Allergies Common Treatments The Interaction Between Fruit Juice and Allegra By Daniel More, MD Daniel More, MD Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California. Learn about our editorial process Updated on February 15, 2021 Medically reviewed by Jurairat J. Molina, MD Medically reviewed by Jurairat J. Molina, MD Facebook Jurairat J. Molina, MD, is a board-certified allergist who has been practicing in field of allergy and clinical immunology for the past two decades. She owns Corpus Christi Allergy Associates in Corpus Christi, Texas. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Allegra Basics Allegra and Juice Allergy Drug Options Other Affected Drugs If you're taking prescription or over-the-counter Allegra for allergies, you should be aware that these medications can interact with fruit juices such as: Apple juiceGrapefruit juiceOrange juice In fact, if you drink fruit juice or even fruit punch within an hour or two of taking your medicine, you may lose the effectiveness of the drug entirely. Westend61 / Getty Images What Is Allegra? Allegra (fexofenadine), is a non-sedating antihistamine that's available over-the-counter (OTC). Since becoming available without a prescription, as well as being approved for young children (as young as six months), Allegra will likely become even more popular for people with allergy symptoms. However, taking Allegra along with juice reduces its absorption by between 30% and 60%, depending on the juice, making the medicine less effective. Allegra and Fruit Juice To be absorbed into your bloodstream, Allegra depends on specialized receptors on cells that line your small intestine called organic anion transporting polypeptides or OATPs. OATP proteins help chemicals (including some medications) cross the biological membranes that are otherwise impermeable to these drugs. Apple, grapefruit, and orange juices contain compounds (including one called naringin) that inhibit OATPs, thus limiting how much Allegra your body absorbs. It takes very little juice for this inhibition to occur. Consumption of drinks with as little as 5% juice can inhibit OATPs. Overall, taking Allegra with fruit juice may decrease the absorption by up to 60%, making the medicine far less effective in the treatment of allergy symptoms. A decrease of 60% of the dose doesn't mean that you'll get 40% of the drug's effect. It takes a certain amount of the drug for you to notice any effect, and a significant reduction in dose might mean you'll get absolutely no help from it. Researchers believe the absorption-inhibiting compounds in the juice have higher concentrations in commercially available juices as well as those that are calcium-fortified. Those compounds are present in whole fruit too. It's safest to avoid fresh fruit or fruit juices for 1 to 2 hours before and after taking Allegra. Otherwise, they could significantly reduce the effectiveness of Allegra and leave your allergy symptoms or hives uncontrolled. Allergy Drug Options If you're finding it tricky to juggle a twice-a-day medication and fruit intake, you have other options. You may want to switch to a different allergy medication that isn't affected by fruit. A number of different medications are available for allergic rhinitis and hives (urticaria.) If you have hives or moderate-to-severe hayfever, a medication like Zyrtec (cetirizine) or Xyzal (levocetirizine) may be slightly more effective than Allegra, anyway. (However, they cause drowsiness in some people.) Claritin (loratadine) is another option that's similar to Allegra. Treating Seasonal Allergies Other Drugs Affected by Juice It's not only Allegra levels in the body that may be affected by the intake of fruit or fruit juice. Fruit may also interfere with enzymes in the small intestine that metabolize drugs, causing too much or too little of the drug to be absorbed the body. Some of these drugs include: Statin drugs that lower cholesterol, such as Zocor (simvastatin) and Lipitor (atorvastatin)Drugs that treat high blood pressure, such as Procardia, adalat CC and beta-blockersAnti-anxiety drugs such as buspironeDrugs that treat abnormal heart rhythms such as Pacerone and Nexterone (both amiodarone)Antibiotics such as ciprofloxacin or Cipro, levofloxacin, and itraconazole Some researchers have even suggested that any medication should be taken outside of the four-hour window surrounding the consumption of fruit or fruit juice. That way, you eliminate potential health risks and don't waste your money on drugs that are rendered ineffective by your diet. Timing of Meds and Juice Since the intake of fruit or fruit juice can significantly interfere with Allegra's absorption, take your medication at least two hours before or two hours after drinking fruit juice.If this presents a problem, you may want to take other effective hay fever and hive medications instead. A Word From Verywell This interaction is a good example of how medications may not just interfere with each other, but with the foods in your diet. With any medication, it's important to read the small print and to talk with your healthcare provider and pharmacist about any potential interactions. Also be sure to ask your practitioner, pharmacist, or other healthcare provider if you can drink grapefruit juice while taking your medications, which also has potential for drug interaction. Cut Your Risk of Drug Interactions 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Yu J, Zhou Z, Tay-sontheimer J, Levy RH, Ragueneau-majlessi I. Intestinal drug interactions mediated by OATPs: a systematic review of preclinical and clinical findings. J Pharm Sci. 2017;106(9):2312-2325. doi:10.1016/j.xphs.2017.04.004 Moscou, K, Snipe, K. Pharmacology for pharmacy technicians. New York, NY: Elsevier Health Sciences. Chen M, Zhou SY, Fabriaga E, Zhang PH, Zhou Q. Food-drug interactions precipitated by fruit juices other than grapefruit juice: An update review. J Food Drug Anal. 2018;26(2S):S61-S71. doi:10.1016/j.jfda.2018.01.009 Andrade C. Fruit juice, organic anion transporting polypeptides, and drug interactions in psychiatry. J Clin Psychiatry. 2014;75(11):e1323-5. doi:10.4088/JCP.14f09572 McDonagh, M, Helfhand, M. Drug class review newer antihistamines. Portland, OR: Oregon Health & Science University. Harvard Health Publishing, Harvard Medical School. By the way, doctor: Is it okay to drink grapefruit juice, as long as I don't take my statin at the same time? The Medical Letter. In brief: fexofenadine (allegra) and fruit juice. Additional Reading Akamine Y, Miura M, Komori H, et al. The change of pharmacokinetics of fexofenadine enantiomers through the single and simultaneous grapefruit juice ingestion. Drug Metab Pharmacokinet. 2015;30(5):352-357. doi:10.1016/j.dmpk.2015.06.005 Luo J, Imai H, Ohyama T, et al. The Pharmacokinetic Exposure to Fexofenadine is Volume-Dependently Reduced in Healthy Subjects Following Oral Administration With Apple Juice. Clin Transl Sci. 2016;9(4):201-206. doi:10.1111/cts.12400 Won CS, Lan T, Vandermolen KM, et al. A modified grapefruit juice eliminates two compound classes as major mediators of the grapefruit juice-fexofenadine interaction: an in vitro-in vivo "connect". J Clin Pharmacol. 2013;53(9):982-990. doi:10.1002/jcph.136 By Daniel More, MD Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit