Cleveland Clinic © 1995-2020. Why You Shouldn’t Stop. We do not endorse non-Cleveland Clinic products or services. Eating grapefruit while taking these drugs can increase the risk of side effects. J Adv Pract Oncol. Other statin drugs remain largely unaffected by the consumption of grapefruit. Avoid a second heart attack if they have cardiovascular disease. Luckily for grapefruit fans, there are cases in which moderate amount should be safe. The AAFP recommends avoiding lovastatin (Mevacor, Altoprev) and simvastatin (Zocor) if you are taking macrolide antibiotics for bacterial infections. Policy. Furanocoumarins are also found in other fruit (eg, pomegranates), and in vegetables (eg, parsnips and celery), however, they are especially concentrated in grapefruit juice and fresh grapefruits. January 20, 2016. US Food & Drug Administration. What is most important is that you avoid the regular consumption or overconsumption of furanocoumarin in any form. Advertising on our site helps support … Read More, Fitness, health and wellness tips sent to you weekly. atorvastatin (Lipitor) fluvastatin (Lescol) lovastatin (Mevacor) pitavastatin (Livalo) simvastatin (Zocor) pravastatin (Pravachol) rosuvastatin (Crestor) Calcium channel blockers 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. Most doctors will tell you that an occasional serving of juice or fruit will do you no harm. What is known is that statin drug levels can increase by anywhere from 80 percent to 260 percent if the medication is taken at the same time as grapefruit. If taken 12 hours apart, that drops to between 44 percent and 66 percent. Do your statins and grapefruit safely mix? Cleveland Clinic is a non-profit academic medical center. Grapefruit juice and some drugs don't mix. Stanley Hazen, MD, PhD, Preventive Cardiology Head at Cleveland Clinic’s Heart and Vascular Institute, says it’s a frequent topic of concern. No one has the same reaction when mixing grapefruit with lovastatin, atorvastatin, or simvastatin. If you truly love grapefruit and can't do without it, ask your doctor about switching to another statin or lowering your dose. Do you take statin medications to lower “bad” LDL cholesterol? J Food Drug Anal. Dr. Hazen says the original studies linking grapefruit ingestion to delayed statin metabolism involved over two quarts of grapefruit juice per day. Why Grapefruit and Statin Drugs Do Not Mix, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved. 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. When this happens, the drug concentration can increase dramatically and, with it, the risk of side effects. “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. In addition to lowering "bad" LDL cholesterol and raising "good" HDL cholesterol, statin drugs can also decrease the level of triglycerides circulating in your blood. This is because the two drugs are broken down by an entirely different enzyme known as CYP2C9. Other drugs are equally affected by grapefruit and grapefruit juice. The effect remains the same whether you cook the grapefruit or drink frozen or homogenized juice. Problems can occur for those who are sensitive to statin medications or those who have kidney disease or other illnesses. Currently, healthcare professionals advise it is safe to drink grapefruit juice and eat grapefruit if you're taking other types of statins. Taking a Statin After a Heart Attack? Grapefruit contains a chemical that interferes with your body’s ability to break down or metabolize certain statin medications. Speak with your doctor or pharmacist if you regularly consume grapefruit to ensure that it doesn't interfere with your medications. CORONAVIRUS: UPDATED VISITOR RESTRICTIONS, INCREASED SAFETY MEASURES + COVID-19 TESTING. Neurological symptoms, including confusion and memory loss, Certain anti-arrhythmia drugs, like amiodarone, Certain anti-anxiety drugs, like buspirone, Some antihistamines, like Allegra (fexofenadine), Some hypertension medications, like nifedipine, Some organ transplant rejection drugs, like cyclosporine. In some cases, the fruit can block enzymatic action and increase the concentration of the drug. Grapefruit juice decreases the activity of the cytochrome P450 3A4 (CYP3A4) enzymes that are responsible for breaking down many drugs and toxins. Grapefruit juice affects certain statins more than others. High dosages are correlated with increased side effects. Grapefruit Juice and Some Drugs Don't Mix. When statin takers eat large amounts of grapefruit, the level of statins in their blood can increase, raising the possibility of side effects. Can You Have Grapefruit Juice If You Take Plavix? Jennifer Moll, MS, PharmD, is a pharmacist actively involved in educating patients about the importance of heart disease prevention. Advertising Policy Cleveland Clinic is a non-profit academic medical center. Eating grapefruit while taking these drugs can increase the risk of side effects. “I personally tell my folks who have had no issues with taking a statin, ‘Go ahead and eat the grapefruit, but in moderation.’ Better they eat a low-calorie fruit — and if we find symptoms of statin intolerance, we can cross that bridge, if need be.”. The main agents responsible for the grapefruit juice effect on statins are bergamottin in fresh grapefruit and its derivative, 6′,7′-dihydroxybergamottin (DHB) in juice concentrate, which are furanocoumarins. The grapefruit effect. There is a popular assumption that grapefruit may be safe if eaten before or after a dose of Lipitor, Mevacor, or Zocor. Should You Cancel Your Holiday Gatherings This Year Because of COVID? Bitter oranges, pomelos, tangelos, and Seville oranges contain high levels of furanocoumarin and should also be avoided. Side effects from grapefruit-statin interaction can be mild, such as muscle and joint pain. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036, Cleveland Clinic. This warning has led to a lot of questions from people taking this type of medication.