Ask A Pharmacist: Grapefruit Juice and Medication

Emailed question: “I love grapefruit! Can you explain why I cannot eat this fruit while I am on Lipitor?”

Lipitor (atorvastatin) belongs to a statin drug class that lowers LDL (bad cholesterol) and elevates HDL (good cholesterol). This medication is eliminated from the body by specific liver enzyme, CYP3A4. Grapefruit (juice or whole fruit) prevents that enzyme from breaking down Lipitor, resulting in higher drug levels in the body that can lead to serious undesirable effect such as muscle pain, soreness or tenderness or worst kidney failure. If you cannot refrain from eating grapefruit, Crestor (rosuvastatin), Pravachol (pravastatin) and Lescol (fluvastatin) are other statins that does not interact with grapefruit or juice. Please speak to your doctor if it will be appropriate for you to switch to another statin.

Note: Seville orange and pomelo are other fruits that prevent drug breakdown from liver enzyme CYP3A4.

The following are other medications that interact with these fruits:
Amiodarone, diazepam, triazolam, budesonide, buspirone, felodipine, nifedipine, carbamazepine, carvedilol, clomipramine, cyclophosphamide, cyclosporin, ergotamine, lovastatin, simvastatin, itraconazole, sildenafil, tadalafil, vardenafil, quinidine, sertraline, sirolimus, tacrolimus, verapamil

For more information, ask a pharmacist at consultpharmacist.com!