Q. I have gotten conflicting information from my doctor, a couple of pharmacists and patient information inserts about how to avoid interactions between statins and grapefruit:
Don't take the medication with grapefruit juice.
Don't have grapefruit products at the same time of day as a statin.
It’s OK to have grapefruit products after, but not before, a statin.
Don't have more than 1 quart (though one said 8 oz.) of grapefruit products a day.
Don't have any grapefruit products at all while taking statins.
This warning applies to other citrus products beside grapefruit.
I hope you can clarify this. I have been avoiding grapefruit (though not other citrus) completely, and would like to be able to eat it again if it is safe to do so.
A. Certain cholesterol-lowering drugs such as atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) interact with compounds in grapefruit and its juice. These natural chemicals can slow the rate at which the drugs are processed by the body. This may result in a higher blood level of the drug and consequently a greater risk of side effects.
Only grapefruit and bitter orange (not regular oranges) contain the active compounds. The enzymes that are affected may show changed activity for more than 24 hours after a person drinks a glass of juice, so the idea that one could have grapefruit for breakfast and take a pill before bedtime is mistaken.
Some people are far more susceptible to this effect than others. We are sending you our Guides to Grapefruit Interactions and Cholesterol-Lowering Drugs for lots more information on the interaction and on statin drugs that are not affected by grapefruit.