Lansoprazole Grapefruit juice

Clinically important, potentially hazardous interactions with aluminum, aminophylline, aspirin, chlorambucil, cimetidine, clarithromycin, cyclophosphamide, cyclosporine, dicumarol, diuretics, docetaxel, estrogens, grapefruit juice, indomethacin, influenza vaccines, itraconazole, ketoconazole, lansoprazole, live vaccines, methotrexate, montelukast, omeprazole, oral contraceptives, pancuronium, phenobarbital, phenytoin, ranitidine, rifampicin, rifampin, timolol, tolbutamide, vitamin A... 

Grapefruit juice has little effect on the AUC of lansoprazole or omeprazole, but modestly reduces the formation of the sulphone metabolites, which is unlikely to be clinically relevant. 

In a randomised, crossover study 21 subjects were given a single 60-mg dose of lansoprazole with either 200 mL of water or freshly-squeezed grapefruit juice. The AUC of lansoprazole was slightly increased by 18%, and the formation of the sulphone metabolite was reduced by the grapefruit juice. Metabolism to the hydroxyl metabolite was not significantly affected. ... 

From the studies above it appears that grapefruit juice may have a minor inhibitory effect on the metabolism of omeprazole and lansoprazole by the cytochrome P450 isoenzyme CYP3A4 (which results in the sulphone metabolites). This was suggested to be due to intestinal inhibition of CYP3A4., Grapefruit juice does not affect the metabolism (hydroxyla-tion) of the proton pump inhibitors by CYP2C19. 

The small changes in lansoprazole and omeprazole pharmacokinetics are not clinically relevant, so it appears that they may be taken with grapefruit juice. See also Proton pump inhibitors + Food or Drinks , p.970, for the... 

Uno T, Yasui-Furukori N, Takahata T, Sugawara K, Tateishi T. Lack of significant effect of grapefruit juice on the plwrmacokinetics of lansoprazole and its metabolites in subjects with different C YP2C19 genotypes. J Clin Pharmacol (2005) 45,690-4. 

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