Grapefruit is undeniably healthy -- it’s packed with vitamins, minerals, antioxidants and fiber that  your body needs. As healthy as grapefruit is, people taking certain medications shouldn’t mix grapefruit with their prescriptions. The medications affected by grapefruit include certain statins, which are used to treat high cholesterol. 


Statins are among the most commonly prescribed medications in the world and are used by nearly half of all Americans aged 75 and older and nearly one in five adults aged 40 to 59 also taking the medication. 


Statins are important medications that many people need in order to lower their risk of cardiovascular disease, but when it comes to grapefruit and statins, here’s what you need to know.



What are statins and what do they do?


Statins are prescription medications that are designed to lower total cholesterol levels in the body. High cholesterol levels put people at greater risk for developing cardiovascular disease and experiencing serious health conditions like high blood pressure, stroke, and heart attack. 


Statin medications stop the body from producing additional cholesterol while simultaneously encouraging the body to absorb cholesterol that has built up on the walls of the arteries. Although cholesterol levels can also be lowered by making lifestyle changes such as exercising more, losing weight, quitting smoking, and eating a healthier diet, some people will still need to take medication in order to address their condition. 


Statin medications include:

  • Atorvastatin (Lipitor)
  • Simvastatin (Zocor)
  • Pitavastatin (Livalo)
  • Rosuvastatin (Crestor)
  • Lovastatin (Mevacor)
  • Fluvastatin (Lescol)
  • Pravastatin (Pravachol)



Which statin medications interact with grapefruit?


Not all statins interact with grapefruit. Therefore, it is important to ask your doctor about your specific medication and how it might interact with grapefruit. 


However, if you have been prescribed atorvastatin (Lipitor), lovastatin (Mevacor), or simvastatin (Zocor), you will need to avoid grapefruit, as each of these medications has been found to interact negatively with both grapefruit and grapefruit juice. 


It should also be noted that only oral statins pose the risk of a negative interaction with grapefruit. Statin medications that are received via skin patch or injection do not interact with grapefruit in the same way because they are not processed in the digestive tract, so there is less of a risk of adverse effects from an interaction.



How do statins interact with grapefruit?


Grapefruit and grapefruit juice interact with statins through an organic chemical compound called furanocoumarins. Furanocoumarins are present in many different plants, including grapefruit, and they have the ability to deactivate the CYP3A4 enzyme. 


Although eating grapefruit normally isn’t harmful, people taking certain statins cannot take the medication because the CYP3A4 enzyme is used by the body to process these medications. If the CYP3A4 enzyme is deactivated, the statins cannot be properly broken down by the body, which means that greater quantities of the drug will be absorbed, making the medication more powerful. 


While this might seem like a good thing for people who have high cholesterol, it can make patients more likely to experience side effects of their medication and can also cause liver damage. Statins that do not interact with grapefruit are metabolized by a different enzyme, CYP2C9, that is not affected by furanocoumarins. 



What are the risks of grapefruit and statin interactions?


People who eat grapefruit or drink grapefruit juice while taking atorvastatin, lovastatin, or simvastatin are more likely to experience side effects of their medication. Women aged 65 and older are especially likely to develop side effects from the combination. 


Mild side effects include muscle and joint pain, while more severe side effects include the following:


  • Muscle breakdown
  • Digestive problems
  • Neurological side effects such as confusion and memory loss
  • Liver damage
  • Increased blood sugar


People who experience muscle breakdown and liver damage may experience kidney failure. 





Everyone reacts to the interaction between grapefruit and statins differently, so there is no safe amount of grapefruit consumption that can be recommended. 


Patients experiencing uncomfortable side effects caused by statins may benefit from taking a nutritional supplement designed to support nutrient levels while taking medication






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