Grapefruit juice significantly increases lovastatin levels by inhibiting its metabolism, raising the risk of severe muscle damage.
Even small amounts (e.g., one glass) can cause significant interaction lasting up to 24 hours.
Interaction applies to whole grapefruit and its juice; Seville oranges may have similar effects.
Elderly patients or those with kidney/liver issues are at higher risk.
Monitor for muscle symptoms and creatine kinase levels if exposure occurs.
Grapefruit juice contains furanocoumarins that inhibit the CYP3A4 enzyme in the intestines and liver, which is responsible for metabolizing lovastatin, leading to reduced clearance and elevated plasma concentrations of the drug.
Heightened risk of statin-induced myopathy, including muscle pain, weakness, and potentially life-threatening rhabdomyolysis; may also increase liver enzyme elevations.
Avoid consumption of grapefruit juice and products containing it while taking lovastatin; if unavoidable, limit to small amounts and monitor closely or consider switching to a statin less affected by CYP3A4 (e.g., rosuvastatin). Consult a healthcare provider for personalized advice.
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