Blog | Friday, August 22, 2008

A juicy dilemma

It's a classic image for the AARP set: The glass of OJ and the pile of pills next to one's plate at the breakfast table.

But this week, researchers presented a study that suggests orange, apple and grapefruit juice can reduce the absorption of some very important drugs, the New York Times and several hundred other news outlets reported.

Fexofenadine, ciprofloxacin, levofloxacin, itraconazole, atenolol, celiprolol, talinolol, cyclosporine, etoposide-- all are on the list of drugs affected by the three juices. And the study researchers from the University of Western Ontario suspect more will be added to the list, the Times article said.

Given that the jury is still out on how many drugs are affected by juice, what will/should physicians do in terms of educating patients about their prescriptions? Should they tell them to take all pills with water, to be on the safe side? Should they tell them why, or is that too much information to go into?

Should they tell certain patients to avoid drinking juice altogether (as has been done for years for patients who take drugs that interact with grapefruit juice), until more is known about how long the interaction effect lasts? What about eating an orange or an apple around the time one takes his or her pills-- should doctors address that, as well?

In other words, what should doctors do with information like this, while they wait for more clarifying research to emerge? It seems like a tough spot to be in.