Grapefruit and cholesterol8/13/2023 ![]() 2 They note that a meta-analysis 3 in 2003 estimated that 40 mg of simvastatin reduces low-density lipoprotein (LDL) cholesterol by 37%, but double this dosage and LDL drops by 43%. 2ĭespite the fact that the studies examining possible cause-and-effect relationships between statins and muscle necrosis were characterized by large doses of grapefruit juice, 2 a universal prohibition followed nonetheless: No grapefruits or grapefruit juice for users of atorvastatin, simvastatin, or lovastatin!įast-forward to 2016, where a Top Paper by Lee, Morris, and Wald reframes the grapefruit-statin interaction. 2 Drinking grapefruit juice with lovastatin, simvastatin, or atorvastatin also may induce rhabdomyolysis, a complication related to statin use in certain individuals (incidence of 4 per 100,000 person-years with these 3 statins). 2 Taking atorvastatin with grapefruit juice, for example, increases this statin’s blood level 1.8 times. Furanocoumarins in grapefruit juice inactivate CYP3A4, the enzyme responsible for metabolizing lovastatin, simvastatin, and atorvastatin (but not fluvastatin, rosuvastatin, or pravastatin). Later, grapefruit products were found to increase levels of many other drugs, including statins. Felodipine concentrations in the patients’ blood increased. In an experiment designed to determine the effect of ethanol on felodipine levels, 1 researchers used grapefruit juice to mask the taste of alcohol. Prescription drugs and grapefruit a “deadly mix.” (2012).cc.nih.gov/ccc/patient_education/drug_nutrient/grapefruit1.pdf NIH Clinical Center patient education materials: Important drug and food information.Statins: Are these cholesterol-lowering drugs right for you? /diseases-conditions/high-blood-cholesterol/in-depth/statins/art-20045772 Statin side effects: Weigh the benefits and risks. ![]() Effect of low furanocoumarin hybrid grapefruit juice consumption on midazolam pharmacokinetics. ![]() heart-health/grapefruit-juice-and-statins fda.gov/forconsumers/consumerupdates/ucm292276.htm
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