Yes, grapefruit juice is rich in vitamins and nutrients. For many, a glass of grapefruit juice is a healthy way to start the day. However, if you are taking certain medications, such as certain heart medications called statins, you should avoid drinking grapefruit juice while taking these medications.Grapefruit juice inhibits the body’s ability to break down these drugs, which can lead to adverse effects.
Grapefruit juice and certain statins should not be mixed
Grapefruit juice should not be combined with certain statins (used to treat high cholesterol) such as Lipitor (atorvastatin), mevastatin (lovastatin), and Zocox (simvastatin). Grapefruit juice inhibits enzyme systems that help break down dozens of medications, including Lipitor, Mevacor, and Zocor.
If you drink grapefruit juice while taking any of these drugs, too much of the drug’s active ingredient may enter your bloodstream. This can lead to adverse effects, such as dangerous muscle disease or liver damage. More specifically, grapefruit juice inhibits P450, the liver enzyme system that breaks down drugs.
By messing with this liver enzyme, more of the active ingredient can affect your body. In other words, the effects of statins increased in people who drank grapefruit juice. Side effects of statins include muscle and liver damage. Cytochrome P450 enzymes are stored in the endoplasmic reticulum of cells not only in the liver, but also in the kidneys, gastrointestinal tract and lungs.
These P450 enzymes break down drugs by oxidizing them. In addition to grapefruit juice, more specifically the furanocoumarins in grapefruit juice, other substances inhibit cytochrome P450 enzymes, including cimetidine (a histamine blocker used to treat gastroesophageal reflux disease) , erythromycin (an antibiotic), and isoniazid (a drug used to treat tuberculosis).
Keep in mind that there are several other drugs that can be confused with cytochrome P450, so discuss with your doctor if you have any questions about potential interactions. Your doctor should also check whether the medications you are taking have adverse interactions with each other or with your diet.
How long you take one of these drugs and how long you eat grapefruit or drink grapefruit juice does not reduce your risk of a drug-related adverse reaction — an interaction that can occur up to three days after consuming grapefruit. This means you can’t drink grapefruit juice in the morning and take your medicine later in the day.
You have several options:
- You can eliminate grapefruit from your diet and replace it with other fruits and juices, or
- If you want to continue consuming grapefruit products, talk to your doctor about using alternative medicines.
Several of the available statins do not interact with grapefruit juice and are safe to use.These include:
- Crestor (rosuvastatin)
- Lescol (fluvastatin)
- Pravastatin (pravastatin)
If you have any questions about grapefruit juice drug interactions, discuss these issues with your doctor. Remember, your doctor is a good source of information to help guide you through your treatment and work to ensure your health.
Frequently Asked Questions
Does Lipitor have a grapefruit warning?
Yes, you should not eat grapefruit or drink grapefruit juice while taking Lipitor (atorvastatin). Compounds in grapefruit can interact negatively with certain statins, including Lipitor, Altoprev (lovastatin), and Zocor (simvastatin).
What happens if I eat grapefruit while taking Lipitor?
Grapefruit should not be eaten while taking Lipitor because it can cause dangerous interactions. Grapefruit contains a substance called furanocoumarin, which interferes with liver enzymes that break down drugs. As a result, blood levels of the active pharmaceutical ingredient become dangerously elevated, which can lead to serious muscle disease or liver damage.
What medicines should not be mixed with grapefruit?
Avoid eating grapefruit or drinking grapefruit juice if you take any of the following medicines:
- Adalat CC (nifedipine), a high blood pressure medication
- Allegra (fexofenadine), an antihistamine
- Buspar (buspirone), an anti-anxiety medication
- Cordarone (amiodarone), an arrhythmia drug
- Entocord EC (budesonide), a corticosteroid
- Lipitor (atorvastatin), a statin
- Mevacor (lovastatin), a statin drug
- Neoral (cyclosporine), an organ transplant anti-rejection drug
- Procardia (nifedipine), a high blood pressure drug
- Pacerone (amiodarone), an arrhythmia drug
- Sandimmune (cyclosporine), an organ transplant anti-rejection drug
- Uceris (budesonide), a corticosteroid
- Zocor (simvastatin), a statin drug