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What Are The Repercussions Of Consuming Grapefruit Juice After Taking Procardia And Metformin?
Question: I have an aunt who is 59 years old who is overweight and is taking Procardia XL 60 miliigrams a day, Lipitor 20 milligrams and Metformin 500 milligrams twice a day. One day after eating lunch and drinking grapefruit juice, she became dizzy and fell bruising her arm. What was the cause of her symptoms?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
Regarding your concern I would explain that cutaneous bruising may be caused by several causes as follows:
- a micro-trauma may be the reason of small blood vessels disruption and blood leaking outside into the surrounding tissues. In such case trying to rest the arm and avoiding strenuous exertion is all that is required.
- an increased fragility of the small blood vessels which is common in the setting of diabetes or impaired glucose metabolism, leading to blood vessels disruption with the same consequence.
- not rarely such hemorrhagic diathesis may be caused by impaired coagulation functions due to decreased coagulation factors level or dysfunctional coagulation cascade or due to decreased platelets count.
Coming to this point, it is necessary to perform some medical tests:
- complete blood count,
- bleeding and coagulation time,
- INR,
- aPTT,
- fasting blood glucose,
- glycosylated hemoglobin (HbA1C)
In addition it is necessary to properly control blood pressure values.
She needs to discuss with her doctor no the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
Regarding your concern I would explain that cutaneous bruising may be caused by several causes as follows:
- a micro-trauma may be the reason of small blood vessels disruption and blood leaking outside into the surrounding tissues. In such case trying to rest the arm and avoiding strenuous exertion is all that is required.
- an increased fragility of the small blood vessels which is common in the setting of diabetes or impaired glucose metabolism, leading to blood vessels disruption with the same consequence.
- not rarely such hemorrhagic diathesis may be caused by impaired coagulation functions due to decreased coagulation factors level or dysfunctional coagulation cascade or due to decreased platelets count.
Coming to this point, it is necessary to perform some medical tests:
- complete blood count,
- bleeding and coagulation time,
- INR,
- aPTT,
- fasting blood glucose,
- glycosylated hemoglobin (HbA1C)
In addition it is necessary to properly control blood pressure values.
She needs to discuss with her doctor no the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Do you think that her low blood pressure of 85/55 and her sudden dizziness is due to blood and food interactions. Since studies shows that nifedipine (Procardia XL) and drinking grapefruit juice is not recommended? Or what do you think caused her current symptoms?
Brief Answer:
My answer as follows:
Detailed Answer:
Hello!
Yes, the dizziness and falling could be explained by her low blood pressure.
From the other hand, it is well known that grapefruit interacts with Procardia XL, by reducing the metabolism of nifedipine and thus increasing its effects, leading to a drop in blood pressure values.
For this reason, I would recommend avoiding grapefruit in the future.
It is also necessary to closely monitor her blood pressure, frequently during the day. If her blood pressure values are below 110/60 mm Hg most of the time, she should discuss with her doctor on the possibility of making further changes to her anti-hypertensive therapy (reduce the doses) in order to avoid low blood pressure and its consequences (dizziness, fainting and falling).
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello!
Yes, the dizziness and falling could be explained by her low blood pressure.
From the other hand, it is well known that grapefruit interacts with Procardia XL, by reducing the metabolism of nifedipine and thus increasing its effects, leading to a drop in blood pressure values.
For this reason, I would recommend avoiding grapefruit in the future.
It is also necessary to closely monitor her blood pressure, frequently during the day. If her blood pressure values are below 110/60 mm Hg most of the time, she should discuss with her doctor on the possibility of making further changes to her anti-hypertensive therapy (reduce the doses) in order to avoid low blood pressure and its consequences (dizziness, fainting and falling).
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You are the best, thank you. My thinking was right. I appreciate your time and effort in this endeavor. I hope to discuss more health issues with you in the future.
Wishing you greatness.
Goodnight.
Wishing you greatness.
Goodnight.
Brief Answer:
You are welcome!
Detailed Answer:
I am glad to have been helpful to you!
I remain at your disposal for any further discussions in the future.
Kind regards,
Dr. Iliri
You are welcome!
Detailed Answer:
I am glad to have been helpful to you!
I remain at your disposal for any further discussions in the future.
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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