Don't mix grapefruit and statins

PEOPLE'S PHARMACY

November 22, 2007|By Joe Graedon and Teresa Graedon

I have received conflicting information from my doctor, a couple of pharmacists and patient-information inserts about how to avoid interactions between statins and grapefruit. I hope you can clarify this. I have been avoiding grapefruit (though not other citrus) completely, and would like to be able to eat it again if it is safe to do so.

Certain cholesterol-lowering drugs such as atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) interact with compounds in grapefruit and its juice. These natural chemicals can slow the rate at which the drugs are processed by the body. This may result in a higher blood level of the drug and consequently a greater risk of side effects.

Only grapefruit and bitter orange (not regular oranges) contain the active compounds. The enzymes that are affected may show changed activity for more than 24 hours after a person drinks a glass of juice, so the idea that one could have grapefruit for breakfast and take a pill before bedtime is mistaken.

Some people are far more susceptible to this effect than others.

I want to respond to your reader who wanted to know why you would disagree with using bourbon as an effective cough suppressant for children.

When I was a child, my mother would give me a tablespoon of whiskey when I had a stomachache. Today, at the age of 42, guess what I am? Yep, an alcoholic (in recovery).

Was the remedy the cause of my alcoholism? I can't help but wonder. A child should never be given alcohol. Period.

We've heard from readers on both sides of this issue. One reminisced: "My grandparents used the same cough remedy in the 1930s -- bourbon, honey and freshly squeezed lemon juice. I still use it."

Pediatricians caution parents not to use cough medicines for young children (younger than 6) because there is no evidence that they work. That is especially true of alcohol-containing cough medicines, homemade or over the counter.

I have swelling and pain in my joints. A cousin with arthritis recommended a compounded cream called ketoprofen gel. What can you tell me about this medicine, its side effects and its interactions with other drugs?

Ketoprofen, like ibuprofen, is a nonsteroidal anti-inflammatory drug. You won't find this on the shelf in a chain store, but some pharmacists can compound this topical treatment without a prescription. Putting the pain reliever right on the joint minimizes side effects such as stomach irritation or elevated blood pressure. Many people find it is helpful in reducing joint pain.

I have arthritis and some patches of psoriasis on my skin. I would like to try turmeric, but want to know if this would be worthwhile.

Turmeric has been used to season food for thousands of years. Its medicinal properties have been recognized for nearly that long.

Some research indicates that turmeric and its primary component, curcumin, can ease the inflammation of psoriasis and arthritis (Current Opinion in Pharmacology, June 2007). It may also help prevent atherosclerosis and certain cancers.

While in Africa, I started drinking rooibos tea every day. Now that I am back home in Houston, my usual fall allergies have not appeared. Have you heard of this effect before?

We have heard of rooibos tea ("red bush" tea) from South Africa. It has been used traditionally against pollen allergies, but there is not a lot of clinical research to support its effectiveness. One study did suggest that there is an effect on the immune system that might help relieve allergic symptoms (Bioscience, Biotechnology and Biochemistry, October 2001).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: peoplespharmacy.com.

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