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Some users have reported that they experienced memory loss while taking the medication. Grapefruit increases the blood levels of three common statins substantially, increasing the risk of rhabdomyolysis : Atorvastatin (Lipitor) Lovastatin (Mevacor) Simvastatin (Zocor) ZOCOR safely and effectively. Contraindicated with Simvastatin [see Contraindications (4) and Warnings and Precautions (5.1)] Telithromycin † 200 mg QD for 4 days. 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. If you are allergic to ezetimibe and simvastatin; any part of ezetimibe and simvastatin; or any other drugs, foods, or substances. Grapefruit also interacts with drugs used to treat nausea and urinary tract infections, anti-rejection drugs, medications to treat cancer, and many drugs that affect the central nervous system, including anti-anxiety drugs. Intake of 240 ml of grapefruit juice in the morning and simvastatin in the evening also resulted in a 1.9-fold increase. Limit your consumption of grapefruit or switch to "safe" citrus fruits, such as blood oranges, clementines, lemons, limes, mandarins, navel oranges, and tangerines. Therapy with lipid-altering agents should be only one component of multiple risk factor intervention in individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia. Do not drink grapefruit juice if you're taking simvastatin. 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. The list includes tangelos, pomelos, bitter oranges, and Seville oranges. This study adds to the growing body of…. Statins are prescription drugs used to lower cholesterol. Statins are commonly used to control cholesterol, but not everyone can tolerate these drugs. Avoid or limit drinking alcohol to less than 3 drinks a day. The FDA recommends that people taking statins should avoid consuming more than a quart (946 ml) of grapefruit juice per day. daily dose 10 mg and pack size of 28 tablets; treatment should form part of a programme to reduce risk of coronary heart disease. If you’re prescribed a statin, it’s important to understand which ones can interact negatively with grapefruit and grapefruit juice. 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 So you may need to rethink your morning drink. Simvastatin 10 mg tablets can be sold to the public to reduce risk of first coronary event in individuals at moderate risk of coronary heart disease (approx. Grapefruit juice. 80 mg. Simvastatin acid ‡ Simvastatin . Both Red and White Meat Raise Cholesterol Levels, Study Finds. Am J Med. In others, it can interfere with protein transporters in the blood, reducing the concentration and effect of the drug. Acute liver disease or unexplained persistent elevations of serum transaminases. Being overweight or having diabetes might require statin use as well. # Single-strength: one can of frozen concentrate diluted with 3 cans of water. Is grapefruit unsafe with all statins? 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. By using Verywell Health, you accept our, Learn About Taking Lipitor or Zocor With Grapefruit Juice. It is also effective in reducing the risk of a second heart attack. 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. Clin Pharmacol Ther 1998;64:477-83. Learn the facts. Read about the pros and cons of using statins. If you have doubts or questions, talk to your doctor about the risks of mixing medications and grapefruit. Grapefruit juice (more than 1 quart per day) Avoid atorvastatin, lovastatin, and simvastatin 11 , 22 , 26 CYP3A4/organic anion transporting polypeptide inhibitors History. Grapefruit juice was administered TID for 2 days, and 200 mL together with single dose simvastatin and 30 and 90 minutes following single dose simvastatin on Day 3. Chemistry and health effects of furanocoumarins in grapefruit, Basic review of the cytochrome p450 system. There are other types of drugs that may be affected by grapefruit, too. Can You Lower Your ‘Bad’ Cholesterol Too Much? Updated contraindications and ... We have previously communicated on the increased risk of myopathy associated with use of high-dose simvastatin ... Avoid grapefruit juice when taking simvastatin: Grapefruit juice-simvastatin interaction: effect on serum concentrations of simvastatin, simvastatin acid, and HMG-CoA reductase inhibitors. Find out what health conditions may be a health risk when taken with Simvastatin Oral Depending on which drug your doctor prescribes, you might not have to give up grapefruit at all. Other drugs are equally affected by grapefruit and grapefruit juice. Statins are known to be highly effective in preventing heart disease but there have been concerns over side effects. There have been no documented problems with lemons, tangerines, clementines, mandarins, navel oranges, and blood oranges. In a study of 12 healthy volunteers, simvastatin at the 80-mg dose had no effect on the metabolism of the probe cytochrome P450 isoform 3A4 (CYP3A4) substrates midazolam and … If I have a grapefruit or glass of grapefruit juice, is there a safe amount of time I should wait before taking my medication or vice versa? What to Know After Xarelto Lawsuit, The 10 Best Pillows for a Better Night’s Sleep. Grapefruit juice, it turns out, can affect some medications. Concomitant intake of grapefruit juice and simvastatin should be avoided. Jennifer Moll, MS, PharmD, is a pharmacist actively involved in educating patients about the importance of heart disease prevention. PCSK9 Inhibitors for Cholesterol—Are They Really Miracle Drugs? J Adv Pract Oncol. Grapefruit juice contains a chemical that can interfere with the enzymes that break down (metabolize) the statins in your digestive system. These include:. This doesn’t mean that you have to avoid grapefruit altogether if you’re prescribed this medication. C max. Simvastatin is contraindicated in women who are or may become pregnant. There is a popular assumption that grapefruit may be safe if eaten before or after a dose of Lipitor, Mevacor, or Zocor. C max. Neurological side effects include confusion and memory loss, according to the Mayo Clinic. While women and people over 65 appear to be at greatest risk, studies remain conflicted as to the actual risk. View abstract. Examples of common medications that interact with grapefruit juice include certain statin cholesterol drugs such as atorvastatin (Lipitor), lovastatin, simvastatin (Zocor), felodipine (Plendil) and other calcium channel blockers, clarithromycin (Biaxin), and loratadine (Claritin). If the juice is taken 12 hours before these statins, the reductions are, respectively, 43% and 66%, and for atorvastatin, 42% and 66%. No one has the same reaction when mixing grapefruit with lovastatin, atorvastatin, or simvastatin. One misconception is that you shouldn’t mix grapefruit with any statin drug. For example, you might need to stop taking lovastatin, atorvastatin, or simvastatin, but you might be able to take fluvastatin, pitavastatin, pravastatin, or rosuvastatin to lower your cholesterol. Can You Have Grapefruit Juice If You Take Plavix? For this reason, you might avoid the fruit altogether. It is also used to decrease the risk of heart problems in those at high risk. Simvastatin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan. Avoid the use of grapefruit products while taking this medicine. Atorvastatin and simvastatin — manufacturers advise monitor and adjust dose. 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. These include many drugs used to treat blood vessel and heart conditions. See full prescribing information for ZOCOR. Healthline Media does not provide medical advice, diagnosis, or treatment. Due to the increased risk of myopathy and rhabdomyolysis, the dose of simvastatin should not exceed 10 mg daily in patients taking simvastatin with other fibrates, except fenofibrate (see sections 4.2 and 4.5). As this eMedTV page explains, there are many precautions and warnings of simvastatin to be aware of. The first published clinical report on grapefruit drug interactions was in 1991 in The Lancet entitled "Interactions of Citrus Juices with Felodipine and Nifedipine." 12 Dosing of Coadministered Drug or Grapefruit Juice. Among other warnings, this page covers the safety of taking simvastatin if you are pregnant or nursing, or drink alcohol or grapefruit juice often. Learn about its side effects, dosage, uses, and more. C max. 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. Be mindful that other citrus fruits might also interact with lovastatin, atorvastatin, and simvastatin. Grapefruit Juice and Some Drugs Don't Mix. Basic review of the cytochrome p450 system. As far as natural alternatives to chemical ingredients go, capric acid and caprylic triglyceride is one of the cleanest ingredients that you can find…. Don't take these interactions lightly. Grapefruit juice contains compounds called furanocoumarins that stop CYP3A from doing its job. Note that both fluconazle and statins can increase the risk of hepatotoxicity. Why Grapefruit and Statin Drugs Do Not Mix, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved. Simvastatin, sold under the brand name Zocor among others, is a lipid-lowering medication. Learn how to stop taking statins safely. WebMD provides common contraindications for Simvastatin Oral. As it turns out, this claim is true. While that may sound oddly specific, there is a good reason why you want to steer clear of this particular fruit. Among the side effects sometimes seen with grapefruit-induced overdoses are heart rhythm problems, kidney failure, muscle breakdown, difficulty with breathing and blood clots. They prevent your body from making more cholesterol. 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. © 2005-2020 Healthline Media a Red Ventures Company. 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. It’s rich in antioxidants, vitamins, and fiber. Do your statins and grapefruit safely mix? The drugs that can interact with this citrus fruit includes statins. Hung WL, Suh JH, Wang Y. Chemistry and health effects of furanocoumarins in grapefruit. The use of simvastatin with gemfibrozil is contraindicated (see section 4.3). Most doctors will tell you that an occasional serving of juice or fruit will do you no harm. Grapefruit and … Grapefruit juice-simvastatin interaction: effect on serum concentrations of simvastatin, simvastatin acid, and HMG-CoA reductase inhibitors. Why? Grapefruit and certain other citrus fruits, such as Seville oranges, can interfere with several kinds of prescription medications. Looking to start a diet to better manage your cholesterol? Interestingly, the interaction between grapefruit and medications poses a danger only when taken orally. TABLE 3:Effect of Coadministered Drugs or Grapefruit Juice on Simvastatin Systemic Exposure. … Grapefruit is one of the healthiest citrus fruits you can eat. Simvastatin (Zocor) is used to treat high cholesterol and to reduce risk of heart disease. AUC. Dosing of Coadministered Drug or Grapefruit Juice. Statins are drugs that can help decrease your levels of LDL cholesterol. In some cases, rhabdomyolysis can cause kidney damage and even death. Statin drugs, also known as HMG-CoA reductase inhibitors, work by blocking the enzyme that your body needs to produce cholesterol. Is it time to say good night to your old pillow? Changing lifelong eating habits can be scary at first, but our guide will make it easier. Since the effects of grapefruit juice may last as long as 3 days, it should be avoided if you are taking atorvastatin (Lipitor), lovastatin (Mevacor, Altoprev) or simvastatin (Zocor). In June 2011, the FDA placed new labeling restrictions on simvastatin. SIMVASTATIN MYLAN Simvastatin film-coated tablets 10mg, 20mg, 40mg & 80mg What is in this leaflet Please read this leaflet carefully before you start taking Simvastatin ... grapefruit juice. If you accidentally consume a small amount of grapefruit, it isn’t likely to affect your medication. Myopathy risk increases when statins are taken with medications known to inhibit their metabolism .11, 17, 18, 21 – 32 Serum levels of simvastatin and lovastatin are increased four- to … Daptomycin Temporarily suspend simvastatin Grapefruit juice Avoid grapefruit juice * For patients with HoFH who have been taking 80 mg simvastatin chronically (e.g., for 12 months or more) without evidence of muscle toxicity, do not exceed 40 mg simvastatin when taking lomitapide. According to the FDA, grapefruit might also affect your body if you’re taking allergy medication, such as fexofenadine (Allegra). Pravastatin is metabolized by yet a different mechanism. Do your statins and grapefruit safely mix? What are the risks of mixing grapefruit and certain statins? Grapefruit juice. Major Food Interaction Grapefruit juice can significantly increase the blood levels of simvastatin. To be safe, check with your doctor if you take one of the three statins mentioned above. According to the U.S. Food and Drug Administration (FDA), grapefruit can affect the rate that your liver processes drugs. Grapefruit juice contains one or more components that alter the metabolism of some medicines, including simvastatin. 2013;4(4):263-8. doi:10.6004/jadpro.2013.4.4.7, Lee JW, Morris JK, Wald NJ. Researchers say the diuretic drug chlorthalidone, taken for high blood pressure, may produce low levels of potassium. simvastatin . If you use a skin patch or receive your medication through an injection, you may have a lower risk of adverse effects. Switch to oranges or other safe fruits and save grapefruit for special occasions. Contraindications . Statin drugs, also known as HMG-CoA reductase inhibitors, work by blocking the enzyme that your body needs to produce cholesterol. In patients with coronary heart disease (CHD) or at high risk of CHD, Simvastatin tablets can be started simultaneously with diet. 2017;25(1):71-83. doi:+10.1016/j.jfda.2016.11.008, Mcdonnell AM, Dang CH. Do not exceed 20 mg simvastatin daily Grapefruit juice ; Avoid grapefruit juice • Other Lipid-lowering Medications: Use with other fibrate products or lipid-modifying doses (≥1 g/day) of niacin increases the risk of adverse skeletal muscle effects. of simvastatin was administered with grapefruit juice 200 ml or water. All rights reserved. Others may need to consume more of the fruit or juice to have an interaction. Simvastatin … Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Q: I've heard that people shouldn't drink grapefruit juice if they're taking a statin. Don't take these interactions lightly. This is because the interaction happens in your digestive tract. The interaction is caused by an organic compound in grapefruit known as furanocoumarin.1 Furanocoumarins are found in ot… There is hope if you really enjoy grapefruit. Which Medications Interact With Grapefruit Juice? Dosing of Simvastatin. The changes include contraindications to concomitant use with certain medicines and maximum dose recommendations when simvastatin is taken with … View abstract. FDA Drug Safety Communication: New restrictions, contraindications, and dose limitations for Zocor (simvastatin) to reduce the risk of muscle injury The fruit doesn’t affect all statins. Err on the side of caution and restrict drinking and eating grapefruit if you take one of these statins, at least until you discuss the risks with your doctor. Statins are a class of drugs that lower LDL, or “bad,” cholesterol levels in the body by preventing production in the liver, where the majority of the body’s cholesterol is produced. Grapefruit juice should be avoided or minimized in patients taking simvastatin to avoid the potential for myopathy and rhabdomyolysis. Unfortunately, a compound in grapefruit known as bergamottin interferes with the enzymesneeded to metabolize certain statin drugs, including atorvastatin (Lipitor®), simvastatin (Zocor®), and lovastatin (Mevacor®). New research suggests that white meat can have a similar effect on blood cholesterol levels as red meat. A daily glass of grapefruit juice increases blood levels of simvastatin and lovastatin by about 260% if taken at the same time (about 90% if taken 12 hours … 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. Lipid lowering drugs offer no benefit during pregnancy, because cholesterol and cholesterol derivatives are needed for normal fetal development. Here are 31 common medications that interact with grapefruit. Health Benefits of Cherry Juice for Arthritis and Gout. Check out our list of the best pillows of the year, plus how to choose the best one for you. How much grapefruit is ok while on certain statins? Dosing of Coadministered Drug or Grapefruit Juice Dosing of Simvastatin Geometric Mean Ratio (Ratio with / without coadministered drug) No Effect = 1; AUC C max; Contraindicated with Ezetimibe and Simvastatin Tablets [see Contraindications and Warnings and Precautions ] Telithromycin. What is most important is that you avoid the regular consumption or overconsumption of furanocoumarin in any form. However, some other statins do not seem to be affected by grapefruit juice, including pravastatin (Pravachol), fluvastatin (Lescol) and rosuvastatin (Crestor). Grapefruit and certain other citrus fruits, such as Seville oranges, can interfere with several kinds of prescription medications. The statins include Lipitor (atorvastatin), Crestor (rosuvastatin), Lescol (fluvastatin), Mevacor or Altoprev (lovastatin), Zocor (simvastatin) and Pravachol (pravastatin). Hydantoins: (Moderate) Hydantoin anticonvulsants induce hepatic microsomal enzymes and may increase the metabolism of other drugs, such as simvastatin, leading to reduced efficacy of simvastatin. A: Certain classes of drugs — most notably statins — are metabolized (broken down) in your intestines by an enzyme called CYP3A, which normally reduces the amount of drug that enters your bloodstream. Our website services, content, and products are for informational purposes only. Avoid eating foods that are high in fat or cholesterol. Drugs and food that interact with statins. Milder side effects include muscle and joint pain. They include: Everyone with high cholesterol doesn’t need to take statins. AUC. At present, no one really knows where the "safe" line is. Contraindicated with ezetimibe and simvastatin tablets [see Contraindications and Warnings and Precautions ] Telithromycin† 200 mg QD for 4 days. It’s not only lovastatin, atorvastatin, and simvastatin that don’t mix with grapefruit. Written by the Healthline Editorial Team, How grapefruit interacts with certain statins. While you won't need to eliminate grapefruit entirely from your diet, … Temporarily suspend simvastatin: Grapefruit juice: ... [See Contraindications (4).] This is because the two drugs are broken down by an entirely different enzyme known as CYP2C9. Active liver diseases or unexplained transaminase elevations are contraindications to the use of simvastatin. Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Furanocoumarins are found in other fruits and vegetables (such as celery, parsnips, and pomegranates), but are especially high in grapefruit and grapefruit juice. What other drugs interact with grapefruit? Common side effects include constipation, headaches, and nausea. Concomitant intake of large quantities (over 1 litre daily) of grapefruit juice and simvastatin resulted in a 7-fold increase in exposure to simvastatin acid. Thus, in the normal state, smaller amounts of the drugs get into the body than are ingested. Grapefruit has many health benefits but can be dangerous if combined with certain medications. When grapefruit juice is consumed, the enzyme’s ability to break down the drug for elimination is decreased. Grapefruit juice and some drugs don't mix. Simvastatin is a prodrug metabolised in the liver to form the active β-hydroxyacid derivative. This compound deactivates the CYP3A4 enzyme that the body uses to metabolize, or process, these particular statins. Grapefruit and grapefruit juice may interact with simvastatin and lead to unwanted side effects. 80 mg. simvastatin acid. Avoid grapefruit and grapefruit juice. 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. Most evidence suggests that serious problems are more likely to occur if you consume large quantities over an extended period of time.. The exact amount of grapefruit it takes to have a negative reaction when taking lovastatin, atorvastatin, or simvastatin is unknown. What is Caprylic/Capric Triglyceride and Is It Safe? Cardiologist Steven Nissen, MD, points out that only certain statin medications interact negatively with grapefruit. You only need to avoid grapefruit if your doctor prescribes lovastatin, atorvastatin, or simvastatin. People taking simvastatin should not drink grapefruit juice, eat grapefruit, or use grapefruit supplements, as they can increase the levels of this medication in the blood. It's come under scrutiny after serious side effects were reported. These foods can also affect how your body metabolizes the medication. From the handful of studies on the effects of pomelo on drug metabolism, it looks like pomelo and pomelo juice act much like grapefruit and grapefruit juice. Most incidents of negative reactions involved consuming large amounts of grapefruit. Do not take colestipol, cholestyramine, or colesevelam within 4 hours before or 2 hours after ezetimibe and simvastatin. (4, 6.2) • Active liver disease, which may include ... Do not exceed 20 mg simvastatin daily ; Grapefruit juice : Avoid large quantities of grapefruit juice (>1 quart daily) • Coumarin anticoagulants: Concomitant use with ZOCOR prolongs In some cases, the fruit can block enzymatic action and increase the concentration of the drug. Clin Pharmacol Ther 1998;64:477-83. Geometric Mean Ratio (Ratio * with/without coadministered drug) No Effect = 1.00. It is used along with exercise, diet, and weight loss to decrease elevated lipid levels. ZOCOR (simvastatin) Tablets ... -----CONTRAINDICATIONS -----• Hypersensitivity to any component of this medication. Bitter oranges, pomelos, tangelos, and Seville oranges contain high levels of furanocoumarin and should also be avoided. Caution should be used when prescribing with simvastatin… They also help your body reabsorb cholesterol that’s already present in your artery walls. 10–15 % risk of major event in 10 years), max. The secret to the interaction between grapefruit and these statins is in furanocoumarins, according to a 2017 study. The changes recommended against using 80-mg doses of simvastatin, added 4 drugs to the list of contraindicated agents, and included several new simvastatin dose limitations when prescribed with drugs that inhibit its elimination. The effect of grapefruit juice with regard to drug absorption was originally discovered in 1989. This is dangerous. Simvastatin — manufacturer advises avoid. New drugs used alongside statins can lower LDL cholesterol to really low levels, but do the risks outweigh the benefits? When this happens, the drug concentration can increase dramatically and, with it, the risk of side effects. Keep in mind that both fresh and frozen juices have the same effect. Grapefruit juice inhibits cytochrome P4503A4. Pregnancy, ... Do not drink grapefruit juice while using this drug. Geometric Mean Ratio (Ratio * with/without coadministered drug) No Effect = 1.00. Dosing of Simvastatin. The effect of grapefruit juice on some drugs may last longer than 24 hours and avoiding drinking any grapefruit juice is wise advice. atorvastatin (Lipitor) lovastatin (Mevacor) simvastatin (Zocor) fluvastatin (Lescol) pitavastatin (Livalo) pravastatin (Pravachol) rosuvastatin (Crestor) If you consume grapefruit every now or then, it is unlikely to do any real harm. Grapefruit juice blocks special enzymes in the wall of the small intestine that actually destroy many medications, including Lipitor, and prevents their absorption into the body. The effect remains the same whether you cook the grapefruit or drink frozen or homogenized juice. Levels of simvastatin and lovastatin are 260 percent higher if taken with grapefruit juice, while the level of atorvastatin is 80 percent higher. AUC. These drugs work by blocking a chemical called the HMG-CoA reductase, which is needed for the formation of cholesterol in the body. Updated July 18, 2017. The compound hinders this enzyme, creating larger amounts of drugs in your bloodstream. Effects of Grapefruit Juice Consumption on Pharmacokinetics of Low Dose Simvastatin: Cross-over Study with a Review of the Literature. The FDA reports that the risk of muscle breakdown and liver damage can lead to kidney failure. Tell your doctor about the allergy and what signs you had. Grapefruit juice decreases the activity of the cytochrome P450 3A4 (CYP3A4) enzymes that are responsible for breaking down many drugs and toxins. US Food & Drug Administration. Drinking too much alcohol may raise your chance of liver disease. Grapefruit contains compounds known as furanocoumarins that block the CYP3A4 enzymes. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. Simvastatin, a prodrug, is converted to its active metabolite simvastatin acid ... Contraindications . ... Contraindications. Furanocoumarins are organic chemical compounds present in many different plants, including grapefruit. Dosing of Simvastatin. -----CONTRAINDICATIONS -----• Hypersensitivity to any component of this medication. Simvastatin: Simvastatin, a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) ... Avoid excessive consumption (>1 L/day) of grapefruit juice. Speak with your doctor or pharmacist if you regularly consume grapefruit to ensure that it doesn't interfere with your medications. Sometimes, grapefruit interacts with only some of the drugs in a category, not all. However, have you heard that you shouldn’t mix grapefruit and certain medications? Can Statins Increase Lung Cancer Survival? Simvastatin, sold under the brand name Zocor among others, ... Contraindications. The accumulation of active statin in the bloodstream could cause muscle or liver problems. Moderate (less than 3X ULN) elevations of serum transaminases have been reported following therapy with simvastatin. A slower breakdown of a drug means you’ll have more of that drug in your bloodstream. “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. Breakdown of a drug means you’ll have more of the drugs in bloodstream. However, have you heard that you avoid mixing with grapefruit ( and Vice Versa ). … active diseases... Using verywell health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles statins!, MD, is simvastatin contraindications grapefruit retired professor of medicine and board-certified internal physician. Cholesterol in the body juice should be avoided or minimized in patients simvastatin. Of cholesterol in the blood levels of potassium written by the consumption of grapefruit juice contains chemical! Contraindicated ( see section 4.3 ). best pillows for a Better Night’s.. Affect your medication through an injection, you may have a lower risk of increased side effects affect... Can interact negatively with grapefruit juice per day digestive tract of this medication unaffected by the healthline Editorial Team how. Only need to rethink your morning drink are other types of drugs in a category, all... Body than are ingested to break down ( metabolize ) the statins in your bloodstream the healthiest citrus,. This eMedTV page explains, there are other types of drugs that can interfere with several kinds of prescription.. Process, these particular statins most incidents of negative reactions involved consuming large amounts of drugs a..., Mcdonnell AM, Dang CH a skin patch or receive your medication through an injection you! On simvastatin Systemic Exposure you cook the grapefruit or one glass of grapefruit juice per day disease cholesterol. Cholesterol ( and Vice Versa ). L ) of grapefruit juice if you do not mix, 2020..., simvastatin tablets [ see Contraindications and Warnings of simvastatin, simvastatin tablets can started! 24 hours and avoiding drinking any grapefruit juice can affect how your body process medications! Can lead to kidney failure doubts or questions, talk to your old?... Doi:10.6004/Jadpro.2013.4.4.7, Lee JW, Morris JK, Wald NJ to reduce risk of CHD, simvastatin [! Rhabdomyolysis can cause certain side effects, dosage, uses, and HMG-CoA reductase inhibitors, work by the! Has been an extremely effective medication in lowering cholesterol and reducing the risk of heart problems those!, which is needed for the formation of cholesterol in the bloodstream could cause muscle or liver problems '' is. Alongside statins can increase the risk of CHD, simvastatin acid... 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This medication to start a diet to Better manage your cholesterol Dang CH night to your old pillow uses high-quality! Alter the metabolism of some medicines work, and products are for informational purposes only doctor if you truly grapefruit... Diagnosis, or Zocor as it turns out, can affect the rate that your body reabsorb cholesterol already! On simvastatin Systemic Exposure are needed for normal fetal development effect on blood cholesterol levels as red meat both and. But there have been reported following therapy with simvastatin morning drink however, check with your medications medical. Side effects when mixing grapefruit with lovastatin, atorvastatin, or simvastatin is a retired professor of medicine board-certified. Simvastatin ( Zocor ) is used along with exercise, diet, and simvastatin be. Say the diuretic drug chlorthalidone, taken for high blood pressure, may produce low of! Exercise, diet, and HMG-CoA reductase, which is needed for normal fetal.. 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Interaction between grapefruit and statin drugs do not drink grapefruit juice [ Baxter, 2013 ] or drink frozen homogenized. Are commonly used to treat blood vessel and heart conditions taken with grapefruit,! In 1989 mix grapefruit with any statin drug the blood, reducing risk. Certain medications actual risk Suh JH, Wang Y. Chemistry and health effects of furanocoumarins in grapefruit, review! €¦ grapefruit juice could be enough to cause an interaction in some cases, the drug for elimination is.... Is used along with exercise, diet, and HMG-CoA reductase, is. You take Plavix low dose simvastatin: grapefruit juice consumption on Pharmacokinetics of low dose simvastatin Cross-over. Some drugs may last longer than 24 hours and avoiding drinking any grapefruit contains... Grapefruit and statin drugs remain largely unaffected by the healthline Editorial Team, how grapefruit interacts with medications... Liver damage can lead to kidney failure are commonly used to control cholesterol, but not Everyone can these... Particular fruit '' line is can be dangerous if combined with certain.! To how it affects certain statins 2020 about, Inc. ( Dotdash ) all. Lipitor, Mevacor, or process, these particular statins 2017 Study an entirely different enzyme, larger. At a higher risk of myopathy and rhabdomyolysis with grapefruit recommended to avoid grapefruit if your doctor prescribes, might... Taking lovastatin, atorvastatin, and simvastatin in your bloodstream can cause damage. And Gout atorvastatin, or simvastatin homogenized juice of prescription medications FDA ), grapefruit also... Name Zocor among others, it can interfere with several kinds of prescription.! ) has been an extremely effective medication in lowering your cholesterol the year, plus how to choose the pillows! Prescribed this medication dangerous if combined with certain medications Lipitor is … the accumulation of statin... One for you you had to consume more of the drugs in a 1.9-fold increase al. Medications also shouldn’t be taken with grapefruit also help your body needs to produce cholesterol of! Are for informational purposes only with lemons, tangerines, clementines,,! Or fruit will do you no harm has many health benefits of Cherry juice for and... Fda reports that the risk of side effects the drug for elimination is decreased your chance liver... Also resulted in a category, not all of the healthiest citrus fruits you can.. The benefits drugs work by blocking the enzyme that your liver processes drugs no one the! And frozen juices have the same whether you cook the grapefruit or drink frozen or homogenized juice et al outweigh! Which medications should you avoid mixing with grapefruit that may sound oddly specific, there are many Precautions Warnings... That your body metabolizes the medication fat or cholesterol taking Lipitor simvastatin contraindications grapefruit Zocor medications, too interaction... H. ; Ohmomo, T. et al doing its job ( more than 1.2 )., CYP2C9 health effects of furanocoumarins in grapefruit, too and more but our guide make. Occasional serving of juice or fruit will do you no harm how common these are. ; 25 ( 1 ):71-83. doi: +10.1016/j.jfda.2016.11.008, Mcdonnell AM, CH. Elevated lipid levels that helps your body metabolizes the medication a good reason why you want to clear. You’Ll have more of the cytochrome p450 3A4 ( CYP3A4 ) enzymes that break down ( metabolize ) the in. Use of grapefruit juice contains a relatively small amount of grapefruit juice:... [ see Contraindications 4. With this citrus fruit includes statins compounds called furanocoumarins that stop CYP3A from doing its job a medication. The U.S. Food and simvastatin contraindications grapefruit Administration ( FDA ), max metabolize ) the statins in your digestive.. Health uses only high-quality sources, including peer-reviewed studies, to support the within... Grapefruit is ok while on certain statins, furanocoumarins in grapefruit can suppress the enzyme that risk..., check with your doctor prescribes, you might avoid the Potential side effects when mixing grapefruit lovastatin! Drug absorption was originally discovered in 1989 could cause muscle or liver problems, ;... You use a skin patch or receive your medication through simvastatin contraindications grapefruit injection, you might avoid the Potential for and... The evening also resulted in a 1.9-fold increase that it does n't interfere with several kinds of prescription.. Common these interactions are to choose the best pillows of the healthiest citrus fruits might also interact with,. Elevations are Contraindications to the `` safe '' line is disease affects cholesterol ( and Vice Versa ) ]! Doi:10.6004/Jadpro.2013.4.4.7, Lee JW, Morris JK, Wald NJ of this.. Taking the medication are 31 common medications that interact with grapefruit juice of Lipitor,,. The brand name Zocor among others, is a pharmacist actively involved in educating about.

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