Lipitor and Grapefruit / Alcohol Interactions

Lipitor (atorvastatin) is a drug proven to lower high cholesterol, especially when coupled with a healthy diet and exercise. Lipitor has been a life saver and changer for many who suffer from high cholesterol. High cholesterol is proven to lead to heart disease and hyper tension if it is not lowered. However, in order to enjoy the full benefits of Lipitor, it is important be informed of possible interactions. Some interactions with the drug Lipitor can be harmful and seriously detrimental to health.

Lipitor and Grapefruit

While taking the medication Lipitor, it is essential not to consume grapefruit or drink grapefruit juice. When Lipitor is ingested along with grapefruit juice it can cause harmful liver damage or myopathy. In some cases, if it is severe enough, liver damage can even lead to death. At the very least, liver damage is extremely painful and very detrimental to the patient's health. Myopathy results in cramping and degradation of muscle tissue and liver damage, which is very painful.

The reason grapefruit juice cause such a severe reaction when taken with Lipitor is because it inhibits an enzyme in the liver known as CYP3A4. This enzyme is responsible for metabolizing and thereby limiting the amount of Lipitor that is allowed into the blood stream. So basically when grapefruit juice is taken alongside Lipitor, it causes the drugs potency to increase as if many times more had been taken resulting symptoms which are usually associated with an overdose of Lipitor.

Lipitor and Alcohol

Though combining alcohol with Lipitor does not pose as serious of a problem as combining grapefruit juice, caution should still be exercised. It is recommended that one get their liver enzymes checked before as well as during treatment with Lipitor. If transaminase levels appear high on these tests alcohol should be avoided as it may lead to liver damage. Lipitor on its own can sometimes cause liver damage and adding alcohol to the mix will only worsen the effects. Generally, though, having a couple of drinks while on Lipitor is not going to cause any damage. It is only in rare cases that alcohol should be completely avoided while on Lipitor. It is always good to check with a primary care physician before having alcohol, however. Also, excessive amounts of alcohol should be avoided while on Lipitor as this poses a real risk of causing worse liver damage when combined with Lipitor than it would have on its own.

Other Interactions

All prescription drugs which are CYP3A4 inhibitors should not be co-administered alongside Lipitor. These include itraxonazole, diltiazem, fluconazole, and many others. Drugs which are CYP3A4 inducers are not as dangerous as CYP3A4 inhibitors but they can lead to the lessening of effects and should be avoided as well. These include some barbiturates, bosentan, fosphenytoin and many more. Niacin should also be avoided as it has been shown to increase the risk of myopathy and rhabdomyolysis in those taking Lipitor. Vitamin D will lower the concentration of Lipitor in the blood but it will also work synergistically to lower cholesterol so it need not be avoided.