title: Hidden sources of grapefruit in beverages: potential interactions with immunosuppressant medications.
abstract: OBJECTIVE
  The interaction between grapefruit-containing beverages and immunosuppressants is not well defined in the literature. This study was conducted to investigate possible sources of grapefruit juice or grapefruit extract in common US-manufactured beverages. The goal was to identify those products that might serve as hidden sources of dietary grapefruit intake, increasing a transplant patient's risk for drug interactions.
  
  
  METHODS
  A careful review of the ingredients of the 3 largest US beverage manufacturer's product lines was conducted through manufacturer correspondence, product labeling examination, and online nutrition database research. Focus was placed on citrus-flavored soft drinks, teas, and juice products and their impact on a patient's immunosuppressant regimens.
  
  
  RESULTS
  Twenty-three beverages were identified that contained grapefruit. Five did not contain the word "grapefruit" in the product name. In addition to the confirmed grapefruit-containing products, 17 products were identified as possibly containing grapefruit juice or grapefruit extract.
  
  
  CONCLUSIONS
  A greater emphasis should be placed upon properly educating patients regarding hidden sources of grapefruit in popular US beverages and the potential for food-drug interactions.
authors.affiliation: PharmD Candidate.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Auten
authors.affiliation: PharmD Candidate.
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Beauchamp
authors.affiliation: PharmD Candidate.
authors.lastname: Joshua Taylor
authors.affiliation: Clinical Associate Professor of Pharmacy Practice, University of Missouri-Kansas City.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Hardinger
keywords: drug interaction; grapefruit; immunosuppression