Drug interactions
Atorvastatin + Grapefruit
Severity: Moderate
Atorvastatin and Grapefruit: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Grapefruit juice inhibits intestinal CYP3A4 and increases atorvastatin exposure, particularly with large daily quantities. This may raise the risk of muscle toxicity.
What this interaction means in plain words
Atorvastatin and Grapefruit can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Furanocoumarins in grapefruit inhibit intestinal CYP3A4, reducing first-pass metabolism of atorvastatin.
What to do
Advise avoiding large amounts of grapefruit juice (over about 1.2 L daily per labeling) and counsel on reporting muscle symptoms.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Atorvastatin
- Atorvastatin + Tipranavir Contraindicated
- Atazanavir + Atorvastatin Major
- Atorvastatin + Clarithromycin Major
- Atorvastatin + Cobicistat Major
- Atorvastatin + Cyclosporin Major
- Atorvastatin + Danazol Major
Frequently asked questions
Can I take Atorvastatin with Grapefruit?
MediHelp rates the interaction as moderate. Atorvastatin and Grapefruit can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Grapefruit juice inhibits intestinal CYP3A4 and increases atorvastatin exposure, particularly with large daily quantities. This may raise the risk of muscle toxicity.
How serious is the interaction between Atorvastatin and Grapefruit?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise avoiding large amounts of grapefruit juice (over about 1.2 L daily per labeling) and counsel on reporting muscle symptoms.
What other medicines interact with Atorvastatin?
MediHelp also lists interactions of Atorvastatin with, for example, Tipranavir, Atazanavir, Clarithromycin. The full list is on the Atorvastatin page.
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