Harvard Heart Letter

By the way, doctor: What's the problem with grapefruit juice and statins?

Q. A warning on my statin prescription tells me not to drink grapefruit juice or eat grapefruit. Does this mean I can never enjoy this delicious fruit again?

A. I can understand your disappointment at this double whammy. Here's some news I hope will at least partly cheer you up: You don't have to give up grapefruit forever as long as you (and your doctor) are willing to switch to a statin or other cholesterol-lowering agent that isn't affected by grapefruit juice.

Grapefruit juice and grapefruit itself can boost blood levels of some statins and a variety of other drugs (see table). Something in grapefruit — scientists aren't yet sure what — latches onto an enzyme in the intestines called CYP3A4. This enzyme partially breaks down some drugs, so knocking it out of action means more of the drugs get into the bloodstream. In the case of statins, abnormally high blood levels can damage muscles or the liver.

To continue reading this article, you must login.
  • Research health conditions
  • Check your symptoms
  • Prepare for a doctor's visit or test
  • Find the best treatments and procedures for you
  • Explore options for better nutrition and exercise
Learn more about the many benefits and features of joining Harvard Health Online »