On Statins? Avoid These Juices

Grapefruit and Pomegranate

ABC News medical contributor, Dr. Marie Savard, in an opinion piece, advises the approximately 13 million Americans taking statins to lower cholesterol, that there are side effects that doctors often don’t take into account.

Statin drugs including Lipitor, Pravachol, and Crestor, among others, are taken to lower LDL or low-density lipoproteins, the bad cholesterol.

Fatigue was found to be a real concern for some users.  A study released in May, showed that pravastatin and simvastatin were associated with a decrease in energy and activity levels among users when compared to a placebo.

Both statins were found to be effective against LDL cholesterol.

Dr. Savard says other side effects can include muscle weakness and memory problems, which many doctors may not fully be aware of.

Researchers may be able to screen patients most likely to experience muscle weakness and pain, the most common side effects of the drugs, by looking for a genetic variant.  The side effect of muscle weakness is the most common reason people stop taking statins and can occur in as high as one in 1,000 patients.

On Foods to Avoid when on Statins

Dr. Savard says avoiding grapefruit juice is important as it can interfere with how the statin metabolizes in the body. Pomegranate juice should also be avoided for the same reason.

Grapefruit and other juice products appear to interfere with an enzyme the body uses to break down certain statins.  Included are Zocor (simvastatin), lovastatin (Mevacor, Altoprev) and to a lesser extent Lipitor (atorvastatin). Grapefruit juice may increase the amount of drug that remains in the body.

Higher levels of statin in the blood may result in muscle weakness.  Dr. Savard encourages the warning be added to the drug labels.

Pravachol or pravastin is not thought to be altered by grapefruit juice.

Statins and Inflammation

In November, industry sponsored research released by the American Heart Association found that statins could also help reduce the risk of heart attack and stroke.   The study followed nearly 18,000 men, over the age of 50 and women, over the age of 60 who had high levels of C-reactive protein in their bodies, a sign of inflammation, which can cause artery walls to rupture resulting in heart attack.

Those taking Crestor had a 54 percent reduction in the rate of heart attack when compared to a placebo. But some patients experience muscle pains according to the results, published in the New England Journal of Medicine.

LEARN MORE

• NEJM on C-reactive protein, November 2008
• Legal Examiner Help Center- Cholesterol drugs overview
• Legal Examiner, Cheyenne, Vytorin, Zetia used as last resort, August 2008