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Food and medicine interaction

Grapefruit and grapefruit juice and some statins, such as simvastatin (Zocor) and atorvastatin (Lipitor)

EstablishedEvidence level: established. Shown in drug labeling or in controlled studies in people.

Last reviewed

What can happen

Grapefruit can let more of the statin into the bloodstream. FDA warns that with a lot of grapefruit juice, too much of some statins may stay in the body, raising the risk of muscle and liver damage.

Why it happens
Grapefruit blocks CYP3A4, an enzyme in the small intestine that normally breaks down part of the dose before it is absorbed.
At ordinary food amounts
Ordinary amounts can matter: FDA says the effect depends on the person, the drug and how much juice you drink, and the drug label or your pharmacist will say how much, if any, is allowed.

What to do

Ask your pharmacist whether your particular statin is affected; not all are. Do not stop or switch a statin on your own; your prescriber can choose one that grapefruit does not affect.

Never stop or change a prescribed medicine without talking to the prescriber.

Common questions

Can I have grapefruit and grapefruit juice while taking statins?

Ask your pharmacist whether your particular statin is affected; not all are. Do not stop or switch a statin on your own; your prescriber can choose one that grapefruit does not affect. Ordinary amounts can matter: FDA says the effect depends on the person, the drug and how much juice you drink, and the drug label or your pharmacist will say how much, if any, is allowed.

Sources

  1. U.S. Food and Drug Administration. Grapefruit Juice and Some Drugs Don't Mix (consumer update).
  2. MedlinePlus (U.S. National Library of Medicine). Simvastatin: drug information.
  3. Bailey DG, Dresser G, Arnold JM. Grapefruit-medication interactions: forbidden fruit or avoidable consequences? CMAJ. 2013. PMID 23184849.

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