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A pink grapefruit with a silver spoon in itMost know that grapefruit does not mix well with many prescription medications. But now, scientists have expanded the list of medications that interact with grapefruit in potentially dangerous ways.

On the revised list are 43 drugs, up from 17 in 2008. Widely-used cholesterol-lowering statins and blood-pressure medications are among the drugs that might rise to harmful levels in the blood if a patient eats grapefruit or drinks grapefruit juice.

As it stands, there are now more than 85 drugs that may interact with grapefruit. The number of drugs that may result in potentially fatal side effects when mixed with grapefruit increased from 17 to 43 during the past four years. This equates to more than six new potentially risky drugs a year.

The list includes some statins that lower cholesterol (such as atorvastatin, lovastatin, and simvastatin), some antibiotics, cancer drugs, and heart drugs. Most at risk are older people who use more prescriptions and buy more grapefruit.

Here’s what happens: Grapefruit contains furanocoumarins, which block an enzyme that normally breaks down certain medications in the body. When it is left unchecked, medication levels can grow toxic in the body.

It’s not just grapefruits, either. Other citrus fruits such as Seville oranges (often used in marmalade), limes, and pomelos also contain the active ingredients (furanocoumarins), but have not been as widely studied.

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