Table of ContentsView AllTable of ContentsThe ConcernRisksSafety and ConsiderationsOther DrugsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
The Concern
Risks
Safety and Considerations
Other Drugs
Frequently Asked Questions
Arda Mutlu / EyeEm / Getty Images
The problem with furanocoumarins is that they deactivate an enzyme in the liver and intestines known as cytochrome P4503A4 (CYP3A4),which the body uses to break down certain drugs so that they can be excreted from the body. When this happens, the drug concentration can increase dramatically and, with it, the risk of side effects.
The abnormal accumulation of atorvastatin, lovastatin, or simvastatin in the blood can lead to a rare butpotentially serious side effect calledrhabdomyolysis, a breakdown of muscle tissue that can lead to kidney failure and death
What Are the Side Effects of Statins?
There is a popular assumption that grapefruit may be safe if eaten before or aftera dose of Lipitor, Mevacor, or Zocor. At present, no one really knows where the “safe” line is.
How this translates to the “safe” consumption of grapefruit remains unclear. Most healthcare providers will tell you that an occasional serving of juice or fruit will do you no harm. Most evidence suggests that serious problems are more likely to occur if you consume large quantities over an extended period of time.
Limit your consumption of grapefruit or switch to “safe” citrus fruits, such as blood oranges, clementines, lemons, limes, mandarins, navel oranges, and tangerines. Bitter oranges,pomelos, tangelos, and Seville oranges contain high levels of furanocoumarin and should also be avoided.
These include:
Speak with your healthcare provider or pharmacist if you regularly consume grapefruit to ensure that it doesn’t interfere with your medications.
A Word From Verywell
If you truly love grapefruit and can’t do without it, ask your healthcare provider about switching to another statin or lowering your dose. If you consume grapefruit every now or then, it is unlikely to do any real harm. What is most important is that you avoid the regular consumption or overconsumption of furanocoumarin in any form. Switch to oranges or other safe fruits and save grapefruit for special occasions.
Grapefruit contains a compound known as furanocoumarin, which deactivates an enzyme that breaks down certain drugs, including statins. As a result, the drug concentration increases dramatically. This can cause a rare but serious condition that causes breakdown of muscle tissue and can lead to kidney failure.
Grapefruit and grapefruit juice can negatively interact with medications in several different classes. However, not all drugs in each class of medications are affected. Some of the drugs that interact with grapefruit include:Allegra (fexofenadine), an allergy medicationAmiodarone, a heart arrhythmia drug sold under the brand names Pacerone and CordaroneBudesonide, a corticosteroid sold under the brand names Entocord EC and UcerisBuspar (buspirone), an anti-anxiety medicationCyclosporine, an organ-transplant anti-rejection drug sold under the brand Ames Neural and SandimmuneLipitor (atorvastatin), a statinNifedipine, a high-blood-pressure medication sold under the brand names Procardia and Adalat CCZocor (simvastatin), a statinIf you are uncertain whether or not you can eat grapefruit with a medication you are currently taking, read the label that came with the medication or talk to your pharmacist.
Grapefruit and grapefruit juice can negatively interact with medications in several different classes. However, not all drugs in each class of medications are affected. Some of the drugs that interact with grapefruit include:
If you are uncertain whether or not you can eat grapefruit with a medication you are currently taking, read the label that came with the medication or talk to your pharmacist.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hung WL, Suh JH, Wang Y.Chemistry and health effects of furanocoumarins in grapefruit.J Food Drug Anal. 2017;25(1):71-83. doi:+10.1016/j.jfda.2016.11.008Mcdonnell AM, Dang CH.Basic review of the cytochrome p450 system.J Adv Pract Oncol. 2013;4(4):263-8. doi:10.6004/jadpro.2013.4.4.7Lee JW, Morris JK, Wald NJ.Grapefruit Juice and Statins.Am J Med. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036Cleveland Clinic.Do your statins and grapefruit safely mix?US Food & Drug Administration.Grapefruit juice and some drugs don’t mix.Harvard Health Letter.Grapefruit juice and statins.Additional ReadingKurata, M.; Hagiwara, H.; Ohmomo, T. et al.Effects of Grapefruit Juice Consumption on Pharmacokinetics of Low Dose Simvastatin: Cross-over Study with a Review of the Literature.Med Chem.2012:2:048-050. DOI: 10.4172/2161-0444.1000113.Lee, J.; Morris, J.; Wald, N. et al.Grapefruit Juice and Statins.Am J Med.2016;129(1):26-29. DOI: 10.1016/j.amjmed.2015.07.036.U.S. Food and Drug Administration.Grapefruit Juice and Some Drugs Don’t Mix.Silver Spring, Maryland.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hung WL, Suh JH, Wang Y.Chemistry and health effects of furanocoumarins in grapefruit.J Food Drug Anal. 2017;25(1):71-83. doi:+10.1016/j.jfda.2016.11.008Mcdonnell AM, Dang CH.Basic review of the cytochrome p450 system.J Adv Pract Oncol. 2013;4(4):263-8. doi:10.6004/jadpro.2013.4.4.7Lee JW, Morris JK, Wald NJ.Grapefruit Juice and Statins.Am J Med. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036Cleveland Clinic.Do your statins and grapefruit safely mix?US Food & Drug Administration.Grapefruit juice and some drugs don’t mix.Harvard Health Letter.Grapefruit juice and statins.Additional ReadingKurata, M.; Hagiwara, H.; Ohmomo, T. et al.Effects of Grapefruit Juice Consumption on Pharmacokinetics of Low Dose Simvastatin: Cross-over Study with a Review of the Literature.Med Chem.2012:2:048-050. DOI: 10.4172/2161-0444.1000113.Lee, J.; Morris, J.; Wald, N. et al.Grapefruit Juice and Statins.Am J Med.2016;129(1):26-29. DOI: 10.1016/j.amjmed.2015.07.036.U.S. Food and Drug Administration.Grapefruit Juice and Some Drugs Don’t Mix.Silver Spring, Maryland.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hung WL, Suh JH, Wang Y.Chemistry and health effects of furanocoumarins in grapefruit.J Food Drug Anal. 2017;25(1):71-83. doi:+10.1016/j.jfda.2016.11.008Mcdonnell AM, Dang CH.Basic review of the cytochrome p450 system.J Adv Pract Oncol. 2013;4(4):263-8. doi:10.6004/jadpro.2013.4.4.7Lee JW, Morris JK, Wald NJ.Grapefruit Juice and Statins.Am J Med. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036Cleveland Clinic.Do your statins and grapefruit safely mix?US Food & Drug Administration.Grapefruit juice and some drugs don’t mix.Harvard Health Letter.Grapefruit juice and statins.
Hung WL, Suh JH, Wang Y.Chemistry and health effects of furanocoumarins in grapefruit.J Food Drug Anal. 2017;25(1):71-83. doi:+10.1016/j.jfda.2016.11.008
Mcdonnell AM, Dang CH.Basic review of the cytochrome p450 system.J Adv Pract Oncol. 2013;4(4):263-8. doi:10.6004/jadpro.2013.4.4.7
Lee JW, Morris JK, Wald NJ.Grapefruit Juice and Statins.Am J Med. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036
Cleveland Clinic.Do your statins and grapefruit safely mix?
US Food & Drug Administration.Grapefruit juice and some drugs don’t mix.
Harvard Health Letter.Grapefruit juice and statins.
Kurata, M.; Hagiwara, H.; Ohmomo, T. et al.Effects of Grapefruit Juice Consumption on Pharmacokinetics of Low Dose Simvastatin: Cross-over Study with a Review of the Literature.Med Chem.2012:2:048-050. DOI: 10.4172/2161-0444.1000113.Lee, J.; Morris, J.; Wald, N. et al.Grapefruit Juice and Statins.Am J Med.2016;129(1):26-29. DOI: 10.1016/j.amjmed.2015.07.036.U.S. Food and Drug Administration.Grapefruit Juice and Some Drugs Don’t Mix.Silver Spring, Maryland.
Kurata, M.; Hagiwara, H.; Ohmomo, T. et al.Effects of Grapefruit Juice Consumption on Pharmacokinetics of Low Dose Simvastatin: Cross-over Study with a Review of the Literature.Med Chem.2012:2:048-050. DOI: 10.4172/2161-0444.1000113.
Lee, J.; Morris, J.; Wald, N. et al.Grapefruit Juice and Statins.Am J Med.2016;129(1):26-29. DOI: 10.1016/j.amjmed.2015.07.036.
U.S. Food and Drug Administration.Grapefruit Juice and Some Drugs Don’t Mix.Silver Spring, Maryland.
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