Flavonoids and Furanocoumarins Involved in Drug Interactions

Drug interactions can have significant consequences for public health, especially given the growing importance of readily available dietary supplements. The same applies to the consumption of fruit and fruit juices, which are often praised for their health benefits, but which can generate drug interactions. These are well known and documented in the case of grapefruit, which should not be taken with certain medications. Grapefruit contains flavonoids and furanocoumarins, which are responsible for various interactions with the cytochrome P450 enzyme system. However, for young children and the elderly, fruit juices are often used to facilitate treatment. This review examines commonly used fruit juices, particularly from citrus, apple, and red fruits, and discusses potential interactions, disadvantages, and advantages, as well as the chemical structures involved in interactions with cytochromes P-450, P-glycoprotein, and organic anion transporter polypeptide (OATP), responsible for sometimes dangerous changes in bioavailability or potential accumulation of drugs in the body.