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A comment on From its name to its drug interactions, there’s a lot going on with grapefruit.

Re:From its name to its drug interactions, there’s a lot goi... by dmurray on Wednesday October 07, 2020 @05:41AM (#24706613)
My grandfather used to eat grapefruit every day, but had to give it up when he was prescribed Warfarin (a blood thinner). Ironically it seems that it would have been just fine for him to continue so long as he stuck to religiously eating grapefruit every day. He would have needed a substantially lower dose of the drug, but Warfarin is one where you adjust the dose a lot for each patient anyway: the manufacturer recommends starting with 6mg and ending up anywhere from 0.5 to 10mg depending on the patient's response [0].

He was also hospitalised several times, both for his heart problems and stomach cancer. I wonder if hospitals keep grapefruit on hand for patients like this, or if they ban it altogether.

[0] https://www.nps.org.au/australian-prescriber/articles/how-to...

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Re:From its name to its drug interactions, there’s a lot goi... by jalk on Wednesday October 07, 2020 @07:13AM (#24707088)
> the manufacturer recommends starting with 6mg and ending up anywhere from 0.5 to 10mg depending on the patient's response

I tried to explain binary search to my gp when she was trying to find my dose of thyroxin. Unfortunately, according to her, a too high does carries a lot of unpleasant side effects - so linear search it was.

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Re:From its name to its drug interactions, there’s a lot goi... by vikramkr on Wednesday October 07, 2020 @09:41AM (#24708050)
Yeah, binary search where you don't know what the upper bound is with a narrow therapeutic index drug is not necessarily the best option
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Re:From its name to its drug interactions, there’s a lot goi... by buddhiajuke on Wednesday October 07, 2020 @09:47AM (#24708129)
We pretty much did binary search to find my lithium levels. The lethal concentration of lithium is very close to the therapeutic range, but we couldn’t afford to spend long on low doses (since you have to take blood tests to assess effective dosages.)
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Re:From its name to its drug interactions, there’s a lot goi... by krageon on Thursday October 08, 2020 @07:13AM (#24717998)
If you keep a good diary you can limit the blood tests to 1-2 times per year and assess therapeutic effect using self-reporting.
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Re:From its name to its drug interactions, there’s a lot goi... by buddhiajuke on Wednesday October 07, 2020 @09:44AM (#24708090)
My dad used to take warfarin too and keep a very steady diet of dark leafy greens (his poison of choice he wouldn’t give up). There are meds now that are less dependent on food, your grandviejo may want to ask about.
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