Editing CYP3A4 (section)

== Inhibition through fruit ingestion ==
In 1998, various researchers showed that [[grapefruit]] juice, and grapefruit in general, is a potent inhibitor of CYP3A4, which can affect the metabolism of a variety of drugs, increasing their [[bioavailability]].<ref name="GSE_Drug_Effect">{{cite journal | vauthors = He K, Iyer KR, Hayes RN, Sinz MW, Woolf TF, Hollenberg PF | title = Inactivation of cytochrome P450 3A4 by bergamottin, a component of grapefruit juice | journal = Chemical Research in Toxicology | volume = 11 | issue = 4 | pages = 252–9 | date = April 1998 | pmid = 9548795 | doi = 10.1021/tx970192k }}</ref><ref name="Bailey_DG1998">{{cite journal | vauthors = Bailey DG, Malcolm J, Arnold O, Spence JD | title = Grapefruit juice-drug interactions | journal = British Journal of Clinical Pharmacology | volume = 46 | issue = 2 | pages = 101–10 | date = August 1998 | pmid = 9723817 | pmc = 1873672 | doi = 10.1046/j.1365-2125.1998.00764.x }}</ref><ref name="Carbamazepine">{{cite journal | vauthors = Garg SK, Kumar N, Bhargava VK, Prabhakar SK | title = Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy | journal = Clinical Pharmacology and Therapeutics | volume = 64 | issue = 3 | pages = 286–8 | date = September 1998 | pmid = 9757152 | doi = 10.1016/S0009-9236(98)90177-1 | s2cid = 27490726 | doi-access = free }}</ref><ref name="Bailey_DG2004">{{cite journal | vauthors = Bailey DG, Dresser GK | s2cid = 11525439 | title = Interactions between grapefruit juice and cardiovascular drugs | journal = American Journal of Cardiovascular Drugs | volume = 4 | issue = 5 | pages = 281–97 | year = 2004 | pmid = 15449971 | doi = 10.2165/00129784-200404050-00002 }}</ref><ref name="Bressler_R">{{cite journal | vauthors = Bressler R | title = Grapefruit juice and drug interactions. Exploring mechanisms of this interaction and potential toxicity for certain drugs | journal = Geriatrics | volume = 61 | issue = 11 | pages = 12–8 | date = November 2006 | pmid = 17112309 }}</ref> In some cases, this can lead to a fatal interaction with drugs like [[astemizole]] or [[terfenadine]].<ref name="Bailey_DG1998"/> The effect of grapefruit juice with regard to drug absorption was originally discovered in 1989. The first published report on grapefruit drug interactions was in 1991 in the ''Lancet'' entitled "Interactions of Citrus Juices with [[Felodipine]] and [[Nifedipine]]", and was the first reported food-drug interaction clinically. The effects of grapefruit last from 3–7 days, with the greatest effects when juice is taken an hour previous to administration of the drug.<ref name="Clin Pharm">{{cite journal | vauthors = Lilja JJ, Kivistö KT, Neuvonen PJ | title = Duration of effect of grapefruit juice on the pharmacokinetics of the CYP3A4 substrate simvastatin | journal = Clinical Pharmacology and Therapeutics | volume = 68 | issue = 4 | pages = 384–90 | date = October 2000 | pmid = 11061578 | doi = 10.1067/mcp.2000.110216 | s2cid = 29029956 }}</ref>

In addition to grapefruit, other fruits have similar effects. [[Noni]] (''Morinda citrifolia''), for example, is a [[dietary supplement]] typically consumed as a juice and also inhibits CYP3A4.<ref>{{cite web|url=http://www.mskcc.org/cancer-care/herb/noni|title=Integrative Medicine, Noni|publisher=Memorial Sloan-Kettering Cancer Center|access-date=27 June 2013|archive-date=20 August 2013|archive-url=https://web.archive.org/web/20130820052559/http://www.mskcc.org/cancer-care/herb/noni|url-status=live}}</ref> [[Pomegranate]] juice has shown some inhibition in limited studies, but has not yet demonstrated the effect in humans.<ref>{{cite journal | vauthors = Hidaka M, Okumura M, Fujita K, Ogikubo T, Yamasaki K, Iwakiri T, Setoguchi N, Arimori K | s2cid = 7997718 | title = Effects of pomegranate juice on human cytochrome p450 3A (CYP3A) and carbamazepine pharmacokinetics in rats | journal = Drug Metabolism and Disposition | volume = 33 | issue = 5 | pages = 644–8 | date = May 2005 | pmid = 15673597 | doi = 10.1124/dmd.104.002824 }}</ref><ref name="pmid31924158">{{cite journal |vauthors=Anlamlert W, Sermsappasuk P |title=Pomegranate Juice does not Affect the Bioavailability of Cyclosporine in Healthy Thai Volunteers |journal=Curr Clin Pharmacol |volume=15 |issue=2 |pages=145–151 |date=2020 |pmid=31924158 |pmc=7579232 |doi=10.2174/1574884715666200110153125}}</ref>