Foods and Beverages that Interact with Statins

By Jacob Silvers, PharmD Candidate Class of 2020
University of Arizona College of Pharmacy

What is a ‘Statin’?

‘Statin’ is the term used to identify a class of medications that reduce cholesterol by lowering cholesterol production in the liver. The generic versions of these medications often have the ending -statin (i.e. brand name Lipitor is also known as atorvastatin). These medications are commonly prescribed for high cholesterol and can reduce the risk of cardiovascular disease and stroke.

Why do foods or beverages interact with medications?

A medication-food interaction occurs when food alters the absorption, effect, or breakdown of a medication. In the case of statins, the most likely issues are decreased breakdown of the medication or increased effect. Statins are usually metabolized by the liver, and foods that are also metabolized by the liver can slow this process. This can cause the statin to stay in your body much longer, and possibly even allow the drug to build up above normal levels. Another possible problem are foods that contain statins or statin like medications. Both issues result in increased concentrations of the statin medication in your body, leading to an increased risk for side effects, such as muscle pain, soreness, dark urine, or liver damage.

What foods or beverages should I avoid?

The most discussed interaction is the grapefruit. Grapefruits can slow or halt some liver enzymes and should generally be avoided while taking statins. This includes grapefruit juice and other derivatives of grapefruits. The severity of this interaction varies greatly between people and is difficult to predict. Red yeast rice is another potential problem because it contains small amounts of the medication lovastatin. Taking this supplement at the same time as a statin medication may raise your statin levels. Always talk to your healthcare providers before taking supplements.

A well-known food that has many medication interactions is alcohol. Alcohol can interfere with metabolic processes; especially, those that involve the liver. Other articles on WellRx.com have discussed the side effects of drinking alcohol with prescription medications and have links to resources from the National Institute of Health.  Alcohol should be avoided or limited while taking any prescription medication. If you are worried about a medication interaction, ask your pharmacist for more information.

References:

1. Lee, Jonathan W., et al. “Grapefruit Juice and Statins.” The American Journal of Medicine, vol. 129, no. 1, 2016, pp. 26–29., doi:10.1016/j.amjmed.2015.07.036. https://www-sciencedirect-com.ezproxy3.library.arizona.edu/science/article/pii/S0002934315007743
2. Bailey, D. G. “Predicting Clinical Relevance of Grapefruit-Drug Interactions: a Complicated Process.” Journal of Clinical Pharmacy and Therapeutics, vol. 42, no. 2, 2016, pp. 125–127., doi:10.1111/jcpt.12463. https://www-embase-com.ezproxy3.library.arizona.edu/a/#/search/results?subaction=viewrecord&rid=6&page=1&id=L613295722
3. Merck. Prescribing Information for Zocor. 1999. https://www.merck.com/product/usa/pi_circulars/z/zocor/zocor_pi.pdf
4. Grieco, A., Miele, L., Pompili, M., Biolato, M., Vecchio, F. M., Grattagliano, I., and Gasbarrini, G. Acute hepatitis caused by a natural lipid-lowering product: when “alternative” medicine is no “alternative” at all. J Hepatol 2009;50(6):1273-1277. https://www-ncbi-nlm-nih-gov.ezproxy3.library.arizona.edu/pubmed/19398239?dopt=Abstract