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Grapefruit

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  • #1

    Grapefruit

    I apologize if this is an inappropriate post but this is the best forum for these types of questions.
    There have been questions regarding exclusively breastfed infants (receiving about 10 feeds a day) that are post liver transplant on Prograf and the effects of grapefruit and pommegranate intake will have via the MOTHER'S breastmilk on the medicine the infant is taking.

    My thoughts are that not enough would go through the breastmilk to effect the dose the infant is taking. My other thoughts are if this were a mom that loves grapefruit and drinks several glasses per day, would enough go through the breastmilk to effect the infants dose of this medication?? My best answer if this were the case would be to monitor the infant closely. And another thought is to treat it like we advise women wanting to drink some alcohol. Breastfeed the baby first then have a glass to give it time to clear before the next breastfeeding.

    Any thoughts?
    Last edited by susannetrout; 03-03-2011, 03:16 PM.
    Tags: None
  • #2
    Grapefruit

    Dear Susanne,
    Tacrolimus (Prograf) is metabolized mainly via the hepatic cytochrome P450 enzyme 3A4. We know that grapefruit can inhibit this enzyme causing the drug levels to be elevated. Therefore, we do not recommend for these mothers to take grapefruit. We do not have enough data at this time to comment on the safety of pomegranate. Hope this is helpful.
    Maria Milla, MD
    InfantRisk Center

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    • #3
      The mother is not taking Prograf, the infant is. I'm curious if the mom were to drink grapefruit juice will enough pass through the breastmilk to effect levels in the infant.

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