Other drugs are equally affected by grapefruit and grapefruit juice. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Cleveland Clinic © 1995-2020. Policy. J Adv Pract Oncol. There are other types of drugs that may be affected by grapefruit, too. US Food & Drug Administration. This warning has led to a lot of questions from people taking this type of medication. 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. Hung WL, Suh JH, Wang Y. Chemistry and health effects of furanocoumarins in grapefruit. Grapefruit Juice and Some Drugs Don't Mix. When this happens, the drug concentration can increase dramatically and, with it, the risk of side effects. Do your statins and grapefruit safely mix? “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.”. Advertising on our site helps support our mission. 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. Statins protect your heart by lowering "bad" cholesterol. If you consume grapefruit every now or then, it is unlikely to do any real harm. And statins help keep LDL levels in check for those patients who find simple diet and lifestyle changes are not enough. What is most important is that you avoid the regular consumption or overconsumption of furanocoumarin in any form. Effects of Grapefruit Juice Consumption on Pharmacokinetics of Low Dose Simvastatin: Cross-over Study with a Review of the Literature. Advertising on our site helps support our mission. While that may sound oddly specific, there is a good reason why you want to steer clear of this particular fruit. Big effect. Looking to start a diet to better manage your cholesterol? Err on the side of caution and restrict drinking and eating grapefruit if … Taking a Statin After a Heart Attack? The interaction is caused by an organic compound in grapefruit known as furanocoumarin.1 Furanocoumarins are found in ot… 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. Calcium channel blockers 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. 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. Changing lifelong eating habits can be scary at first, but our guide will make it easier. The grapefruit effect. In others, it can interfere with protein transporters in the blood, reducing the concentration and effect of the drug. Bitter oranges, pomelos, tangelos, and Seville oranges contain high levels of furanocoumarin and should also be avoided. Pravastatin is metabolized by yet a different mechanism. 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. As with any medication, taking the correct dose of statins is important. 2017;25(1):71-83. doi:+10.1016/j.jfda.2016.11.008, Mcdonnell AM, Dang CH. Summary: Grapefruit can increase the side effects of some statin cholesterol medications, causing muscle damage. When statin takers eat large amounts of grapefruit, the level of statins in their blood can increase, raising the possibility of side effects. PCSK9 Inhibitors for Cholesterol—Are They Really Miracle Drugs? Grapefruit Juice and Statins. 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. 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. 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 … Cleveland Clinic is a non-profit academic medical center. Side effects from grapefruit-statin interaction can be mild, such as muscle and joint pain. 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. “This is an issue only for lovastatin and simvastatin and is only problematic at the highest dosages,” says Dr. Nissen, Cardiovascular Medicine Department Chair at Cleveland Clinic’s Heart and Vascular Institute. Switch to oranges or other safe fruits and save grapefruit for special occasions.
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