Q. My 15-year-old son has a hard time getting up in the morning. He’s always running late and insists that I have Red Bull for him to drink on his way out the door. He says it gives him energy. If I run out, he complains bitterly that he can’t get going in the morning.
I know that Red Bull contains caffeine, but I can’t tell how much from the label. Is this a problem for his health? His breakfast is rarely more than a bagel or a piece of toast. He often buys soft drinks at school and I worry about all the sugar and caffeine.
A. An eight-ounce can of Red Bull contains 80 mg of caffeine, almost twice as much as a 12-ounce can of cola. For comparison, a mug of coffee has around 100 mg of caffeine and a cup of tea has approximately 30 mg.
Adolescents are often sleep deprived, but relying on caffeine to wake up can create a vicious cycle. A study in the journal Pediatrics (Jan 2003) has shown that teenagers who consume too much caffeine sleep less well and are sleepier during the daytime.
His high carbohydrate “breakfast” means that his blood sugar and insulin levels will rise rapidly, but they will drop abruptly by mid morning and make it harder for him to stay alert. Getting off this roller coaster would be better for his health. Youngsters who get a balanced breakfast, including some protein, do better in school.
Q. I’ve seen your columns about grapefruit but I didn’t pay attention. Now I need your help. I recently filled a prescription for Zocor. The sticker on the bottle said to avoid eating or drinking grapefruit with this medication.
When I asked my cardiologist he said he knew nothing about a grapefruit warning. I also take Zestril and verapamil for high blood pressure.
My neighbor gives me fresh grapefruit, which is delicious. He takes Lipitor and says grapefruit is safe if you take the pill late in the evening. Is that true?
A. Grapefruit raises blood levels of Lipitor, Zocor and Mevacor (lovastatin). The effect can last beyond 24 hours and increase the risk of side effects. Taking the pill in the evening doesn’t help, but switching to a different cholesterol-lowering drug could solve the problem.
Several blood pressure medications, including verapamil, but not Zestril, are also affected by grapefruit. If you want to enjoy grapefruit your cardiologist will need to prescribe medicine that does not interact.
We are sending you our Guides to Grapefruit Interactions and Cholesterol Lowering Drugs so your doctor can prescribe drugs that are not incompatible with grapefruit. Anyone who would like copies, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. JL-97, P. O. Box 52027, Durham, NC 27717-2027.
Q. I have gastroparesis, which is caused by diabetes. After a meal I become extremely nauseated. Gastroenterologists have prescribed a drug called domperidone since nothing else works. It is available only in Canada because it is not FDA approved. It has been used safely in Canada for more than a decade, so why isn’t it available here? Can I import it legally?
A. Domperidone (Motilium) is an interesting drug that is available elsewhere in the world for nausea and delayed stomach emptying. We don’t know why the FDA has not approved it, but since it is unavailable in the U.S., it is perfectly legal to import domperidone.
The People's Perspective on Medicine