Grapefruit + Ranitidine Bismuth Citrate
Ranitidine Bismuth Citrate brand name: Tritec.
Grapefruit has a minor interaction with Ranitidine Bismuth Citrate. Grapefruit juice does not seem to affect renal P-glycoprotein (P-gp).
Read the full interaction reportGrapefruit and Ranitidine Bismuth Citrate
Here is the interaction we found between these two, with the evidence behind it.
P-GLYCOPROTEIN SUBSTRATES
Why this applies to Ranitidine Bismuth Citrate
Ranitidine Bismuth Citrate falls under P-GLYCOPROTEIN SUBSTRATES — the group Grapefruit interacts with.
While most in vitro research shows that grapefruit products inhibit P-gp,, research in humans is less clear. Two small clinical studies in healthy adults using digoxin as a probe substrate show that grapefruit juice does not inhibit P-gp in the kidneys. It is unclear whether this applies to intestinal P-gp, for which digoxin is not considered to be a sensitive probe. Grapefruit juice has been shown to reduce levels of fexofenadine, and increase levels of quinidine. However, as both of these drugs are also substrates of other enzymes and transporters, it is unclear what role, if any, intestinal P-gp has in these findings.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Good news here: the link between grapefruit and ranitidine bismuth citrate (Tritec) is pretty weak. Ranitidine is a transport protein (P-glycoprotein) substrate, and grapefruit might nudge that pump in the gut. But the evidence is shaky and mostly from test-tube work. In real people, studies haven't shown grapefruit meaningfully changing drugs handled the same way, and ranitidine itself isn't a prodrug, so its acid-lowering job stays the same.
If anything theoretical happened, you might see a slightly stronger effect, but that's not something we'd expect to cause trouble for an H2 blocker. Enjoying grapefruit with this medicine is very likely fine. Still, if you take other prescriptions too, run your full list by your pharmacist, since grapefruit matters far more with some other drugs.
- Soldner A, Christians U, Susanto M, et al. Grapefruit juice activates P-glycoprotein-mediated drug transport. Pharm Res 1999;16:478-85. PubMed
- Damkier P, Hansen LL, Brosen K. Effect of diclofenac, disulfiram, itraconazole, grapefruit juice and erythromycin on the pharmacokinetics of quinidine. Br J Clin Pharmacol 1999;48:829-38. PubMed
- Bailey DG, Dresser GK, Munoz C, et al. Reduction of fexofenadine bioavailability by fruit juices. Clin Pharmacol Ther 2001;69:P21.
- Edwards DJ, Fitzsimmons ME, Schuetz EG, et al. 6',7'-Dihydroxybergamottin in grapefruit juice and Seville orange juice: effects on cyclosporine disposition, enterocyte CYP3A4, and P-glycoprotein. Clin Pharmacol Ther 1999;65:237-44. PubMed
- Becquemont L, Verstuyft C, Kerb R, et al. Effect of grapefruit juice on digoxin pharmacokinetics in humans. Clin Pharmacol Ther 2001;70:311-6. DOI
- Dresser GK, Bailey DG, Leake BF, et al. Fruit juices inhibit organic anion transporting polypeptide-mediated drug uptake to decrease the oral availability of fexofenadine. Clin Pharmacol Ther 2002;71:11-20. PubMed
- Parker RB, Yates CR, Soberman JE, Laizure SC. Effects of grapefruit juice on intestinal P-glycoprotein: evaluation using digoxin in humans. Pharmacotherapy 2003;23:979-87. PubMed
- Di Marco MP, Edwards DJ, Wainer IW, Ducharme MP. The effect of grapefruit juice and seville orange juice on the pharmacokinetics of dextromethorphan: the role of gut CYP3A and P-glycoprotein. Life Sci 2002;71:1149-60. PubMed
- Dresser GK, Kim RB, Bailey DG. Effect of grapefruit juice volume on the reduction of fexofenadine bioavailability: possible role of organic anion transporting polypeptides. Clin Pharmacol Ther 2005;77:170-7. PubMed
- Min, D. I., Ku, Y. M., Geraets, D. R., and Lee, H. Effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of quinidine in healthy volunteers. J Clin Pharmacol 1996;36(5):469-476. PubMed
- Jia Y, Liu J, Xu J. Influence of grapefruit juice on pharmacokinetics of triptolide in rats grapefruit juice on the effects of triptolide. Xenobiotica. 2017 Apr 16:1-5. PubMed
- Guideline on the investigation of drug interactions. CPMP/EWP/560/95/Rev. 1 Corr. 2. European Medicines Agency, 2015. Available at: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-investigation-drug-interactions-revision-1_en.pdf (As
- Piscitelli J, Nikanjam M, Capparelli EV, et al. Fexofenadine Plasma Concentrations to Estimate Systemic Exposure in Healthy Adults Using a Limited Sampling Strategy with a Population Pharmacokinetic Approach. Ther Drug Monit 2023;45(4):539-545. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Grapefruit Also Interacts With Other Medications
Grapefruit has 778 major, 151 moderate, 61 minor known drug interactions in our database — the Ranitidine Bismuth Citrate one above is one of them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Grapefruit
We haven’t checked that one against Grapefruit yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Grapefruit. Pick one to open its full report.
Questions About Grapefruit or Ranitidine Bismuth Citrate
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Grapefruit or Ranitidine Bismuth Citrate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
- Is Grapefruit-Flavored Drink Mix Safe With My Medications? ›
- Which Drugs For GERD Are Safe With Celexa (Citalopram)? ›
- Grapefruit With Finasteride Interaction ›
- Can Diet Pills Cause A Positive Drug Test? ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Ranitidine Bismuth Citrate
This page covers Grapefruit only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ranitidine Bismuth Citrate page lists 73 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), St. John's Wort (major), African Wild Potato (moderate), Banderol (moderate) and Beer (moderate).
By severity: 2 major · 43 moderate · 28 minor.
Taking Grapefruit as Part of a Dietary Supplement Product? Check It for Interactions
We hold 1,144 real supplement products containing Grapefruit, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Grapefruit. Your product may carry other ingredients that interact with Ranitidine Bismuth Citrate too, on top of Grapefruit — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Grapefruit and Ranitidine Bismuth Citrate Sit Against Everything Else
Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.
#111 of 1,452 supplements looked up here in the last 7 days
#1,847 of 2,830 medications looked up here in the last 7 days
Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.
About Grapefruit
What is Grapefruit?
- Source of vitamin C
- Digestive complaints
- Antimicrobial (seed extract)
- Weight management
- Skin and cosmetic uses
Grapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for serious interactions with many prescription medicines, so anyone taking medication should check with a pharmacist or doctor before consuming it regularly.
About Ranitidine
What Is Ranitidine Used For?
Brand name: Tritec
Ranitidine treats a range of stomach acid–related conditions. Prescription-strength ranitidine (capsules, tablets, and oral solution) is used for active duodenal ulcers (ulcers in the small intestine), active benign gastric ulcers (stomach ulcers), GERD (acid reflux disease), erosive esophagitis (acid damage to the esophagus), and pathological hypersecretory conditions — rare disorders where the stomach makes far too much acid, such as Zollinger-Ellison syndrome. It is also used as maintenance therapy to keep duodenal and gastric ulcers from coming back after they have healed.
Over-the-counter products — including Acid Reducer and Acid Reducer 150 tablets — are approved to relieve heartburn associated with acid indigestion and sour stomach, and to prevent that heartburn when taken before eating or drinking foods that trigger it.
Other Drugs & Grapefruit
Browse every other medication we’ve checked against Grapefruit — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
778 interactions
- Diltiazem ›
- Nifedipine ›
- Metronidazole ›
- Hydrocortisone ›
- Erythromycin ›
- Estradiol ›
- Lidocaine ›
- Guaifenesin ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Doxorubicin ›
- Fluticasone ›
- Miconazole ›
- Nitrazepam ›
- Procainamide ›
- Trimipramine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Methotrexate ›
- Ofloxacin ›
- Rifampin ›
- Sotalol ›
- Sumatriptan Succinate ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Azithromycin ›
- Caffeine (otc Drug) ›
- Ciclesonide ›
- Clobazam ›
- Clonazepam ›
- Clorazepate ›
- Cyclobenzaprine ›
- Dapsone ›
Showing 60 of 778 major interactions — see all 778 on the Grapefruit page.
151 interactions
- Diclofenac Sodium ›
- Theophylline ›
- Ibuprofen ›
- Naproxen ›
- Propranolol ›
- Levothyroxine ›
- Flurbiprofen ›
- Oxycodone ›
- Phenytoin ›
- Diclofenac Potassium ›
- Formoterol ›
- Indomethacin ›
- Acetaminophen ›
- Meloxicam ›
- Nortriptyline ›
- Bendamustine ›
- Levothyroxine Sodium ›
- Riluzole ›
- Carisoprodol ›
- Celecoxib ›
- Clozapine ›
- Diclofenac Epolamine ›
- Glipizide ›
- Hexobarbital ›
- Irbesartan ›
- Moclobemide ›
- Nadolol ›
- Nilutamide ›
- Oxycodone Hydrochloride ›
- Piroxicam ›
- Propafenone ›
- Ropinirole ›
- Tapentadol ›
- Valsartan ›
- Abrocitinib ›
- Agomelatine ›
- Anagrelide ›
- Azilsartan ›
- Belzutifan ›
- Bendamustine Hydrochloride ›
- Brivaracetam ›
- Diclofenac ›
- Empagliflozin ›
- Fenfluamine ›
- Fezolinetant ›
- Fluvoxamine ›
- Fomoterol ›
- Gliclazide ›
- Glimepiride ›
- Ibuprofen Lysine ›
- Lesinurad ›
- Lumiracoxib ›
- Mefenamic Acid ›
- Mephenytoin ›
- Mephobarbital ›
- Mexiletine ›
- Montelukast Sodium ›
- Naproxen Sodium ›
- Nateglinide ›
- Olanzapine ›
Showing 60 of 151 moderate interactions — see all 151 on the Grapefruit page.
61 interactions
- Doxycycline ›
- Minocycline ›
- Tetracycline ›
- Ranitidine ›
- Triamcinolone ›
- Apomorphine ›
- Morphine Sulfate ›
- Ivermectin ›
- Betamethasone ›
- Cimetidine ›
- Digoxin ›
- Doxycycline Hyclate ›
- Prucalopride ›
- Acebutolol ›
- Clobetasol ›
- Cortisone Acetate ›
- Dabigatran ›
- Loperamide ›
- Minocycline Hydrochloride ›
- Triamcinolone Acetonide ›
- Afatinib Dimaleate ›
- Alvimopan ›
- Apomorphine Hydrochloride ›
- Belinostat ›
- Betamethasone Dipropionate ›
- Betamethasone Valerate ›
- Betrixaban ›
- Chlortetracycline ›
- Danicopan ›
- Demeclocycline ›
- Dolutegravir ›
- Domperidone ›
- Doxycycline Monohydrate ›
- Doxycyline ›
- Fidaxomicin ›
- Fludrocortisone ›
- Linagliptin ›
- Loncastuximab Tesirine-lpyl ›
- Lusutrombopag ›
- Niraparib Tosylate ›
- Omacetaxine Mepesuccinate ›
- Opicapone ›
- Oxytetracycline ›
- Rucaparib Camsylate ›
- Sofosbuvir ›
- Talazoparib ›
- Tenofovir Alafenamide Fumarate ›
- Vecuronium ›
- Vericiguat ›
- Vismodegib ›
- Betamethasone Dipropionate, Calcipotriene ›
- Amphotericin, Tetracycline ›
- Atropine, Morphine Sulfate ›
- Dolutegravir, Emtricitabine, Tenofovir Alafenamide ›
- Emtricitabine, Tenofovir Alafenamide Fumarate ›
- Fam-trastuzumab, Deruxtecan-nxki ›
- Ledipasvir, Sofosbuvir ›
- Linagliptin, Metformin Hydrochloride ›
- Loperamide, Simethicone ›
- Metformin, Linagliptin ›
Showing 60 of 61 minor interactions — see all 61 on the Grapefruit page.
No interaction 1,839 drugs checked — show the list
We also checked Grapefruit against these medications and found no known interaction in our sources. Open any page to confirm.
- Methylphenidate ›
- Aspirin ›
- Metoprolol ›
- Isotretinoin ›
- Tirzepatide ›
- Docusate ›
- Methamphetamine ›
- Metformin ›
- Semaglutide ›
- Lisdexamfetamine ›
- Hydroxyurea ›
- Valacyclovir ›
- Amphetamine ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Pregabalin ›
- Gabapentin ›
- Dextroamphetamine ›
- Lamotrigine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Insulin Degludec, Liraglutide ›
- Bisoprolol ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Atenolol, Chlorthalidone ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Aspirin, Butalbital ›
- Aminophylline, Amobarbital, Ephedrine ›
- Enalapril Maleate ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Cephalexin ›
- Ezetimibe ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Levetiracetam ›
- Cyclopentolate ›
- Levodopa ›
- Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide ›
- Aspirin, Ethoheptazine, Meprobamate ›
- Canagliflozin, Metformin ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Daunorubicin, Cytarabine ›
- Insulin Aspart, Insulin Degludec ›
- Amobarbital, Ephedrine Sulfate ›
- Alginic Acid, Aluminum Hydroxide ›
- Efgartigimod Alfa-fcab ›
- Sodium Bicarbonate (otc Drug) ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Measles, Mumps, Rubella Virus Live ›
- Saxagliptin, Metformin Xr ›
- Mannitol ›
- Peginterferon Alfa-2a, Ribavirin ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
Showing the 60 most looked-up of 1,839 medications checked with no known interaction — see the full Grapefruit list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Ranitidine Bismuth Citrate Is Linked to Lower Levels of 6 Nutrients
Natural Medicines records Ranitidine Bismuth Citrate as a medicine that can lower these. This is not an interaction with Grapefruit — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Ranitidine Bismuth Citrate nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Grapefruit and Ranitidine Bismuth Citrate Together: Common Questions
Can you take Grapefruit with Ranitidine Bismuth Citrate?
How serious is the Grapefruit and Ranitidine Bismuth Citrate interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Ranitidine Bismuth Citrate and Grapefruit?
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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.