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Interactions

Selected HMG-CoA Reductase Inhibitors/Grapefruit

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug, changing your diet or commencing any course of treatment.

Medical warning:

Very important. A change in your diet, medicine, or dosage may be necessary. Promptly consult your doctor or pharmacist.

How the interaction occurs:

Grapefruit or grapefruit juice can increase the amount of cholesterol medicine that your body absorbs.

What might happen:

The amount of cholesterol medicine in your blood may increase. This may increase your risk of developing serious muscle disorders.

What you should do about this interaction:

While you are taking this medicine, do not eat grapefruit or drink grapefruit juice at any time. You may choose an alternative citrus beverage (such as orange juice). In the event that you are instructed by a healthcare professional (e.g., doctor, pharmacist, or dietitian) to eat grapefruit or drink grapefruit juice, you should immediately discuss with your doctor the effects of grapefruit on the blood levels of this medicine. If you consume grapefruit juice, talk to your doctor about alternative medications.Tell your doctor immediately if you develop muscle aches and pains or an unusual change in your amount of urine. Contact your healthcare professional (e.g., doctor or pharmacist) for more information.Your healthcare professionals may be aware of this interaction and may be monitoring you for it. Do not start, stop, or change your medicine or diet before checking with them first.

References:

1.Bailey DG, Malcolm J, Arnold O, Spence JD. Grapefruit juice-drug interactions. Br J Clin Pharmacol 1998 Aug;46(2):101-10.

2.Kantola T, Kivisto KT, Neuvonen PJ. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther 1998 Apr;63(4):397-402.

3.Choice of lipid-lowering drugs. Med Lett Drugs Ther 1998 Dec 18; 40(1042):117-22.

4.Ando H, Tsuruoka S, Yanagihara H, Sugimoto K, Miyata M, Yamazoe Y, Takamura T, Kaneko S, Fujimura A. Effects of grapefruit juice on the pharmacokinetics of pitavastatin and atorvastatin. Br J Clin Pharmacol 2005 Nov;60(5):494-7.

5.Lilja JJ, Kivisto KT, Neuvonen PJ. Duration of effect of grapefruit juice on the pharmacokinetics of the CYP3A4 substrate simvastatin. Clin Pharmacol Ther 2000 Oct;68(4):384-90.

6.Lilja JJ, Kivisto KT, Neuvonen PJ. Grapefruit juice increases serum concentrations of atorvastatin and has no effect on pravastatin. Clin Pharmacol Ther 1999 Aug;66(2):118-27.

7.Reddy P, Ellington D, Zhu Y, Zdrojewski I, Parent SJ, Harmatz JS, Derendorf H, Greenblatt DJ, Browne K Jr. Serum concentrations and clinical effects of atorvastatin in patients taking grapefruit juice daily. Br J Clin Pharmacol 2011 Sep;72(3):434-41.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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