Can you eat grapefruit while taking statins?

• Level E Grapefruit juice can block the action of intestinal CYP3A4, so instead of being metabolized, more of the drug enters the blood and stays in the body longer. US Food and Drug Administration, Grapefruit Juice and Some Drugs Don't Mix, updated 2021
• Level E Seville oranges (often used to make orange marmalade), pomelos, and tangelos (a cross between tangerines and grapefruit) might have the same effect as grapefruit juice. FDA, Grapefruit Juice and Some Drugs Don't Mix, consumer update, 2021
• Level E Ask your doctor or pharmacist if grapefruit juice interacts with your medication. US Food and Drug Administration, Grapefruit Juice and Some Drugs Don't Mix, updated 2021

Text in quotation marks is word for word from the official source. Level E means the position of an expert body or a drug label. How we grade evidence.

Evidence behind the advice

• Level B In a randomized crossover trial in 10 healthy volunteers, one 6.8 fl oz (200 mL) glass of grapefruit juice a day for 3 days raised blood exposure to simvastatin 3.6-fold and its active acid 3.3-fold. Br J Clin Pharmacol, 2004
• Level C In 7 healthy volunteers on 6.8 fl oz (200 mL) of grapefruit juice 3 times a day, the juice's effect on the CYP3A4 drug enzyme lasted at least 48 hours, with midazolam exposure still 1.47 times normal on day 3. Biol Pharm Bull, 2013

The other side and the limits

• Level A Most grapefruit juice drug studies measure blood levels, not blood pressure or outcomes, so the clinical importance of many interactions remains uncertain. Complement Ther Med, 2025
• Level E FDA warns that Seville oranges, pomelos and tangelos may interact with drugs like grapefruit juice, and ordinary tangerines are not on that list. U.S. FDA Consumer Update, Grapefruit Juice and Some Drugs Don't Mix (content current as of 07/01/2021)

Levels: A is a meta-analysis of trials, B a randomized trial, C an observational study, D lab work or case reports, E an expert position. How we grade evidence.

Check your exact statin first. The labels on this page are for simvastatin and atorvastatin. Your pharmacist can tell you whether your statin is affected.

Spacing does not solve it. In the study below, the effect of grapefruit juice on the gut enzyme lasted at least 48 hours, so spacing the juice and the pill a few hours apart may not help. FDA says Seville oranges, pomelos and tangelos may act the same way. Ordinary sweet oranges and tangerines are not on its list, which is not the same as FDA calling them safe with every drug.

These studies measured drug levels in the blood, not muscle damage, and a review of juice studies with blood pressure drugs called the clinical importance of such interactions uncertain. That uncertainty is a reason to ask your pharmacist, not to ignore the label or to stop your statin on your own.

Evidence behind this note

1. Level B In a randomized crossover trial in 10 healthy volunteers, one 6.8 fl oz (200 mL) glass of grapefruit juice a day for 3 days raised blood exposure to simvastatin 3.6-fold and its active acid 3.3-fold. Br J Clin Pharmacol, 2004
2. Level C In 7 healthy volunteers on 6.8 fl oz (200 mL) of grapefruit juice 3 times a day, the juice's effect on the CYP3A4 drug enzyme lasted at least 48 hours, with midazolam exposure still 1.47 times normal on day 3. Biol Pharm Bull, 2013
3. Level A Most grapefruit juice drug studies measure blood levels, not blood pressure or outcomes, so the clinical importance of many interactions remains uncertain. Complement Ther Med, 2025
4. Level E FDA warns that Seville oranges, pomelos and tangelos may interact with drugs like grapefruit juice, and ordinary tangerines are not on that list. U.S. FDA Consumer Update, Grapefruit Juice and Some Drugs Don't Mix (content current as of 07/01/2021)

Written from the positions and data on this page, reviewed by the Bioma editorial system. How we verify.

• Grapefruit: what the research says
• Grapefruit juice: what the research says