Dr. Roach: Grapefruit can interfere with medication | Lifestyles

Dear Dr. Roach: If taking blood pressure medication (losartan) at night, is it okay to eat grapefruit in the morning? Are there other foods that can interfere with blood pressure medication? Does the time of day make a difference? –DL

To respond: Grapefruit juice can interfere with the metabolism of certain drugs, making some more toxic and others less effective. There are only a few drugs where this effect is significant, such as some HIV drugs. Losartan and grapefruit juice have minimal interaction. {

Sometimes separating the drug and grapefruit juice is enough to eliminate the interaction, but in other cases grapefruit juice should only be consumed sparingly or not at all. Your pharmacist is the expert on this.

The main dietary concern with losartan involves foods high in potassium. A few people, such as those with kidney disease, may need to limit their potassium intake when taking losartan or similar medications. Your doctor is the expert on this.

Dear Dr. Roach: I am 76 years old and constipation has never been a problem until now! I have long suffered from benign prostatic hyperplasia and nightly multiple urination is the norm. I was recently prescribed tamsulosin. Could this be the cause of my bowel changes? – SIR

To respond: When a symptom appears after a new medication, it is always wise to consider whether it is a side effect of the medication. It could definitely be for you, but constipation is not a common side effect (6% of men have diarrhea and there are only occasional cases of constipation).

Constipation is more common as we age. Sixteen percent of 65-year-old men suffer from constipation, which rises to 26% of 80-year-old men (the rate for women is about 10% higher). I would also review your diet for any changes, as well as make sure you have adequate but not excessive water intake.

Finally, low thyroid levels are common in older people, and it’s worth doing a quick blood test if the problem persists.

(Dr. Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803. )

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