Rhabdomyolysis Risk for Statin Users Increased By Drinking Grapefruit Juice

Risk is Most Significant for Patients on Cholesterol-lowering Zocor

There is an increased risk of developing rhabdomyolysis, a potentially life-threatening muscle disorder, for patients taking statins when they drink grapefruit juice.  This problem occurs because grapefruit contains a chemical that inactivates a liver enzyme involved in drug metabolism, and regular consumption of grapefruit juice can lead to excessively high levels of the medicine in the blood.  The risk of developing rhabdomyolysis due to this drug-food interaction of a statin and grapefruit juice is greatest with cholesterol-lowering Zocor, according to the British Medicines and Healthcare Products Regulatory Agency.

More generally, the muscle toxicity condition called rhabdomyolysis is a recognized adverse reaction for patients taking high doses of any statin drug.  Simply put, with rhabdomyolysis a person's muscle fibers break down and are released into the blood circulation system, thereafter potentially damaging the kidneys.

During the past year or so, the risk of rhabdomyolysis due to the use of Crestor -- which is the most potent of all anti-cholesterol drugs -- has been the subject of a relatively high-profile debate between the consumer advocacy group Public Citizen and AstraZeneca, the manufacturer of Crestor.  A March 2005 letter by Public Citizen to the FDA regarding Public Citizen's allegation that Crestor has higher rates of rhabdomyolysis compared to other statins can be viewed here:

http://www.citizen.org/publications/release.cfm?ID=7370

The use of cholesterol-lowering statin medications among persons aged 45 and older more than tripled during recent years.  A statin was prescribed 40.5 physician visits per 100 population in 2001 to 2002, compared to 12.3 physician visits per 100 population in 1995 to 1996.  This trend is expected to continue due to new cholesterol treatment guidelines.

(Posted by: Tom Lamb)