But, not all statins are affected. Furthermore, product manufacturers are reluctant to disclose ingredients of popular sodas, which makes it difficult for pharmacists and patients to determine interactions. What is atorvastatin (Lipitor)? The list of potential adverse effects from statins includes: In rare cases, the interaction between grapefruit and some members of the statin class can be serious, including muscle breakdown (rhabdomyolysis), which can lead to permanent kidney injury or even death. But grapefruit is usually eaten in the morning, and the morning is the best time of day to take simvastatin. Here are examples of some types of drugs that grapefruit juice can cause problems (interact) with: Some statin drugs to lower cholesterol, such as Zocor (simvastatin) and Lipitor (atorvastatin). 8600 Rockville Pike Can Statins Increase Lung Cancer Survival? 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. Did you know that Fresca (soft drink) is bad for people who take. | Other grapefruit-drug interactions. Some statins Statins are first-choice options for treating high cholesterol. This lowers your bodys overall levels of low-density lipoprotein (LDL) cholesterol levels. If you have been prescribed a statin drug to treat high cholesterol, your healthcare provider or pharmacist may have advised you to avoid grapefruit or grapefruit juice while on treatment. Praluent vs Repatha: What's the difference? 1 One of the key risk factors for ED is high cholesterol. If you're taking a statin, you may need to avoid grapefruit and grapefruit juice but it depends on what kind of statin you're taking. 2023 SingleCare Administrators. High cholesterol and high blood []. Statin medications that should NOT be taken with grapefruit are: Other common statins, including fluvastatin (Lescol XL), pitavastatin (Livalo); pravastatin (Pravachol); rosuvastatin (Crestor, Ezalor), do not have any interactions with grapefruit. H&H Publications. Get a better understanding of how having high cholesterol increases your chances of hypertension, or high blood pressure. In contrast, our study identified 5 products that contain grapefruit juice and did not have grapefruit listed in the product name. This warning has led to a lot of questions from people taking this type of medication. Increasing a drug's bioavailability from 5% to 10% will double its concentration in the body, making it more powerful than it's meant to be, resulting in a risk for new or worsened side effects. The published case study of tacrolimus and SunDrop17 appears to indicate that the potential exists for significant interaction, although a controlled pharmacokinetic study18 failed to support this hypothesis. The goal was to identify those products that might serve as hidden sources of dietary grapefruit intake, increasing a transplant patients risk for drug interactions. , a once-daily glass of grapefruit juice raised simvastatin and lovastatin blood levels by about 260% when taken at the same time. How this translates to the "safe" consumption of grapefruit remains unclear. What other drugs interact with grapefruit? Pharmacy Times. Don't take these interactions lightly. The mean values ranged from 3% to 11% of the corresponding water value. Similar to how it affects certain statins, furanocoumarins in grapefruit can suppress the enzyme that helps your body process these medications. The generic version of Lasix, furosemide, costs $19 without insurance. The purpose of this study was to compile a comprehensive list of popular beverages manufactured in the United States that contain or possibly contain grapefruit constituents. Symptoms of ED include. This may cause certain side effects and affect how well the drug works. Green tea or green tea extracts may also increase blood levels of simvastatin in some people. Digestive problems. Can I eat an occasional grapefruit while taking atorvastatin? Accessed May 18, 2022, at http://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/food-and-nutrition/faq-20057918. But grapefruit's reputation for interfering with some medications is well-deserved. Products that possibly contained grapefruit were defined as those that had a listing of citrus flavors or ingredients that were unable to be confirmed or discounted as grapefruit or grapefruit extract. Statins help decrease these risks by slowing the buildup of plaque. When statin takers eat large amounts of grapefruit, the level of statins in their blood can increase, raising the possibility of side effects. Taking your statin medication at a certain time of day can make the medication more effective. High blood pressure and high blood cholesterol are among the most significant risk factors for developing heart disease. Why do you have to avoid grapefruit when taking Latuda? If you have doubts or questions, talk to your doctor about the risks of mixing medications and grapefruit. How What Youre Eating Could Be Affecting Your Medications. If . Studies with these fruits are not as frequent, so their risk level is not fully known. Can I drink grapefruit juice with simvastatin? Grapefruit juice affects certain statins more than others. Grapefruit contains compounds called furanocoumarins that block the effects of CYP3A4 an enzyme in the wall of your small intestine that breaks down certain substances, including simvastatin. This is an issue only for lovastatin (Mevacor) and simvastatin (Zocor, or Vytorin) and typically is only problematic at the highest dosages. Get the latest in health news delivered to your inbox! Grapefruit Juice and Statins. This compound deactivates the CYP3A4 enzyme that the body uses to metabolize, or process, these particular statins. This study found that there was no significant alteration in cyclosporin concentrations. Statins are a certain type of drug that might interact with grapefruit. Statins and Testosterone. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, andmore. Accessibility If you truly love grapefruit and can't do without it, ask your healthcare provider about switching to another statinor lowering your dose. If you eat grapefruit while taking atorvastatin, simvastatin, and lovastatin, you may have elevated side effects - but generally arent in any immediate danger to your health. The beverage product review resulted in several products that contained verifiable amounts of grapefruit or grapefruit extract (Table 2). 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. What should you know about "Statin" Medications? (2017). The CYP 450 system is a diverse family of over 60 enzymes that function to catalyze the oxidation of organic substances. While many medications dont react at all to eating grapefruit or drinking grapefruit juice, statins, medications that are prescribed to lower cholesterol, do have serious interactions with grapefruit. To continue reading this article or issue you must be a paid subscriber. Published Online Dec 1, 2005. They can reduce your LDL cholesterol by around 30%, sometimes even 50% with high doses. 1. These briny snacks may help with gut health, weight loss, and more, To improve kidney health, youll need to monitor your sodium, phosphorus, and purine intake, Heres are some signs that your medication dose might be too high. Ill discuss how statins work, and discuss any other interactions they might have with other drugs or foods. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036. December 26, 2022 Saved Stories Roughly a century ago, a new fad diet began to sweep the United States. Eur J Drug Metab Pharmacokinet. Plus, get a FREE copy of the Best Diets for Cognitive Fitness. These include: This is because the two drugs are broken down by an entirely different enzyme known as CYP2C9. What happens if you eat grapefruit while on statins? Pravastatin is metabolized by yet a different mechanism. The plaque build-up also increases your risk of cardiovascular disease, heart attack, stroke, and other health problems. Green tea contains catechins and other antioxidant compounds that seem to help lower "bad" LDL and total cholesterol levels. Our expert explains if grapefruit is safe to mix with your statins. Read our. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. This includes a rare but serious condition called rhabdomyolysis, in which muscle tissue breaks down and releases proteins and electrolytes into the blood. Food-drug interactions precipitated by fruit juices other than grapefruit juice: An updated review. These fruits also contain furanocoumarins and may cause the same interactions as grapefruit. The well-documented interaction between grapefruit and grapefruit-containing products and certain medications has been attributed to several different potential mechanisms of interaction. In fact, studies have shown greater reductions in cholesterol levels when taking statins and grapefruit together. Do your statins and grapefruit safely mix? When grapefruit and certain statins are both consumed, the level of statins in the blood can increase. Focus was placed on citrus-flavored soft drinks, teas, and juice products and their impact on a patients immunosuppressant regimens. However, check with your doctor if you experience ill effects, since its unclear how common these interactions are. Epub 2018 Feb 15. Foods to Avoid, Cholesterol is a wax-like substance found in your blood. In this article, well discuss the causes, risks, and symptoms of having cholesterol levels that are too low. In some cases, the fruit can block enzymatic action and increase the concentration of the drug. (2013). I like to drink grapefruit juice but hear that it can interfere with some prescription medications. Here are 31 common medications that interact with. They prevent your body from making more cholesterol. Grapefruit and grapefruit juice can cause too much or too little of a drug to stay in the body. HHS Vulnerability Disclosure, Help Because there are wide variations among individuals, it is best to avoid grapefruit and grapefruit products while you are taking simvastatin. The interaction between grapefruit-containing beverages and immunosuppressants is not well defined in the literature. The interference of intestinal cytochrome P-450 (CYP 450) enzymes by grapefruit furanocoumarin derivatives is currently accepted as the primary mechanism of interaction.1 The CYP 450 3A4 enzyme is an isoform of the CYP 450 system. However, most healthcare providers still recommend that you avoid combining grapefruit and statins until more research is done. This can cause the arteries to narrow and become less flexible, which is a condition called atherosclerosis that increases the risk of heart attack, stroke, coronary artery disease, and other heart problems. Learn why you should take some statins at night. Statin drugs, also known as HMG-CoA reductase inhibitors, work by blocking the enzymethat your body needs to produce cholesterol. If you cant avoid grapefruit, talk to your doctor about, other options for lowering your cholesterol, . This can lead to more statin side effects, like muscle pain and possible muscle breakdown ( rhabdomyolysis ). There are several studies about grapefruit and statin interaction, and recent ones suggest that moderate grapefruit consumption can be compatible with taking lovastatin and other statin drugs. Since the effects of the citrus juice last more than 24 hours, simply taking your meds at a . and transmitted securely. Some statins can also reduce the effectiveness of certain antihistamines, including fexofenadine (Allegra). The compound hinders this enzyme, creating larger amounts of drugs in your bloodstream. Hermann M, Asberg A, Reubsaet JL, Sather S, Berg KJ, Christensen H. Intake of grapefruit juice alters the metabolic pattern of cyclosporin A in renal transplant recipients. The site is secure. out of the bloodstream, and the amount of LDL cholesterol in the blood decreasesreducing plaque build-up in the arteries and lowering the risk of heart disease and other related medical conditions. Inclusion in an NLM database does not imply endorsement of, or agreement with, This study was conducted to investigate possible sources of grapefruit juice or grapefruit extract in common US-manufactured beverages. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. When to Take Atorvastatin: Morning or Night? If youre prescribed a statin, its important to understand which ones can interact negatively with grapefruit and grapefruit juice. Neurological side effects include confusion and memory loss, according to the Mayo Clinic. Grapefruit isnt the only fruit that should be avoided while taking statins. The list of potential adverse effects from statins includes: In rare cases, the interaction between grapefruit and some members of the statin class can be serious, including muscle breakdown (. Seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark-colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. However, grapefruit can negatively interact with certain medications. Immunosuppressant medications that have the potential for significant interactions with grapefruit and grapefruit-containing products4-18. Do your statins and grapefruit safely mix? Kurata, M.; Hagiwara, H.; Ohmomo, T. et al. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. From the 3 major beverage manufacturers in the United States (Coca Cola, Pepsi Cola, Dr. Pepper/7-Up),19-21 23 beverages were identified that contained grapefruit; of these, 5 did not contain the word grapefruit in the product name. What is the difference between Leqvio and Repatha? Additionally, medications used to treat these comorbidities can lead to drug interactions, which can also cause side effects. Can you use limes or lime juice while taking statin drugs (i.e. 2012. If youre interested in taking an OTC product to help lower your cholesterol, its important to do [], One in three adults in the United States has high cholesterol, and more than 60% of adults with high cholesterol dont have the condition under control. A more reasonable level of grapefruit and grapefruit juice consumption has been shown to result in far less effect on statins, he says, adding that patients should still talk with their doctor before eating grapefruit if they take statins. The use of statins for the primary and secondary prevention of atherosclerotic vascular disease has an extensive evidence base and has been proven repeatedly to reduce cardiac events and mortality . How does food interact with your medications? Avoid a second heart attack if they have cardiovascular disease. And Ill overview the other medications that grapefruit has an effect on, as well. Eating grapefruit may negatively interact with certain statin drugs, such as atorvastatin, lovastatin, and simvastatin. Lipitor (atorvastatin): The activity starts within hours of ingestion but the maximal lowering of lipids takes weeks to equilibrate. For this reason, you might avoid the fruit altogether. The effect of grapefruit juice on cyclosporine and prednisone metabolism in transplant patients. If taken 12 hours apart, that drops to between 44 percent and 66 percent. LDL cholesterol is often referred to as "bad cholesterol", and statins reduce the production of it inside the liver. Statins are medications that reduce the inflammation in your artery walls that can lead to blockages that damage your organs. Q: I've heard that people shouldn't drink grapefruit juice if they're taking a statin. Statins are a common medication to lower cholesterol levels. Conflicting evidence was reported in a randomized, 4-way crossover study with a 1-week washout period that studied changes in cyclosporine concentrations due to citrus sodas.18 In the study, 12 healthy volunteers received a single oral dose of cyclosporine with 591 mL of SunDrop, Fresca, grapefruit juice, or water (control). Telephone calls were made to each manufacture to identify beverages that contained grapefruit or grapefruit extract. But the first step in [], Lower cholesterol is usually better than high cholesterol. Many such products contain juice and rely on artificial fruit flavoring for their citrus taste. How Much Cholesterol Should You Have Per Day? Created for people with ongoing healthcare needs but benefits everyone. 2006 Apr;34(4):521-3. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. https://medlineplus.gov/druginfo/meds/a600045.html. doi: 10.1016/j.jfda.2018.01.009. 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