Could Pomegranate Juice React Badly with Crestor?

Do you know which foods might react badly with your medications? You might not, especially if your pharmacist didn’t give you specific information. When you look online, you can find conflicting information, especially with regard to beverages like cranberry or pomegranate juice. What’s the straight and skinny on how these drinks interact with the cholesterol-lowering drug rosuvastatin?

Are There Foods That React Badly with Crestor?

Q. I took Crestor for three years. All was well until I started taking my daily meds with pomegranate juice.

Then I developed cramps and muscle pain. It was awful until I discovered pomegranate acts like grapefruit with a statin. I stopped the Crestor and slowly my aches reduced.

A. Rosuvastatin (Crestor) is a statin-type cholesterol-lowering medication. Other statins (atorvastatin and simvastatin) are metabolized by the CYP3A4 enzyme. Grapefruit juice inhibits this enzyme and can raise blood levels of these drugs (American Journal of Cardiovascular Drugs, vol. 4, no. 5, 2004).  However, it should have no effect on the blood level of rosuvastatin.

Grapefruit Juice Doesn’t Affect Crestor:

Rosuvastatin is metabolized by a different intestinal enzyme, CYP2C9. Although pomegranate juice inhibits 2C9 activity in the laboratory, it doesn’t seem to have much effect on blood levels of the drugs that have been studied (Journal of Clinical Psychiatry, April 2014; European Journal of Drug Metabolism and Pharmacokinetics, June 2017). We don’t think you should worry that it will react badly with Crestor.

Consequently, it isn’t clear that pomegranate juice was the factor that triggered your symptoms. This interaction has not been well studied. Rosuvastatin alone can result in muscle pain for some people, and perhaps that is what you experienced (Pharmacology Research & Perspectives, Nov. 7, 2018). You should let your doctor know about this experience, as you may need to continue with a strategy to reduce your risk of heart disease.

We discuss statin drugs and other ways to lower blood lipids in our eGuide to Cholesterol Control and Heart Health. You may also be interested in our free eGuide to Drug & Food Interactions.