Expert: Eric Brandt - 5/5/2007

Question
The question asked by "Cliff" begged clarification of 'avoid grapefruit and grapefruit juice when taking Lipitor'.

Never, same time, same day, etc. Is the grapefruit substance in question systemic or only interact during digestion and uptake of the statin?

Do the grapefruit hybrids such as tangelos carry similar risks?

If grapefruit increase uptake, why are we not lowering the dose of statins to a level where the grapefruit boost is safe and/or beneficial? This could make partial sustitution additionally beneficial beccause of the benefits of eating citrus fruits?  

Answer
Hi John,
The issue with grapefruit and statins is that he grapefruit juice contains a substance which inhibits the metabolism of the statin, effectively simulating a higher dose. Since the consumption of grapefruit is not as consistant as taking the medication you can not lower the dose one day and not the next. Your blood levels are not consistant. Also the extent to which metabolism would be inhibited would depend on the amount of this substance in the fruit or the juice and that amount is not consistant.
It is best to avoid grapefruit at any time while taking the statin.
Thank you for using Allexperts
Sincerely,
Eric Brandt, B.Sc. Pharm