The NHS has issued a critical safety alert to hundreds of thousands of patients across the UK who are prescribed the powerful opioid painkiller, fentanyl. The warning advises against consuming a common breakfast drink that could dangerously increase medication levels in the body.
The Hidden Danger in Your Breakfast Glass
People taking one of the UK's most commonly prescribed painkillers are being urged to remove grapefruit juice from their diets. Consuming this juice while on fentanyl treatment can inadvertently turn the level of medicine toxic, leading to an increased risk of serious side effects.
Fentanyl was prescribed an astonishing 812,439 times by NHS primary care services in England in 2022 alone. This potent opioid painkiller is primarily used to treat severe pain, such as that experienced during or after major surgery or a serious injury. It works by blocking pain signals travelling between the brain and the rest of the body, while also reducing the anxiety and stress that often accompanies severe pain.
Understanding Fentanyl and Its Side Effects
Medical professionals may consider prescribing fentanyl for other types of long-term pain when weaker painkillers have proven ineffective. The medication is available in various forms, including skin patches, lozenges, tablets that dissolve in the mouth, and nasal sprays.
According to the NHS website: "Like all medicines, fentanyl can cause side effects in some people, but many people have no side effects or only minor ones. You're more likely to get side effects with higher doses of fentanyl."
Common side effects patients should be aware of include:
- Constipation
- Nausea or vomiting
- Stomach pain
- Drowsiness or fatigue
- Dizziness or vertigo
- Confusion
- Headaches
- Itching or skin rashes
More serious, though rare, side effects can include unexplained muscle stiffness and symptoms of low blood pressure such as dizziness, tiredness, and low energy. With long-term use, patients may develop tolerance to their initial dose, requiring higher doses to manage their pain effectively.
Why Grapefruit Juice Poses a Serious Risk
While the NHS confirms that fentanyl is not generally affected by food, it delivers a specific warning about grapefruit juice. An NHS spokesperson explained: "Grapefruit juice can increase the amount of fentanyl in your body so it's a good idea not to drink it."
The danger arises because grapefruit contains natural chemicals that slow down the function of an enzyme called cytochrome, which is found in the small intestine and liver. This interference causes higher levels of the medication to accumulate in the bloodstream, allowing the drug to remain in the body for longer than intended. This increased concentration can potentially lead to an overdose or significantly enhanced side effects.
Beyond grapefruit juice, the NHS advises patients to inform their doctor if they're taking other medications, including those for sleep, high blood pressure, irregular heartbeat, allergies, mental health conditions, or infections. Combining fentanyl with alcohol is also discouraged, particularly when first starting the medication, as it can increase drowsiness and the risk of serious side effects.
While it's generally safe to take fentanyl with some other painkillers like paracetamol, ibuprofen or aspirin, patients should avoid those containing codeine, such as co-codamol, as this combination increases the likelihood of adverse effects.
