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Fruit juice and medicines

In the body: Orange or apple juice can make the allergy medicine fexofenadine (Allegra) work less well, which is why its label says not to take it with fruit juices.

Not rated by dose: a flag on one reviewed food, Orange juice.

For some people. Allergies, medicines and medical conditions: a flag for the people the source names, no wider.

All hazards

The reference value and where it comes from

  • The agency’s figureno agency dose value
  • BasisOrange juice (and apple, grapefruit juice) lowers the oral availability of OATP-substrate drugs: aliskiren AUC -62% (orange juice, 200 mL three times a day for 5 days), fexofenadine AUC to 30-40% of water (1.2 L over 3 h)
  • Source PubMed 21204914

Reviewed foods that carry it

1 reviewed food carries it; none is rated by dose.

How often you can eat it

No food here is rated by dose. Each line says why it’s listed: a flag for the people the source names, advice on handling it, or context.

Named above but not among the foods we review, so no line below: apple juice.

Flags and context, not rated by dose

  • Orange juice

    Worth knowing

    PubMed 21204914 · grade A

    How it’s rated

    Flagged for people taking certain medicines: orange juice can inhibit intestinal OATP uptake and so lower a drug's absorption, the opposite direction to grapefruit's CYP3A4 effect. Chen 2018 lists orange juice with aliskiren, atenolol, celiprolol, montelukast, fluoroquinolones and alendronate as decreased-bioavailability pairs, and fexofenadine fell to 30–40% of the water value with 1.2 L of orange juice over 3 hours. The trial volumes (600 mL a day; 1.2 L in 3 hours) are several glasses, above one 250 mL serving. The flag is advice for people on those drugs, not a dose limit.

    Intake: one 250 mL glass (262 g) a day, 70 kg adult · Level in the food: 62 % fall in aliskiren AUC with orange juice (200 mL three times a day for 5 days) (mean change, n 12, n = 12)

    Measured on: Randomised crossover, 12 healthy volunteers, 150 mg aliskiren on day 3; also fexofenadine AUC 30-40% of the water value with 1.2 L of orange juice over 3 hours (10 subjects).

Sources