http://onlinelibrary.wiley.com/doi/1...C9179C1.d03t03
http://medicine.iupui.edu/clinpharm/...ct_11_2009.pdf
Nice post bro. I never heard the thing with grapefruit juice or tagament for oral gear but I've heard this for years when it came to things like *********, ********, head drugs and yeah I had my run with them. Thank God it's been over for 15 years for me.

But thanks for post very informative

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