Grapefruit and Lipitor (Atorvastatin)

Grapefruit products, such as grapefruit, grapefruit juice, or grapefruit supplements, can interact with some cholesterol-lowering statins and increase the level of medication in your blood.

Lipitor (atorvastatin calcium) is one of these statins. Grape fruit contains some chemicals with actively interact with statins. Such compounds as naringenin and bergamottin inhibit the enzyme cytochrome P450 (CYP3A4) In addition, grapefruit juice contains antioxidants which lower cholesterol levels and improve the proportion of HDL and LDL lipoproteins. Therefore one grapefruit juice daily contributes to the normalization of cholesterol in the blood. When grapefruit is used with Lipitor, cholesterol levels may become too low than is expected and blood levels of Lipitor can be increased.

This means that the drug stays in your body longer when it interacts with grapefruit. In fact, clinical studies have shown that grapefruit can significantly increase the levels of Lipitor in a person's blood.

In one study, drug levels increased by 83 percent in those who drank grapefruit juice three times a day compared to the people who only drank water.

If you are taking Lipitor, you should not:

• Drink grapefruit juice
• Eat grapefruit
• Use grapefruit supplements.

Doing any of these things can increase the levels of medication in your blood. This can increase your chances of developing serious muscle problems (myopathy or rhabdomyolysis) that can lead to kidney failure and other life-threatening complications. Rhabdomyolysis (myoglobinuria with renal insufficiency) is a syndrome that develops because of damage of skeletal muscle resulting in formation of blood-free myoglobin (mioglobinemiya). Myoglobin is filtered by kidneys and appears in the urine (myoglobinuria), which may lead to the development of acute renal failure.

If you are currently on Lipitor and want to continue eating grapefruit or drinking grapefruit juice, talk to your doctor about other Lipitor alternatives. Several cholesterol drugs do not seem to interact with grapefruit. For example, Crestor (rosuvastatin calcium) does not appear to have any negative interactions with grapefruit products. Unlike other cholesterol-lowering medications Crestor can be used while taking grapefruit products. Their interaction is insignificant and does not affect the effectiveness and safety. Among all statin medications Crestor is the only one drug which can be used in patients taking grapefruit.

Grapefruit juice should not be used with:

• Anxiolytics
• Anti-arrhythmic agents
• Antibiotics
• Anti-histamines
• Blood thinners
• Antiepileptics
• Beta blockers
• Calcium channel blockers
• Hormonal medications
• Antimycotics
• PDE5 inhibitors (such as Viagra, Cialis and Levitra)