Statins are frequently prescribed medications used to lower cholesterol. They do so by blocking enzymes necessary to produce cholesterol. Doctors may prescribe statins if your total cholesterol exceeds 240 mg/dL, or if your LDL, or “bad” cholesterol, exceeds 130 mg/dL. Some fruits and juices can interact with statins and increase their absorption, which can lead to rhabdomyolysis, a dangerous side effect that leads to muscle breakdown, kidney damage and in rare cases, death. Clarify your medication’s effects with your doctor.
Of all foods that interfere with statin absorption, grapefruit juice causes the most harm. Avoid grapefruit and products made from grapefruit juice if you’re taking a statin. The chemical in grapefruit and other fruits that increase statin absorption is thought to be fouranocoumarin, the Harvard Medical School Family Health Guide explains. This chemical binds to an enzyme, CYP3A4, which makes it easier for medication to pass from the intestine to the bloodstream, increasing levels in the blood.
Statins such as atorvastatin, simvastatin and lovastatin all react with grapefruit products. Grapefruit products can also increase absorption of drugs that combine simvastatin with ezetimibe and lovastatin with niacin .
Seville oranges, a type of bitter oranges not used in regular orange juice, may also increase statin absorption. Like grapefruit, Seville oranges also contain furanocoumarin. Seville oranges are used to make marmalade and other compotes. Studies on Seville oranges haven’t been as extensive as studies on grapefruit, but people taking statins should probably avoid them, the Harvard Medical School Family Health Guide suggests.
Because tangelos are a hybrid of tangerines and grapefruit, concern exists that they might have the same effect on statin absorption as grapefruit. The United States Department of Agriculture studied 12 samples of tangelos grown in Florida and found that none contained furanocoumarin. They concluded that tangelos were unlikely to have the same effects as grapefruit on statins. Discuss eating tangelos with your own physician, who knows your case best and may prefer that you avoid them while taking statins.