A Potentially Dangerous Grapefruit Cocktail
Question: In past columns you have mentioned the impact of grapefruit and grapefruit juice on medications such as cholesterol-lowering drugs and blood pressure pills. I am very fond of ruby red grapefruit juice, and take Zocor and Cardizem. I questioned my doctor, but she did not seem alarmed. Is there any danger for me in combining grapefruit juice with my medicines?
--E.B., Pasadena
Answer: We are extremely concerned about your combination of Cardizem, grapefruit and Zocor. Both Cardizem and grapefruit can raise blood levels of Zocor, increasing the risk of a rare but dangerous reaction: muscle tissue breakdown.
Grapefruit can have an impact on the blood levels of a number of common medications, including blood pressure pills such as Plendil, Procardia and Sular as well as the anticonvulsant Tegretol and the heartburn drug Propulsid. Other foods may also interfere with medicines’ effectiveness, and your physician can’t be expected to know your diet.
We are sending you our “Guides to Food, Drug and Grapefruit Interactions” so that you can learn more about these potential problems. Anyone else who would like a copy, please send $2 in check or money order with a long (No. 10) stamped, self-addressed envelope: Graedons’ People’s Pharmacy, No. FJ-62, P.O. Box 52027, Durham, NC 27717-2027.
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Q: What can you tell me about the use of horse chestnut seed extract for vein health and treatment of varicose veins? I have seen two ads for this herb: one for Venastat, saying that horse chestnut works to increase vein wall integrity and has minimal side effects, and one for something called “Healthy Legs,” containing horse chestnut seed extract, ginger, gotu kola and grape seed extract.
Since I have been troubled for many years by varicose veins, I would like to know if these herbal supplements are helpful as claimed.
--C.S., Burbank
A: Horse chestnut seed extract has been studied in Europe and found to be good for improving the tone of veins. It also reduces their permeability.
Venastat is a standardized extract similar to those used in the studies. It appears helpful for frostbite, leg ulcers, hemorrhoids and varicose veins. People with varicose veins had less edema and inflammation when taking horse chestnut extract than when taking a placebo.
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Q: What can be done to prevent premature ejaculation? Nothing has worked for me. Is there a solution?
--D.H., Palm Springs
A: Many men experience orgasm within several minutes of initiating intercourse. Not surprisingly, such a short fuse can interfere with mutual satisfaction, since women generally take at least 10 minutes to reach climax.
Some urologists prescribe antidepressant medications such as Prozac, Paxil or Zoloft to delay ejaculation. This is a case of putting a side effect to a new use.
Sex therapists can teach you and your partner nondrug approaches. With patience and support, you should be able to overcome premature ejaculation.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. In this special People’s Pharmacy column, the Graedons answer letters from readers of the Los Angeles Times only. This special column runs the third Monday of every month. Send questions to the Graedons at People’s Pharmacy, care of King Features, 235 E. 45th St., New York, NY 10017, or e-mail them via their Web site at https://www.peoplespharmacy.com. Please include your address, which will not be published, and identify yourself as a reader of The Times.
