Wang Hailian, Deputy Chief of Pharmacist Xuanwu Hospital, Capital Medical University
The reader, Mr. Zhao asked: Since the rise of blood lipids, I have been taking oral statins since last year. I have heard that I can't eat grapefruit when I take medicines. I personally like to eat grapefruit. Can I really eat it?
Wang Hailian, deputy director of Xuanwu Hospital of Capital Medical University, answered: There are two situations. If you are taking simvastatin, lovastatin or atorvastatin, these three lipid-lowering drugs, it is best not to eat grapefruit or oranges. Because grapefruit or Oranges interfere with these 3 statin metabolic enzymes and can increase the risk of muscle toxicity. If you are eating pittastatin, fluvastatin, rosuvastatin, pravastatin, these 4 kinds of statin, you can feel free to eat grapefruit or orange.
There is an important metabolizing enzyme called CYP3A4 in the human body. It is mainly found in the liver and small intestine. It is involved in drug metabolism. CYP3A4 inducer can reduce the efficacy of the drug. Conversely, CYP3A4 inhibitors can increase the efficacy of the drug. Citron or grapefruit juice is CYP3A4 inhibition Agents, will increase the efficacy of some drugs metabolized by CYP3A4, and even aggravate adverse drug reactions. Lovastatin, simvastatin, atorvastatin are mainly metabolized by CYP3A4, fluvastatin and pitavastatin are mainly cleared by CYP2C9 metabolism, Pravastatin and rosuvastatin are more water-soluble and do not need to be metabolized by this enzyme. Therefore, grapefruit or grapefruit juice combined with lovastatin, simvastatin and atorvastatin will increase liver and kidney damage. Risk of rhabdomyolysis. However, if the daily intake of grapefruit juice is less than 250 ml, or if less than half of grapefruit is eaten, the risk is small.
