Can Grapefruit Juice Really Raise Risk of Zocor Muscle Injury?
Grapefruits are full of health benefits like vitamin C, lycopene, and other free-radical-fighting antioxidants, but those who take a Zocor or other statin pills with a glass of grapefruit juice could experience a Zocor muscle injury, rhabdomyolysis, or in rare cases, life-threatening liver or kidney damage.
Though not all scientific studies concur, enough have found a connection between the consumption of grapefruits and the increased risk of statin toxicity that Zocor and other statin medications now include a warning about the interaction. Unfortunately, as this warning exists only in the warnings and precautions section of the label (the “fine print”), many healthcare professionals are still unaware of the risks, and may not alert their patients.
A surprising trigger of Zocor side effects
“The potential of drug interactions with grapefruit juice has been out there a long time,” said Amy Karch, R.N., M.S. from the School of Nursing at the University of Rochester Medical Center, “but most people just aren’t aware of it.”
Grapefruits can raise the risk of Zocor muscle injury because they use the same enzyme for metabolism as that used by statin medications. Once someone swallows a statin pill, the liver releases enzymes that break it down into components usable by the body. Since grapefruits use those same enzymes, a person consuming a couple glasses of grapefruit juice could keep all those enzymes busy, leaving the Zocor to build up to toxic levels in the body.
In an article published in the American Journal of Nursing (December 2004), Karch profiles a patient who took Lipitor, another cholesterol-lowering medication, and two months after going to Florida for the winter, experienced muscle pain, fatigue, and fever. He later went into kidney failure and lost his life. The only major change in his lifestyle was that after moving to Florida, he started drinking two-to-three glasses of fresh grapefruit juice a day.
Risk of Zocor muscle injury recently made news
The FDA recently issued a press release warning that the highest dose (80 mg) of Zocor is linked with serious side effects like Zocor muscle injury and rhabdomyolysis. In fact, statin drugs have long been associated with muscle injury, though scientists haven’t determined exactly why. What is clear is that the more Zocor one has in the bloodstream, the more damage may occur to the muscles.
Injured muscles release waste products into the blood stream, which can overwhelm the efforts of the kidney and liver to remove them, potentially leading to liver disease and renal failure. Since grapefruits have the potential to elevate levels of Zocor in the blood, patients taking Zocor and other statins (particularly Lipitor, Mevacor and generics), should refrain from consuming grapefruits while on these medications, or ask their doctors for alternatives. (Statins like Crestor and Prevachol are believed to be less effected by grapefruit.)
Public watchdog organization pushes for Zocor black box warning
In August 2001, watchdog organization Public Citizen petitioned the FDA to require its sternest black box warning on all statins, to better alert the public of the risk of muscle injury and rhabdomyolysis. So far, the FDA’s recent warning about high-dose Zocor is as far as the agency has gone regarding this particular drug. Meanwhile as more people consider filing a Zocor lawsuit, all eyes are on drugmaker Merck who must not shirk its duty to adequately warn of dangerous Zocor side effects.