Heart Health Heart Disease Living With Taking Lipitor or Zocor With Grapefruit Juice Grapefruit juice inhibits the breakdown of certain medications By Michael Bihari, MD Updated on February 10, 2022 Medically reviewed by Jeffrey S. Lander, MD Print Yes, grapefruit juice chock-full of vitamins and nutrients. For many, a glass of grapefruit juice is a healthy way to start the day. However, if you're on certain medications, such as certain heart medications called statins, you should avoid drinking grapefruit juice while taking these medications. Grapefruit juice can inhibit your body's ability to break down these medications, which in turn, can lead to adverse effects. StockFood - Jonathan Gregson / Riser / Getty Images Grapefruit Juice and Certain Statins Do Not Mix Grapefruit juice and certain statins (used to treat high cholesterol) such as Lipitor (atorvastatin), Mevacor (lovastatin), and Zocor (simvastatin) do not mix. Grapefruit juice inhibits a system of enzymes that helps break down dozens of medications, including Lipitor, Mevacor, and Zocor. If you drink grapefruit juice while taking any of these medications, too much of the drugs’ active ingredient may enter your bloodstream. This could result in adverse effects, such as a dangerous muscle disorder or liver damage. More specifically, grapefruit juice inhibits the hepatic (liver) enzyme system P450, which breaks down drugs. By messing with this liver enzyme, more active ingredient affects your body. In other words, the effects of statin drugs are increased in people who drink grapefruit juice. Adverse effects of statins include muscle and liver damage. Cytochrome P450 enzymes are stored in the endoplasmic reticulum of cells found not only in the liver but also in the kidneys, gastrointestinal tract, and lungs. These P450 enzymes break drugs down by oxidizing them. In addition to grapefruit juice, more technically the furanocoumarins in grapefruit juice, other things inhibit cytochrome P450 enzymes including cimetidine (histamine blocker used to treat GERD), erythromycin (antibiotic) and isoniazid (medication used to treat tuberculosis). Please keep in mind that there are several more drugs that mess with cytochrome P450, and if you have any questions about potential interactions, please discuss them with your physician. Your physician should also check whether the medications that you are taking either have adverse interactions with each other or with your diet. The time that you take one of these medications and the time that you eat grapefruit or drink grapefruit juice does not reduce your risk of drug-related adverse effects–-an interaction can happen up to three days after consuming grapefruit. This means that you cannot drink grapefruit juice in the morning and take your medication later in the day. Medication Options You have several options: You can exclude grapefruit from your diet and substitute other fruits and fruit juices, orIf you want to continue to consume grapefruit products, talk to your physician about using an alternative medication. Several available statins do not interact with grapefruit juice and are safe to use. These include: Crestor (rosuvastatin)Lescol (fluvastatin)Pravachol (pravastatin) More Information If you have any questions about drug interactions with grapefruit juice, please discuss these concerns with your physician. Please remember that your physician is an excellent source of information and is there to help guide you through treatment and work to ensure your good health. Frequently Asked Questions Does Lipitor have a grapefruit warning? Yes, you should not eat grapefruit or drink grapefruit juice while taking Lipitor (atorvastatin). Compounds in grapefruit can negatively interact with certain statins, including Lipitor, Altoprev (lovastatin), and Zocor (simvastatin). What happens if I eat grapefruit while taking Lipitor? Grapefruit should not be eaten while taking Lipitor because it can cause a dangerous interaction. Grapefruit contains substances called furanocoumarins, which interfere with liver enzymes that break down the medication. As a result, blood levels of the drug’s active ingredient become dangerously elevated, which can lead to a serious muscle disorder or liver damage. What medications should not mix with grapefruit? Avoid eating grapefruit or drinking grapefruit juice if you take any of the following medications:Adalat CC (nifedipine), a high-blood-pressure medicationAllegra (fexofenadine), an antihistamineBuspar (buspirone), an anti-anxiety medication Cordarone (amiodarone), a heart arrhythmia drugEntocord EC (budesonide), a corticosteroidLipitor (atorvastatin), a statinMevacor (lovastatin), a statinNeoral (cyclosporine), an organ-transplant anti-rejection drugProcardia (nifedipine), a high-blood-pressure medicationPacerone (amiodarone), a heart arrhythmia drugSandimmune (cyclosporine), an organ-transplant anti-rejection drugUceris (budesonide), a corticosteroidZocor (simvastatin), a statin 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lee JW, Morris JK, Wald NJ. Grapefruit Juice and Statins. Am J Med. 2016;129(1):26-9. doi:10.1016/j.amjmed.2015.07.036 Bushra R, Aslam N, Khan AY. Food-drug interactions. Oman Med J. 2011;26(2):77-83. doi:10.5001/omj.2011.21 Guengerich FP. Intersection of the Roles of Cytochrome P450 Enzymes with Xenobiotic and Endogenous Substrates: Relevance to Toxicity and Drug Interactions. Chem Res Toxicol. 2017;30(1):2–12. doi:10.1021/acs.chemrestox.6b00226 Kiani J, Imam SZ. Medicinal importance of grapefruit juice and its interaction with various drugs. Nutr J. 2007;6:33. doi:10.1186/1475-2891-6-33 Bailey DG, Dresser G, Arnold JM. Grapefruit-medication interactions: forbidden fruit or avoidable consequences?. CMAJ. 2013;185(4):309–316. doi:10.1503/cmaj.120951 U.S. Food & Drug Administration. Grapefruit juice and some drugs don't mix. Additional Reading Trevor AJ, Katzung BG, Kruidering-Hall M. Antifungal Agents. In: Trevor AJ, Katzung BG, Kruidering-Hall M. eds. Katzung & Trevor's Pharmacology: Examination & Board Review, 11e. New York, NY: McGraw-Hill; 2015. Article titled "Drug interactions due to cytochrome P450" by CC Ogu and JL Maxa published in the Baylor University Medical Center Proceedings in 2000. Selected Sources By Michael Bihari, MD Michael Bihari, MD, is a board-certified pediatrician, health educator, and medical writer, and president emeritus of the Community Health Center of Cape Cod. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit