Grapefruit and the drug BuSpar can cause trouble together

PEOPLE'S PHARMACY

February 20, 2000|By Joe Graedon and Teresa Graedon | Joe Graedon and Teresa Graedon,SPECIAL TO THE SUN

Q. My parents live in Florida and have a grapefruit tree. Although they love the fresh fruit, they have stopped eating it because of the problem of grapefruit interactions with medicines.

I eat a grapefruit almost every day because it is so satisfying. I find I am not tempted to snack after breakfast. My doctor has just prescribed BuSpar for stress, and I would like to know if there is a problem with grapefruit. Would I have to avoid grapefruit altogether, or could I take my pill an hour or two later?

A. The anti-anxiety agent BuSpar (buspirone) is profoundly affected by grapefruit. Blood levels of the medication may be four to nine times higher, which could lead to unwanted side effects. Because the grapefruit effect lasts all day, taking your pills an hour later will not prevent the interaction.

Not all drugs react with grapefruit, however, so we are not sure if your parents needed to give up their favorite fresh fruit.

For example, the cholesterol drugs Lipitor, Mevacor and Zocor are affected by grapefruit, but Pravachol is not.

Q. I have something called essential tremor: My hands shake. It is embarrassing to have friends and family members notice this shakiness when I pass a drink or hold my fork.

When I read in your column that the drug Remeron could control this condition, I was elated. I told my doctor, but he said he couldn't locate any research on this and wouldn't prescribe it. He said the condition doesn't need to be treated.

I hate the trembling, especially when I thread a needle or put on eyeliner. Please tell me more about this medicine.

A. Remeron (mirtazapine) is actually an anti-depressant, but it has been helpful for some patients with tremor. Drs. Virginia Pact and Thomas Giduz published their preliminary findings in the journal Neurology (Sept. 22, 1999, Page 1154).

The doctors first suspected that Remeron would be helpful when they collaborated in treating a 73-year-old woman who had Parkinson's disease and was depressed. She had been an avid bridge player, but the Parkinson's disease made her hands shake so much she had trouble holding her cards. When her depression was treated with Remeron, the tremor vanished.

Remeron is taken at bedtime. Possible side effects include drowsiness, dizziness, dry mouth, constipation, increased cholesterol levels and weight gain. Anyone who develops a sore throat, fever or mouth ulcers while on Remeron should get immediate medical attention.

Q. I've been using Afrin for three weeks because of a cold that just wouldn't go away. Now I am having a hard time stopping the nasal spray. I can't breathe through my nose when the Afrin wears off. How can I get off Afrin?

A. Gradual tapering may be the answer. One reader suggested diluting the Afrin with a saline solution (Ayr Saline, NaSal or Ocean) every time the bottle was half-empty. Within several weeks the concentration of Afrin was so low that he had no trouble stopping.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Sun, Features Department, 501 N. Calvert St., Baltimore, Md. 21278, or e-mail them at their Web site (www.peoplespharmacy.com) on the HealthCentral.com network.

King Features Syndicate

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