If you’ve been looking to adopt a more heart-healthy diet, grapefruit may be near the top of your list for breakfast options. But if you’re using certain statins to keep cholesterol down, it could be a dangerous mistake.
Statins are broken down (metabolized) in your intestines by an enzyme called CYP3A. It naturally lowers the dosage entering the bloodstream, and your prescribed dosage takes this account.
Grapefruit, however, can shut CYP3A down. Grapefruit juice, in particular, is high in a compound called furanocoumarins that stops CYP3A from working effectively. This can throw dosing out of whack and lead to it being much more potent than intended.
In some cases, it can even be toxic.
Not all statins are affected the same way, so your grapefruit intake could be just fine. It all depends on what you’re taking. The statins where grapefruit can have a significant effect are:
- Atorvastatin (Lipitor)
- Lovastatin (Mevacor)
- Simvastatin (Zocor)
And the ones where it has little to no effect are:
- Fluvastatin (Lescol)
- Pitavastatin (Livalo)
- Pravastatin (Pravachol)
- Rosuvastatin (Crestor)
There are a few things to keep in mind. First is that regardless of the statin you are on, it is likely safer to eat grapefruit than drink grapefruit juice because of furanocoumarin concentration and absorption. Juice hits a lot harder.
And it’s also possible that it is safe to drink a small glass of grapefruit juice. Research has shown it becomes dangerous when larger amounts, like a quart, are consumed.
There is also research suggesting that grapefruit’s benefits to heart health outweigh the potential risks of mixing it with statins.
So, you may not necessarily have to give up the benefits of grapefruit altogether, just closely monitor intake. Elect to eat it instead of drinking juice for maximum benefit and lowest risk.
To be safe, consult your doctor, and always avoid taking your medication while eating grapefruit.