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Comment by Test0129 | Hacker News Reader

In America, for as long as I remember grapefruit juice interactions are both listed on the bottle and on the pamphlet you receive every single time you get a prescription (renewed or new).

We can't put billboards up for everything. It is your health, and therefore your responsibility, to read the provided literature and raise any questions to your doctor. It's not obscured or hidden knowledge. In fact, it's usually one of the first things mentioned in big, bold text. In addition every pharmacy I've been to offers consulting on medications for free and in general doctors will always go over major interactions with medication (though I've had less luck with this).

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There are plenty of medications I've seen where they specifically call out interactions with grapefruit. And pharmacists will warn you about that, if this is the first time you're taking these meds.

Pharmacists will generally warn you about known major drug interactions, when you should take the medication, etc... when you're getting a new medication that you've not had before. Now, if you've had this medication before, they may not warn you. But they will ask if this is the first time you're taking this medication.

At least, that's always been my experience.

> We can't put billboards up for everything. It is your health, and therefore your responsibility, to read the provided literature and raise any questions to your doctor

I eat thousands of different things every week and I don't ask questions about any of them weekly. Do you? And would you think it's realistic to question everything all the time?

Do you take thousands of different medications weekly? It's pretty realistic to ask about medications you take and what interactions to avoid with that medicine.

You're assuming that only medications interact with food. Maybe you eat thousands of things and some interact with each other. You don't know, you're just hoping it will be fine, because leaving everything about everything is not feasible, which was my point.

>You're assuming that only medications interact with food.

Where did I say that? We're in a topic about medicine interacting with grapefruit. I suggest putting the warning on the medicine is a reasonable approach for this issue.

>Maybe you eat thousands of things and some interact with each other.

Whats your point here? Should every food list every possible interaction with every other existing food and medicine? Will I need to a read a 1400 page book before I can buy an orange?

I'm not sure what you're getting at. The analysis isn't on each thing you eat. It's merely a blacklist of a couple things for the specific medication you're on.

You're missing his point.

Sure, you eat thousands of things. But surely you're consuming less prescribed medicine. The onus is on you to read the material given to you when prescribed potentially life threatening medication. It's prescribed and not over-the-counter for a reason. There's extra precaution placed on the medicine itself, and so you should pay attention to that and read up.

God forbid someone should come at you with a lingonberry before you've acquired a PhD in botany or properly armed yourself.

More seriously, it is easy to overlook the extreme spectrum of knowledge and ignorance in our society. There are other factors too, such as cognitive impairment, state of mind, etc. Ignorance may be a poor defence under law, but in a more ideal world, ignorance of grapefruits shouldn't result in capital punishment.

With the extreme liberalness we accept advertisements everywhere, it doesn't seem unreasonable to dedicate an extra amount of space here and there for friendly warnings.

Edit: I see several comments stating that such warnings are printed on labels. If so, discard my comment. Other than verbal warning, that's probably adequate for our imperfect world.

> Sure, you eat thousands of things. But surely you're consuming less prescribed medicine.

Maybe you eat thousands of things and some interact with each other. You don't know, you're just hoping it will be fine, because learning everything about everything is not feasible, which was my point.

My secondary point is that everyone on this thread is blaming the victim for not doing enough research, while at the same time everyone on this thread is only marginally better - maybe you do enough research in this specific topic, but surely not for everything in life.

It's hardly "research" if it's printed on the information you're given and the pharmacist is legally required to offer to tell you what you should know when you pick up the medicine. In America (or at least in every state I've lived in) you need to explicitly decline counseling by the pharmacist about new medications.

Exactly! If you cannot be bothered to read the actual warnings that come with any medication you're about to eat, then you're kinda askin' for trouble. They give you those instructions and warnings for good reason.

We recently adopted a dog. The first thing we did was find a list of the ~20 common foods that are poisonous for the dog. We now have that list in mind and are careful about him when we are eating those foods. I didn't ask people to add a dog warning label to each food that contains garlic.

I see no reason why prescription drugs shouldn't work the same way (which is, in fact, the way they work now). If you start taking a new prescription drug, find out what foods you can't eat and avoid them. There's no need to add a specific warning to every food that might interact with any given drug.

Agreed. A "read your drug information pamphlet for patients" campaign would be much more helpful than having a bunch of "don't take x,y,z,a,b,c,p,q,r with this food." Because x,y,z,a,b,c,p,q,r already have warnings against the foods that are incompatible.

> I didn't ask people to add a dog warning label to each food that contains garlic.

Dogs can eat garlic. You'd have to be feeding them multiple powdered garlic packets to cause harm, if its even possible.

So you've failed at risk management. This is why we have to have these dumbed down labels.

> "Dogs can eat garlic. You'd have to be feeding them multiple powdered garlic packets to cause harm, if its even possible."

The American Kennel Club [1] and [2] the Pet Poison Help Line (among others) would disagree with your certainty, sir. In this case it is you who have "failed at risk management". You did not bother to consider the risks of posting false / incorrect information on a public forum. This is why we have to have these dumbed down labels. Because people cannot bother to do (literally) ten seconds of research on their favorite search engine before "speaking with authority" on public forums / social media about a topic which they are clearly not nearly as sure of as they believe themselves to be. That's how misinformation spreads so readily these days.

[1] https://www.akc.org/expert-advice/nutrition/can-dogs-eat-gar...

[2] https://www.petpoisonhelpline.com/poison/garlic/

Your first link ( https://www.akc.org/expert-advice/nutrition/can-dogs-eat-gar... ) basically states exactly what the GP said about dosage:

Studies have found it takes approximately 15 to 30 grams of garlic per kilograms of body weight to produce harmful changes in a dog’s blood. To put that into perspective, the average clove of supermarket garlic weighs between 3 and 7 grams, so your dog would have to eat a lot to get really sick. However, some dogs are more sensitive to garlic toxicity than others, and consumption of a toxic dose spread out over a few days could also cause problems.

This means that if your dog accidentally eats something containing a little garlic, they will probably be okay, but intentionally feeding it to your dog is a bad idea.

> "However, some dogs are more sensitive to garlic toxicity than others, and consumption of a toxic dose spread out over a few days could also cause problems."

You wanna risk it with your dog, that's on you… Also, "Dogs can eat garlic." and then ridiculing the person who actually did research about what's safe for their dog, when this person couldn't be bothered to even do a ten second web search to determine if their harshness was even justifiable? And it's worth taking into account that dogs come in a pretty wide variety of sizes and body mass. Larger or more massive dog can obviously tolerate more of a toxic substance before it's a serious issue. Still shouldn't just take this person at their word and start feeding your dog garlic just because some Internet rando says "dogs can eat garlic".

> this person couldn't be bothered to even do a ten second web search

Do you know that it is true? Pretty sure they read the same/similar info from a web search and determined that foods that contain a bit of garlic aren't a big danger to dogs. The context is important (although it's fair to point out that the quote can be taken out of context) -- the discussion was about food that incidentally contained garlic as ingredient (which realistically wouldn't contain a whole lot of it), not feeding whole cloves of garlic to dogs.

I'm aware of that, and you're being needlessly pedantic. There's a sliding scale of toxicity and garlic is on the low end.

If you'd prefer, feel free to insert "grapes" instead. The point remains.

If I am on a medication I always read the pamphlet. If it's a particularly dangerous med when used incorrectly I consult with the pharmacist. As I indicated it is free. If I still don't have answers I call my doctor, or find a doctor I can call. I'm not some super star. I'm not even what I would consider "health conscious". I just know that I don't know something about a drug I am taking and should figure out more.

My burden taking a medication is on a percentage basis an edge case for the general "eating stuff" problem. So the onus is on me to resolve this edge case.

If you really desire some sort of campaign to stop this there are ways that don't impede on businesses and other's lives. You could run commercials about pharmaceutical pamphlets, you could fund a website where people could find their drug and learn quickly about interactions, you could make it a legal obligation of doctors and pharmacists to both tell you the necessary precautions with your medication. All of these would be better solutions than some safety theater like a warning label on an unambiguously safe product except to people taking certain medications. To exemplify this most diet soda contains a required notice "caution phenylketonurics: contains phenylalanine." Did you know this? Do you think the average person finds utility in this? If you are a phenylketonuric you most likely already know about the risks and what to avoid with your condition. Not only that it's incredibly rare on a population basis (~1/15,000). It's not the onus of a business to put this theater on their foods unless the chemical is dangerous to a majority (such as tar in tobacco).

Actually, yea. Many people do. It's relatively common. This is an element of personal responsibility. Granted, I know how to cook and I'm not a big fan of boxed, processed foods. This makes the gamut of foods I care about easier to track.

Plus, knowing that grapefruit helps metabolize different things helpful and cheapens your bartab. You'll get drunk faster after eating a grapefruit or two. Animal derived fats help slow down the inebriation process, like butter and a really greasy beef patty.

This feels like the responsibility of the pharmacy more than that of the grocer who sold you juice. Pharmacies typically put stickers on medication bottles that say, “Do not take with grapefruit juice,” “Avoid sun exposure,” “Take with food,” etc.

Would you want grocery stores to label grapefruits in the produce section?

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