Around seven million adults in the UK who take cholesterol-lowering statins are being urged to exercise caution with their diet, as experts highlight a potentially dangerous interaction with a common fruit.
The Scale of Statin Use and the Hidden Risk
Prescriptions for cholesterol-busting drugs have reached a record high. GP records show a staggering 5.3 million people in England were prescribed statins or ezetimibe in the 2023-24 period, marking a substantial rise from the previous year. These medications are a vital tool in preventing heart attacks and strokes for an estimated seven to eight million UK adults.
However, a warning has been issued by Dipa Kamdar, a senior lecturer in Pharmacy Practice at Kingston University. She emphasises that while improving your diet is beneficial, those on prescription drugs must be careful, as everyday health foods can interfere with treatment.
How Grapefruit Disrupts Medication
Writing in The Conversation, Kamdar explained the specific science behind the hazard. The liver uses enzymes known as cytochrome P450 to break down many prescription drugs. Grapefruit juice contains natural chemical compounds called furanocoumarins, which can block these enzymes.
"If this happens, some drugs can accumulate in the body," Kamdar stated. This dangerous build-up isn't limited to statins. It also affects drugs like ciclosporin, used to prevent organ transplant rejection and manage conditions like psoriasis and rheumatoid arthritis. Excess ciclosporin can lead to side effects ranging from nausea to severe kidney and liver damage.
For statin users, the same mechanism applies. Increased levels of the drug in the bloodstream raise the risk of adverse effects. One rare but serious potential side effect is muscle breakdown. Other common medications, including the blood pressure drug amlodipine and the erectile dysfunction treatment sildenafil, can also interact negatively with grapefruit.
Official NHS and BHF Guidance on Consumption
Both the NHS and the British Heart Foundation (BHF) provide clear guidance for patients. The NHS warns that grapefruit juice can affect some statins and increase the risk of side effects, advising that a doctor may recommend avoiding it completely or only having small quantities.
The BHF offers more specific advice based on the type of statin:
- Simvastatin: Do not eat or drink grapefruit.
- Atorvastatin: You can have grapefruit or its juice occasionally, but not in large amounts.
- Other statins: Grapefruit is generally not considered a problem.
Kamdar's final advice is unequivocal: "If you take any of these prescription drugs, it's best to talk to your doctor or pharmacist before drinking even small amounts of grapefruit juice. It may even be best to avoid it altogether."
Statins are prescribed to lower blood cholesterol, significantly reducing the risk of coronary heart disease, angina, heart attacks, and strokes. With their use so widespread, this dietary warning is a crucial piece of information for safeguarding the health of millions.
