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Are any interactions between grape fruit and Atorvastatin?

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Posted on Mon, 16 May 2016
Question: Dear sir,
My cholesterol is too high and my Doctor told me to take atorvastatin 40 mg daily. I checked the web site and it sounds so bad, so I am not going to take it. I am eating the red grape fruits every day. If I take the statin medication I can not eat the grape fruits. I want to solve the cholesterol problem less side effects. Please give me your wonderful advice.

Thank you so much for your help.

XXXXX
doctor
Answered by Dr. Ilir Sharka (29 minutes later)
Brief Answer:
I would recommend taking fluvastatin.

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

It is true that grapefruit will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

This means that it can lead to adverse effects of atorvastatin like muscle cramps.

I would recommend trying fluvastatin 20-40mg/day, which is a statin that does not interact with grapefruit. You can take as much grape fruit as you like, while on fluvastatin and nothing will happen, as it is safe.

Besides, I would recommend some tips to reduce your cholesterol levels:

-avoid saturated fat (like red meat, butter,etc.) and take a lot of omega 3 fatty acids (present in fish, fish oil, nuts, olive oil, etc.).
-perform a lot of physical activity (walking, jogging, yoga, etc.)
-reduce your weight if you are overweight.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (54 minutes later)
Dear Dr. Lliri,

Thank you so much for your wonderful help. It is wonderful, so I can eat the red grapefruit. Can you suggest the better less side effect drugs ? Or natural products which work like the drug ?

May God bless you always,

XXXX
doctor
Answered by Dr. Ilir Sharka (13 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again XXXX!

As I already explained you the best treatment choice for the reduction of cholesterol levels would be fluvastatin. This is just like atorvastatin (the same pharmacological family), but it has no interactions with grapefruit. It acts by lowering your cholesterol levels, thus reducing your future risk for stroke or cardio-vascular events.

Another natural product would be fish oil or omega 3 which you can buy in the supermarket or in the pharmacy.

Here are some food that you can use daily, which are rich in omega 3 acids, and can help you reduce your cholesterol levels:

1- Fish: top source of omega-3 Fatty Acids (Halibut, Herring, Salmon, Sardines, Mackerel, etc.)

2- Dairy and juices fortified With omega-3s (margarine, milk, juice, soy milk,yogurt)

3- Grains and nuts with omega-3s (flaxseed, peanut butter, oatmeal, walnuts, cereals, etc.)

4- Fresh products With aLA omega-3s. (Brussels sprouts, XXXXXXX Mint, Spinach, Watercress, Parsley,etc.)

You should choose to eat these types of foods more in your diet.

And don't forget to do a lot of physical activity. Walking at least 4Km per day would be recommended. Physical activity can reduce in a noticeable way your cholesterol levels and future cardio-vascular risk.

Hope to have been helpful!

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 4275 Questions

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Are any interactions between grape fruit and Atorvastatin?

Brief Answer: I would recommend taking fluvastatin. Detailed Answer: Hello! Welcome and thank you for asking on HCM! It is true that grapefruit will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. This means that it can lead to adverse effects of atorvastatin like muscle cramps. I would recommend trying fluvastatin 20-40mg/day, which is a statin that does not interact with grapefruit. You can take as much grape fruit as you like, while on fluvastatin and nothing will happen, as it is safe. Besides, I would recommend some tips to reduce your cholesterol levels: -avoid saturated fat (like red meat, butter,etc.) and take a lot of omega 3 fatty acids (present in fish, fish oil, nuts, olive oil, etc.). -perform a lot of physical activity (walking, jogging, yoga, etc.) -reduce your weight if you are overweight. Hope you will find this answer helpful! Kind regards, Dr. Iliri