Lipitor® and grapefruit can create a dangerous combination that can lead to severe problems in some patients, including rhabdomyolysis, liver problems, kidney failure, and sometimes death. It is extremely important for people who take Lipitor®, a brand name of the drug atorvastatin, to abstain from all grapefruit products, including juice and supplements, for the entire time they take the drug. People who need to take a statin drug to help lower their blood cholesterol and do not want to give up grapefruit can discuss other options with their doctors, as not all statin drugs react to grapefruit the way Lipitor® does.
When a person consumes grapefruit or grapefruit juice, specific enzymes in the liver work to metabolize the food or beverage. These enzymes are the same enzymes that process the drug Lipitor® and break it down so there is not too much medication in the patient's body. These enzymes are not able to effectively break down Lipitor® and grapefruit at the same time, so people who consume grapefruit can end up with dangerously high levels of the drug in their systems.
Consuming grapefruit or grapefruit juice at a different time during the day than when the patient takes his or her medication does not make the combination of Lipitor® and grapefruit safe. The liver works to process the drug throughout the day, and it is important to refrain from inhibiting the enzymes from processing the drug. Other juices and fruits do not interact with Lipitor® in this manner.
Combining Lipitor® and grapefruit can lead to serious consequences. Too much of the statin can lead to rhabdomyolysis, a condition that breaks down muscle tissue and releases proteins into the body that the kidneys cannot process properly. This can lead to kidney failure and even death in severe cases. High levels of the drug can also lead to liver problems, including liver failure in some cases.
The chemicals in grapefruit that cause it to be processed by the same liver enzymes as Lipitor® are called furanocoumarins. Researchers at the University of North Carolina-Chapel Hill in the United States identified these chemicals in 2006. Juice companies may use this research in the future to develop a furanocoumarin-free grapefruit juice for patients who take Lipitor®, one of the most widely-prescribed medications in the United States and many other areas of the world.
Zocor®, a brand name of the drug simvastatin, and Mevacor®, a brand name of the drug lovastatin, are other cholesterol-reducing drugs that are broken down by the same enzymes as Lipitor®. Patients who take these medications should also refrain from eating grapefruit. Crestor®, a brand name of the drug rosuvastatin, is a viable alternative for many patients who take statin drugs and do not want to give up grapefruit.