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Imatinib & Fruit interaction



Does anyone know if normal (sweet or blood) oranges or tangerines have any known interaction with imatinib?

I know we’re not allowed grapefruit or bitter orange. 

Thanks Caroline

Seville oranges are out. They're what you use to make marmalade - they'd be very bitter to drink so there's no chance you're going to be served them as juice by accident!

Normal oranges and tangerines are fine but I'm not sure about blood oranges. Nor pink grapefruit, come to think of it - but I assume they're out along with normal grapefruit. 


Grapefruit is pretty special in the changes it makes in the liver when it is being digested - id be surprised anything else does it. From what i understand, it supercharges the liver and can result in too much medication being in your system at once.  

Grapefruit (and some other foods, but primarily grapefruit) inhibit a P450 cytochrome enzyme, specifically CYP3A4. 

CYP3A4 is required to break down your TKI, but when you eat grapefruit the grapefruit "uses up" CYP3A4 in your system. So, there's not enough of it to break down the TKI in the expected time, leading to increased exposure.

It's not just grapefruit, some drugs such as ketoconozole can also inhibit CYP3A4. 


hi david

Side topic but do you know any resources to read up on enzymes and other mechanisms in absorbtion of TKIs? im interested in reading up....

Eva, you can find lots of resources out there on the subject of drug and food interaction with TKIs, but this drug interaction is well worth repeating.

Contrasting effects of diclofenac ( a nonsteroidal anti-inflammatory drug- NSAID-)

and ibuprofen (a commonly used painkiller - NSAID) on active imatinib uptake into leukaemic cells

NSAIDs - taken or applied to reduce inflammation and as an analgesic, reducing pain in certain conditions. Supplied as or contained in medications under a variety of trade names

This is a highly cited paper on P450 methods of action. Warning: it’s not light reading.



I was expressly told last Friday not to eat Star Fruit.

Indeed, don’t eat a whole one. But at the same time, don’t worry if there’s a little bit in your fruit salad. 


Hi guys, any of you know if blackberry or berries en general can interact with TKIS? 

Thank you in advance for your answers.

I am absolutely sure that cranberies are OK! I am not sure about blackeberies... I