Atripla and healthy juices (beet, carrot, etc.?

Question

Dear Dr Bob,

I hope you are doing great!

I have a quick question here, I was wondering if it was ok to take with Atripla a: Carrot, Beet, Apple, Lemon, Grapefruit, Cabbage, Watermelon, Papaya and honey juice? (all fresh and well washed of course).

Sometime i make a juice of all of them and soemtime I combine some of them and feel great but i was wondering if it had any bad interaction with atripla?

Also, a juice like this is good for the liver and kidney right? I ask because in the last 4 months i have gained about 8-10 pounds (fatty foods!) ahd hadnt been eating that much veggies or doing too much excercise! I my last blood wrk}ork a i got a very slightly elevated ALT value (liver enzyme) which i had never had before) and even though the doc told me it was ok and inside the general normal range i though i could drink healthier juices to help my liver out!

So i have started eating healthier and taking this super juice in the mornings and have been feeling better, more ful of energy for the past week!

Hope you can help me to find out if it is ok to take a combo juice like this with atripla in order to help cleanse my liver before my next blood tests!

Take care Dr Bob!

Joel

Thanx a lot!

Joel

Answer

Hello Joel,

The only component of your super juice cocktail that has the potential to cause problems with some HIV medications is grapefruit. It inhibits the cytochrome P450 3A enzyme system which is used to metabolize some HIV medications. Grapefruit juice appears to be more of a problem with protease inhibitors. For example it increased the blood concentration of concurrently administered saquinavir twofold in one study.

I should also point out that while the fruit and veggie juice mix may well be tasty and healthy, it would not have any specific "liver cleansing" effects!

Dr. Bob