Author Topic: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?  (Read 3486 times)

Millet

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Q: I enjoy grapefruit, but have been told to avoid it since I'm taking statins. Why is grapefruit a problem, and is there a way that I can incorporate it into my diet again?

A: Grapefruit contains compounds called furanocoumarins that can affect the rate at which drugs are processed by the liver. If the drug breaks down more slowly, it can accumulate in your bloodstream. This can cause side effects and affect how well the drug works. However, not all statins interact the same way with grapefruit. Zocor and Lipitor have a particularly strong interaction, while Lesco (fluvastatin), Crestor (rosuvastatin) and Pravachol (pravastatin) have little to no effect, according to Harvard Health Publications. The interaction between grapefruit and medications occurs in the digestive tract, so the interaction poses dangers only if taken orally.

Millet 
NOTE: I grow grapefruit and I take Statins. I also like to have grapefruit at breakfast, so I ask my doctor about grapefruit and statin reactions and he switched me to Crestor.  If you take statins and are not sure ask your doctor.
« Last Edit: March 28, 2016, 12:24:33 PM by Millet »

bsbullie

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Millet - my mom takes stantins and loves and eats grapefruit.  Has been eating/taking both for years.  When she asked her doctor, his response was while the literature says you shouldnt consume both however he went on to tell since her numbers and health shows no ill affects...keep doing what you are doing.

My wife is in the same boat.
- Rob

Mark in Texas

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I take a Lipitor generic (Atorvastatin) and do grapefruit either fresh juice or eaten.  Just keep them apart regarding intake timing.  IOW, take your statin wait 30 minutes or so and eat your grapefruit. Confirmed as OK by my doc.   

Tom

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Usually statins are supposed to be more effective if taken at night. I'd guess most grapefruit is eaten in the morning. My dr. said don't drink an enormous amount of grapefruit juice. I've changed dr. and am not currently on a statin. Taking a break I guess and will see how my numbers react. Now I'm eating a whole grapefruit with honey several mornings a week ! Tom
« Last Edit: March 30, 2016, 11:44:37 PM by Tom »

Millet

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I purchase a Ruby Red grapefruit and temperately forgot about it.  About a week later I noticed it still setting on a counter.  I had it for breakfast and it had become extra juicy. Excellent.  I purchased another one and will try the experiment once again. - MIllet. 

Radoslav

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #5 on: December 11, 2018, 06:19:55 AM »
Part list of drugs that interact with Furanocoumarins.:

ANTICANCER
Dasatinib (leukaemia)
Erlotinib (lung cancer and pancreatic cancer)
Everolimus (kidney cancer)
Lapatinib (breast cancer)
Nilotinib (leukaemia)
Pazopanib (kidney cancer)
Sunitinib (kidney/gastrointestinal cancer)
Vandetanib (thyroid cancer)
Venurafenib (skin cancer)
ANTI-INFECTIVE
Erythromycin (antibiotic)
Halofantrine (antimalaria)
Maraviroc (antiHIV)
Primaquine (antimalaria)
Quinine (antimalaria)
Rilpivirine (antiHIV)
ANTICHOLESTEROL
Atorvastatin
Lovastatin
Simvastatin
CARDIOVASCULAR
Amiodarone (heart rhythm disorders)
Apixaban (anticlotting)
L. Fidel et al.
92
Dronedarone (heart rhythm disorders)
Eplerenone (heart failure)
Felodipine (high blood pressure/angina)
Nifedipine (high blood pressure/angina)
Quinidine (heart rhythm disorders)
Rivaroxaban (blood anticlotting)
Ticagrelor (blood anticlotting after heart attack)
CENTRAL NERVOUS SYSTEM
Oral alfentanil (painkiller)
Oral fentanyl (painkiller)
Oral ketamine (painkiller, sedative)
Lurasidone (schizophrenia/mental health problems)
Oxycodone (painkiller)
Pimozide (schizophrenia/other mental health problems)
Ziprasidone (schizophrenia, mania, bipolar disorder)
GASTROINTESTINAL
Domperidone (antinausea)
IMMUNOSUPPRESSANTS
Cyclosporine (post organ transplant, rheumatoid arthritis, psoriasis)
Sirolimus (post organ transplant)
Tacrolimus (post organ transplant)
URINARY TRACT
Solifenacin (frequent urination/incontinence)
Silodosin (enlarged prostate)
Tamsulosin (enlarged prostate)

Source: http://www.cmaj.ca/content/185/4/309/tab-figures-data

This is the reason why Israely breeders are developing cultivars with the taste similar to grapefruit, but with low level of Furanocoumarin.
New cultivars:
Aliza Orah c. reticulata x Chandler citrus maxima
Cookie Frua c. reticulata x “Siamese Sweet citrus maxima

source: https://file.scirp.org/pdf/FNS_2016022315190052.pdf
« Last Edit: December 11, 2018, 06:22:07 AM by Radoslav »

TooFarNorth

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #6 on: December 11, 2018, 07:28:04 AM »
UF 914 grapefruit cultivar is supposed to have little to no effect on statins.  I don't know if it has been released yet, though.


TFN

Ilya11

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #7 on: December 11, 2018, 02:36:55 PM »
.
New cultivars:
Aliza  Orah c. reticulata x Chandler citrus maxima
Cookie Frua c. reticulata x “Siamese Sweet citrus maxima

source: https://file.scirp.org/pdf/FNS_2016022315190052.pdf
Very funny: they should be spelled differently:
Aliza Chandler citrus maxima x Orah c. reticulata
Cookie “Siamese Sweet citrus maxima x Frua c. reticulata
(seed parent precedes a pollen one)
Could be a problem of the back translation from Hebrew :)
Best regards,
                       Ilya

Radoslav

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #8 on: December 11, 2018, 02:46:08 PM »
.
New cultivars:
Aliza  Orah c. reticulata x Chandler citrus maxima
Cookie Frua c. reticulata x “Siamese Sweet citrus maxima

source: https://file.scirp.org/pdf/FNS_2016022315190052.pdf
Very funny: they should be spelled differently:
Aliza  Chandler citrus maxima x Orah c. reticulata
Cookie  Siamese Sweet citrus maxima x Frua c. reticulata
(seed parent precedes a pollen one)
Could be a problem of the back translation from Hebrew :)


My mistake, I rewrote it directly from the book thinking that first is always mother, but for some reason, they put father first.

So correct is:
 
Aliza  Chandler citrus maxima x Orah c. reticulata
Cookie  Siamese Sweet citrus maxima x Frua c. reticulata

It also gives a sense, when you want a big fruit as follower.



https://www.slideshare.net/sukhjindermann/advances-in-breeding-of-citrus

Aliza  Chandler citrus maxima x Orah c. reticulata was named to honor breeder Aliza Vardi.
https://www.jpost.com/Magazine/Three-breakthrough-scientists-you-never-heard-of-489729
« Last Edit: December 11, 2018, 03:20:11 PM by Radoslav »

tropicalgalaxy3000

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #9 on: December 03, 2020, 09:07:27 PM »
From what i heard grapefruit affects various drugs as it doesnt let the body clear the drug out in the natural way(delays it/takes longer to)
all the best

Sandiegojane

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #10 on: December 04, 2020, 01:12:51 AM »
It inhibits CYP3A4, a cytochrome P450 enzyme produced by the liver, which is responsible for metabolizing many drugs.  This can increase the blood concentration of the drug.  For some drugs, this can increase the concentration to toxic levels.  The same thing can happen if you take multiple drugs that are metabolized by the same P450 enzyme because the metabolic effects can be saturated. Talk to your doctor about the possibility of reducing your dose when you are consuming grapefruit.
 

luak

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #11 on: December 04, 2020, 06:29:09 AM »
Does Pomelo’s have the same effect as grapefruit? Seems to be much milder than grapefruit.

Ilya11

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #12 on: December 04, 2020, 12:28:48 PM »
The bitter taste of grapefruit is not due to the presence of furanocoumarins. Pomelos contain approximately the same concentration  as classic grapefruits. For other varieties  the highest, almost 3 fold greater amount is in Combava, limes and sour oranges are also rich in them.
Best regards,
                       Ilya

Millet

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #13 on: December 04, 2020, 04:42:56 PM »
Furanocoumarins inhibit an enzyme, cytochrome P450 3A4, that is responsible for the inactivation of approximately half of all drugs. This enzyme is found in the lining of the gut and in the liver. Furanocoumarins in grapefruit mainly inhibit cytochrome P450 3A4 in the gut.

SoCal2warm

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #14 on: December 06, 2020, 03:38:10 AM »
Does Pomelo’s have the same effect as grapefruit? Seems to be much milder than grapefruit.
Pomelo has the same level of furanocoumarins as grapefruit.

Regular lemons have about twice the level of furanocoumarins as grapefruit, and regular limes have about six times more.
Bergamot is really bad, about four times worse than lime.

Steam distillation of the essential oil of these citruses can remove nearly all of the furanocoumarin.

In most situations you don't need to worry too much about eating the furanocoumarins in lemon because most people do not eat a lemon like they do a grapefruit.
So if you are told to avoid eating grapefruit, there is no reason to worry about a little lemon juice. Even lemonade would probably be fine, because there is actually much less lemon in a glass of lemonade than there is edible citrus you would be eating in a grapefruit.

The citrus species with the highest level of furanocoumarin is Citrus micrantha, the ancestor of limes (regular limes), in case you were wondering. Its levels are off the charts.

All other citrus fruits (both common varieties and unusual species) have only negligible levels of furanocoumarins.
« Last Edit: December 06, 2020, 03:40:51 AM by SoCal2warm »

Ilya11

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #15 on: December 06, 2020, 05:05:49 AM »
Socal, you are using data for the peel, not juice, these are two completely different stories.
Best regards,
                       Ilya

Millet

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #16 on: December 07, 2020, 04:20:54 PM »
University of Florida Professor Gmitter responded that UF 914 a pummelo grapefruit hybrid “produces fruit with excellent quality, beautiful color, flavor and aroma very similar to grapefruit, but usually perceived as sweeter by consumers. And yes, extremely low to undetectable levels of the major bioactive furanocoumarin (FC) compounds. We tested the fruit and juice chemically to measure FC levels. We tested it with human cell cultures to confirm its lack of interaction with drugs; and finally we performed a pilot human subject trial. But to claim that it is safe would require a much larger clinical trial that would cost a lot of money. To date, no one has come forth with funding to support such a trial.”

https://www.youtube.com/watch?v=MnfU1BQ-EE8

« Last Edit: December 07, 2020, 04:29:35 PM by Millet »

shaneatwell

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #17 on: December 07, 2020, 06:34:32 PM »
The CYP inhibition is also used to boost the effect of recreational drugs. Came across that entirely by chance while on a jury for a murder trial. The guys involved all hit 7/11 for grapefruit juice before heading to the railroad overpass to get high. Seemed like such a strange detail I had to look it up.
Shane

SoCal2warm

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #18 on: December 13, 2020, 08:45:15 PM »
University of Florida Professor Gmitter responded that UF 914 a pummelo grapefruit hybrid ... extremely low to undetectable levels of the major bioactive furanocoumarin (FC) compounds. We tested the fruit and juice chemically to measure FC levels.
This is just a guess but I would guess it may have inherited that trait from its parent Siamese Sweet pomelo. Being an acidless pomelo, lacking sourness, might have a connection to low FC levels.
(Siamese Sweet otherwise would not be an appealing commercial variety to consumers due to its lack of sourness and bland flavor)

Epicatt2

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #19 on: December 17, 2020, 01:52:07 AM »
Now I am curious about the furanocoumarin concentrations in grapefruit, in particular the vintage cultivar 'Duncan'.

Does the concentration of FC decrease over time as this cultivar's fruit continues to ripen?  I know from experience that the longer 'Duncans' hang on my tree the sweeter they become up 'til the time they begin to fall from the tree at the end of their season.

I ask here because any (possible) aspect of decreasing FC concentration in citrus fruit as they continue to ripen has not been suggested in this thread.

BTW, I am not taking any drugs that interact with FC.  (Used to take Warfarin but my doctor took me off it several years ago.)

Regards,

Paul M.
==

SoCal2warm

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #20 on: December 17, 2020, 01:28:57 PM »
Does the concentration of FC decrease over time as this cultivar's fruit continues to ripen? 
There was a study that looked at the quantities of FC-like chemicals in the juice of several grapefruit varieties, picked successively, at intervals between December 8 and March 19, and the ones that were left on the tree until March 19 had about a third lower FC levels than the ones picked the earliest on December 8.

Characterization of Furanocoumarin Profile and Inheritance Toward Selection of Low Furanocoumarin Seedless Grapefruit Cultivars, Chunxian Chen, Journal of the American Society for Horticultural Science, Volume 136: Issue 5           

Their measurements were not the most accurate, maybe around a 15% margin of error, it seems to me from looking at the graph.

Epicatt2

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #21 on: December 17, 2020, 01:52:08 PM »
Thanx for the useful reply, SoCal2warm.

One question more:  Was 'Duncan' one of the tested fruit named in that study, do you know?

Cheers!

Paul M.
==

poncirsguy

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Re: Q And A: Why Does Grapefruit Affect Statins (Cholesterol Lowering Drugs)?
« Reply #22 on: December 17, 2020, 08:21:31 PM »
Where Does Valentine pomelo stand with affecting statins.  I have a Valentine pomelo and a statin.

 

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