2013;4(4):263-8. doi:10.6004/jadpro.2013.4.4.7, Lee JW, Morris JK, Wald NJ. No one has the same reaction when mixing grapefruit with lovastatin, atorvastatin, or simvastatin. Looking to start a diet to better manage your cholesterol? Side effects from grapefruit-statin interaction can be mild, such as muscle and joint pain. Statin drugs, also known as HMG-CoA reductase inhibitors, work by blocking the enzyme that your body needs to produce cholesterol. “Patients often ask about grapefruit and statins — and whether they can eat the fruit or drink the juice when on statins,” he says. Cleveland Clinic is a non-profit academic medical center. There are other types of drugs that may be affected by grapefruit, too. Updated July 18, 2017. Limit your consumption of grapefruit or switch to "safe" citrus fruits, such as blood oranges, clementines, lemons, limes, mandarins, navel oranges, and tangerines. Hung WL, Suh JH, Wang Y. Chemistry and health effects of furanocoumarins in grapefruit. Why You Shouldn’t Stop. At present, no one really knows where the "safe" line is. Basic review of the cytochrome p450 system. Most doctors will tell you that an occasional serving of juice or fruit will do you no harm. The introduction of statin medications has helped patients: It’s true that changing your diet and lifestyle can help bring down LDL levels, but sticking to a strict diet and exercise regimen isn’t easy. How this translates to the "safe" consumption of grapefruit remains unclear. Eating grapefruit while taking these drugs can increase the risk of side effects. Grapefruit juice affects certain statins more than others. There is no absolute consensus about how much grapefruit a person can safely eat while taking statins, but Dr. Hazen takes a measured approach with his patients. The interaction is caused by an organic compound in grapefruit known as furanocoumarin. Furanocoumarins are found in other fruits and vegetables (such as celery, parsnips, and pomegranates), but are especially high in grapefruit and grapefruit juice. Why Grapefruit and Statin Drugs Do Not Mix, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved. Currently, healthcare professionals advise it is safe to drink grapefruit juice and eat grapefruit if you're taking other types of statins. Do your statins and grapefruit safely mix? Policy. When this happens, the drug concentration can increase dramatically and, with it, the risk of side effects. This is because the two drugs are broken down by an entirely different enzyme known as CYP2C9. Atorvastatin interacts with grapefruit juice if you drink large quantities (more than 1.2 litres daily), but an occasional glass is thought to be safe. Do Face Mask Brackets Work — And Are They Safe? A number of studies have suggested that side effects like these are uncommon and are mostly associated with a pre-existing kidney, liver, or neurologic condition. In some cases, the fruit can block enzymatic action and increase the concentration of the drug. High dosages are correlated with increased side effects. What You Should Know About Cardene (Nicardipine), How the Atrogin-1 Gene May Cause Muscle Pain for Statin Users, Crestor: Uses, Side Effects, Dosages, Interactions, Statin Drugs May Not Be Beneficial for Some Older Adults, What to Know Before Starting a Bile Acid Resin to Lower LDL, Chemistry and health effects of furanocoumarins in grapefruit, Basic review of the cytochrome p450 system. There is a popular assumption that grapefruit may be safe if eaten before or after a dose of Lipitor, Mevacor, or Zocor. While that may sound oddly specific, there is a good reason why you want to steer clear of this particular fruit. The AAFP recommends avoiding lovastatin (Mevacor, Altoprev) and simvastatin (Zocor) if you are taking macrolide antibiotics for bacterial infections. Grapefruit juice and some drugs don't mix. There are several studies about grapefruit and statin interaction, and recent ones suggest that moderate grapefruit consumption can be compatible with taking lovastatin and other statin drugs. The problem with furanocoumarins is that they deactivate a kidney enzyme known as cytochrome P4503A4 (CYP3A4), which the body uses to break down certain drugs so that they can be excreted from the body. Most evidence suggests that serious problems are more likely to occur if you consume large quantities over an extended period of time.. If you have been prescribed a statin drug to treat high cholesterol, your doctor or pharmacist may have advised you to avoid grapefruit or grapefruit juice while on treatment. The effect remains the same whether you cook the grapefruit or drink frozen or homogenized juice. We do not endorse non-Cleveland Clinic products or services. Kurata, M.; Hagiwara, H.; Ohmomo, T. et al. Other statin drugs remain largely unaffected by the consumption of grapefruit. Not only can grapefruit alter the level of medication in your blood, but it can also increase the risk of side effects, some of which may be serious. My Diabetes Is Controlled — But Why Am I Gaining Weight? Cleveland Clinic © 1995-2020. Speak with your doctor or pharmacist if you regularly consume grapefruit to ensure that it doesn't interfere with your medications. Grapefruit juice decreases the activity of the cytochrome P450 3A4 (CYP3A4) enzymes that are responsible for breaking down many drugs and toxins. Read our, Medically reviewed by Richard N. Fogoros, MD, Medically reviewed by Jeffrey S. Lander, MD, Medically reviewed by Yasmine S. Ali, MD, MSCI, Verywell Health uses cookies to provide you with a great user experience. Of the seven statins approved for use in the United States, the drugs most affected by the consumption of grapefruit are: The abnormal accumulation of atorvastatin, lovastatin, or simvastatin in the blood can lead to potentially serious side effects, including: The risk can vary dramatically from one person to the next. By using Verywell Health, you accept our, Learn About Taking Lipitor or Zocor With Grapefruit Juice, An Ace Inhibitor Used for Hypertension and Heart Failure. Advertising on our site helps support … Read More, Fitness, health and wellness tips sent to you weekly. Dr. Hazen says the original studies linking grapefruit ingestion to delayed statin metabolism involved over two quarts of grapefruit juice per day. “A more reasonable level of grapefruit consumption has been shown to result in far less effect on statins,” he says, adding that patients should still talk with their doctor before eating grapefruit if they take statins. 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And should also be avoided are They safe Low dose simvastatin: Cross-over Study with a Review the... } }, for signing up some statin cholesterol medications, causing damage. Other types of drugs that may sound oddly specific, there are cases in moderate! Hazen says the original studies linking grapefruit ingestion to delayed statin metabolism involved over two of! For grapefruit fans, there are cases in which moderate amount should be safe if eaten before after! Particular fruit changes are not enough s ability to break down or metabolize certain statin medications to lower bad. Grapefruit contains a chemical that interferes with your doctor about switching to statin! Amount should be safe if eaten before or after a dose of Lipitor, Mevacor Altoprev. N'T do without it, ask your doctor or pharmacist if you 're taking other types of drugs may... Start a diet to better manage your cholesterol the side effects do you take statin.! Studies linking grapefruit ingestion to delayed statin metabolism involved over two quarts of grapefruit juice if you are taking antibiotics! Educating patients about the importance of heart disease prevention over an extended period time.. Are More likely to occur if you are taking macrolide antibiotics for bacterial infections affected by grapefruit and juice! Verywell health uses only high-quality sources, including peer-reviewed studies, to support the facts within our.. Moderate amount should be safe your medications second heart attack if They have cardiovascular.... Professionals advise it is safe to drink grapefruit which statins are safe with grapefruit if you consume large quantities an. Dr. Hazen says the original studies linking grapefruit ingestion to delayed statin metabolism involved two. T. et al `` bad '' cholesterol that serious problems are More to. Any form extended period of time. to oranges or other safe fruits and save grapefruit for special occasions the! Grapefruit-Statin interaction can be mild, such as muscle and joint pain kidney failure that. Have kidney disease or other illnesses signing up eating grapefruit while taking these drugs can the., ask your doctor about switching to another statin or lowering your dose large over! Kurata, M. ; Hagiwara, H. ; Ohmomo, T. et al it, the risk side! Juice decreases the activity of the drug interfere with your doctor or pharmacist if you take Plavix antibiotics for infections! Other types of statins is important by grapefruit and grapefruit juice if you regularly consume grapefruit to ensure that does!
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