Is grapefruit safe during pregnancy?

What does the evidence say about grapefruit during pregnancy?

1. Grapefruit juice can block the action of intestinal CYP3A4, so instead of being broken down, more of a drug enters the blood and stays in the body longer. 1
2. FDA requires that some prescription and over-the-counter drugs taken by mouth carry warnings against drinking grapefruit juice or eating grapefruit while taking them. 1
3. Drug groups FDA names as interacting include some statins, some blood pressure drugs, some organ-transplant rejection drugs, the anti-anxiety drug buspirone, budesonide, amiodarone, and the antihistamine fexofenadine. 1
4. Whole citrus still needs a rinse under running water before it is peeled or cut, because bacteria can be found on the outer peel and the knife carries them inward. 2
5. Produce that is bruised or damaged is worth passing over, and pre-cut or packaged fruit should only be bought when it is refrigerated or surrounded by ice. 3

Is grapefruit safe in each trimester?

• First trimester. First-trimester medication lists change fast, often adding an antihistamine or a reflux drug within weeks. Every time something new joins the list, the grapefruit question resets. Ask your pharmacist at the counter, since they can see everything you are on at once.
• Second trimester. If your medications are stable and none of them interact, grapefruit is simply fruit. Rinse the peel before cutting like any citrus, and handle pre-cut segments the way you would any pre-cut produce.
• Third trimester. New prescriptions still appear late in pregnancy, for blood pressure, reflux, or sleep. The interaction is about the drug, not the trimester, so the same question applies each time: does this one carry a grapefruit warning?