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J Adv Pract Oncol. Avoid a second heart attack if they have cardiovascular disease. Little or no effect. Why Grapefruit and Statin Drugs Do Not Mix, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved. Do your statins and grapefruit safely mix? Advertising on our site helps support our mission. Calcium channel blockers Other statin drugs remain largely unaffected by the consumption of grapefruit. When statin takers eat large amounts of grapefruit, the level of statins in their blood can increase, raising the possibility of side effects. 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. Severe side effects include muscle fiber breakdown and kidney failure. Looking to start a diet to better manage your cholesterol? All Rights Reserved. In others, it can interfere with protein transporters in the blood, reducing the concentration and effect of the drug. Can You Have Grapefruit Juice If You Take Plavix? 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. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036, Cleveland Clinic. The grapefruit effect. Speak with your doctor or pharmacist if you regularly consume grapefruit to ensure that it doesn't interfere with your medications. There are other types of drugs that may be affected by grapefruit, too. 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. When this happens, the drug concentration can increase dramatically and, with it, the risk of side effects. The effect remains the same whether you cook the grapefruit or drink frozen or homogenized juice. What is most important is that you avoid the regular consumption or overconsumption of furanocoumarin in any form. Limit your consumption of grapefruit or switch to "safe" citrus fruits, such as blood oranges, clementines, lemons, limes, mandarins, navel oranges, and tangerines. Big effect. Advertising on our site helps support our mission. Err on the side of caution and restrict drinking and eating grapefruit if … Most evidence suggests that serious problems are more likely to occur if you consume large quantities over an extended period of time.. Currently, healthcare professionals advise it is safe to drink grapefruit juice and eat grapefruit if you're taking other types of statins. At present, no one really knows where the "safe" line is. January 20, 2016. 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. If you truly love grapefruit and can't do without it, ask your doctor about switching to another statin or lowering your dose. 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. My Diabetes Is Controlled — But Why Am I Gaining Weight? Cleveland Clinic © 1995-2020. 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. J Food Drug Anal. In addition to lowering "bad" LDL cholesterol and raising "good" HDL cholesterol, statin drugs can also decrease the level of triglyceridescirculating in your blood. Problems can occur for those who are sensitive to statin medications or those who have kidney disease or other illnesses. If you consume grapefruit every now or then, it is unlikely to do any real harm. Summary: Grapefruit can increase the side effects of some statin cholesterol medications, causing muscle damage. Am J Med. High dosages are correlated with increased side effects. As with any medication, taking the correct dose of statins is important. Policy. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Grapefruit juice decreases the activity of the cytochrome P450 3A4 (CYP3A4) enzymes that are responsible for breaking down many drugs and toxins. 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. Policy. Cleveland Clinic is a non-profit academic medical center. Luckily for grapefruit fans, there are cases in which moderate amount should be safe. 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. 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 You Shouldn’t Stop. Do your statins and grapefruit safely mix? Evidence shows that only one instance of grapefruit or grapefruit product consumption can be enough to cause these drugs to build up in your system, and timing doesn't … 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. 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. Grapefruit Juice and Statins. Advertising on our site helps support … Read More, Fitness, health and wellness tips sent to you weekly. Taking a Statin After a Heart Attack? US Food & Drug Administration. Switch to oranges or other safe fruits and save grapefruit for special occasions. 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. Hung WL, Suh JH, Wang Y. Chemistry and health effects of furanocoumarins in grapefruit. Thank you, {{form.email}}, for signing up. How this translates to the "safe" consumption of grapefruit remains unclear. Other drugs are equally affected by grapefruit and grapefruit juice. 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. Stanley Hazen, MD, PhD, Preventive Cardiology Head at Cleveland Clinic’s Heart and Vascular Institute, says it’s a frequent topic of concern. Cleveland Clinic is a non-profit academic medical center. 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