Thread:JohnsThrone/@comment-26501863-20150617024156/@comment-6554265-20150617033209

Grapefruit juice contains furanocoumarins. Furanocoumarins irreversibly inhibit a cytochrome P450 metabolizing enzyme called CYP3A4, as stated above. CYP3A4 is a metabolizing enzyme for almost 50% of drugs, and is found in the liver and small intestinal epithelial cells.[32] As a result, many drugs are impacted by consumption of grapefruit juice. When the metabolizing enzyme is inhibited, less of the drug will be metabolized by it in the epithelial cells. A decrease in drug metabolism means more of the original form of the drug could pass unchanged to systemic blood circulation.[31] An unexpected high dose of the drug in the blood could lead to fatal drug toxicity.[32]

The furanocoumarins found in grapefruit juice are natural chemicals. Thus, they are present in all forms of the fruit, including freshly squeezed juice, frozen concentrate, and whole fruit. All these forms of the grapefruit juice have the potential to limit the metabolizing activity of CYP3A4. One whole grapefruit, or a glass of 200 mL (6.8 US fl oz) of grapefruit juice can cause drug overdose toxicity.[2] [33]