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Why can people on statins not eat grapefruits ?

Why can people on statins not eat grapefruits?

1 March 2021

Thank you for contacting Health at Hand.

It is known that grapefruits contain a group of chemicals, furanocoumarins, which can alter drug metabolism – the amount of time it takes for a drug to be broken down by the body.

Grapefruit juice may increase the plasma concentrations of atorvastatin and simvastatin  and makes side effects more likely.[1] Atorvastatin interacts with grapefruit juice if you drink large quantities (greater than 1.2 litres daily). Currently it is advised by healthcare professionals that you can drink grapefruit juice if you are using other types of statins.[2] 

The chemical furanocoumarin inhibits an enzyme (cytochrome P450 3A4) that breaks down statins. This can result in more ‘active’ drug to be present in the body than was intended with the prescribed dose therefore triggering unpleasant, and sometimes serious, side effects (e.g. rhabdomyolysis).

Rhabdomyolysis breakdown of muscle fibres - resulting in the release of muscle fibre contents e.g. myoglobin, which breaks down into substances that can damage the kidney - had been reported when atorvastatin was taken with daily grapefruit juice, and when simvastatin was taken when the patient was also eating whole grapefruit daily.

We hope that is of some assistance to you.

Answered by the Health at Hand team.

Further reading

Your questions about statins - AXA Health

Statins: Do the benefits outweigh the risks? - AXA Health

What are the best cholesterol lowering foods - Ask the Expert

How to develop healthy eating habits - AXA Health

Fitting change into your lifestyle - AXA Health

Diet and nutrition hub - AXA Health

Fitness and exercise hub - AXA Health

Statins – NHS factsheet

High cholesterol – NHS Factsheet


[1] NICE, CKS (October 2020) Statins. (Accessed: 1st March 2021).

[2] NHS choices (21 June 2018) Does grapefruit affect my medicine?  (Accessed: 1st March 2021).

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