Opioids: Difference between revisions

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-While grapefruit is not psychoactive, it may affect the metabolism of certain opioids. Tramadol, Oxycodone, and Fentanyl are all primarily metabolized by the enzyme CYP3A4, which is potently inhibited by grapefruit juice<ref name=":0">[https://journals.lww.com/journaladdictionmedicine/Citation/2020/04000/Opioid_Toxidrome_Following_Grapefruit_Juice.14.aspx]</ref>. This may cause the drug to take longer to clear from the body. it may increase toxicity with repeated doses. Methadone may also be affected<ref name=":0" />.  Grapefruit juice Codeine and hydrocodone are metabolized by CYP2D6. While the effect on hydrocodone is unclear, people who are on medicines that inhibit CYP2D6, or that lack the enzyme due to a genetic mutation will not respond to codeine as it can not be metabolized into it's active product, morphine. Morphine, hydromorphone, and oxymorphone are not affected by either enzyme.
 ==See also==