Grapefruit juice and cholesterol lowering drugs dont mix

[Lexian]

Interesting article here:

http://www.msnbc.msn.com/id/6388521/

Also really interesting that Lipitor and Zocor are both over the counter drugs in Britian. I thought both required monitoring of certain patient parametets while they were taking the medication.

What do you guys think?

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[dgroulx]

The only statins metabolized by CYP3A4, which would cause a potential problem with grapefruit juice are lovastatin, simvastatin and atorvastatin. Statins should be taken at bedtime and if you have grapefruit juice in the morning, there won't be a problem. If someone is concerned, they could switch to a different statin drug like Crestor or Pravachol.

Statins are well tolerated and no parameters need to be monitored except rechecking your lipids in 6 weeks to see if it is working well for you. If people by it OTC, then they need to know to take one tablet at bedtime, not just when they think their cholesterol is high.

 

[ultracet]

see i'm going to disagree..
i think that there is no way statins should go OTC. I think it would be absolutely stupid.
you do have to monitor liver function.
the grapefruit juice thing is an issue that should be listed on the box (if OTC) in bold print....

 

[Caverject]

LFT's need to be done, this is a drug that doesn't belong OTC.

 

[jdpharmd?]

Statins should be taken at bedtime and if you have grapefruit juice in the morning, there won't be a problem. If someone is concerned, they could switch to a different statin drug like Crestor or Pravachol.

The Pharmacists' Letter is recomending avoiding grapefruit juice all-together in patients taking the affected statins. I guess that's the "CYA" approach.

Most other literature that I've found advises against "consuming large amounts" of GFJ with statins, so I doubt that the problem is as large as we've been led to believe. I would quote some of the articles, but the PL site is down. (I'll be back)

 

[jdpharmd?]

LFT's need to be done, this is a drug that doesn't belong OTC.

Obviosuly not. I love how part of the "solution" to the obesity epidemic and people's laziness is "throw some statins at them, OTC!!"

 

[dgroulx]

I personally can't drink grapefruit juice unless it has some gin mixed in with it.

As for OTC, if a person can follow the instructions and the statin is a lower dose and the person could not afford the medication otherwise, then the benefit will outweigh the risk. Statins are very well tolerated with little to no side effects with small doses. I'm saying that Crestor should be OTC.

 

[bananaface]

At some health expo, one of my classmates saw some company marketing a special brand of grapefruit juice that is supposedly engineered to not be a CYP3A4 inhibitor. If you consider that grapefruit juice is rank anyway, it seems like a pretty narrow market segment to pursue.

 

[ultracet]

I personally can't drink grapefruit juice unless it has some gin mixed in with it.

As for OTC, if a person can follow the instructions and the statin is a lower dose and the person could not afford the medication otherwise, then the benefit will outweigh the risk. Statins are very well tolerated with little to no side effects with small doses. I'm saying that Crestor should be OTC.

did you mean to say that you are NOT saying crestor should be otc?

because if you think crestor should be OTC i think you're crazy

 

[Caverject]

Obviosuly not. I love how part of the "solution" to the obesity epidemic and people's laziness is "throw some statins at them, OTC!!"

It's an obvious ploy by Pfizer and Merck so they can fill up their pockets with more money

 

[dgroulx]

did you mean to say that you are NOT saying crestor should be otc?

because if you think crestor should be OTC i think you're crazy

Yeah, I left out the NOT.