Overview
- Published on December 16, the NHS advisory urges patients on certain prescriptions to avoid grapefruit products and to seek individual advice from a GP or pharmacist.
- Named medicines include some statins (simvastatin, atorvastatin, lovastatin), calcium channel blockers used for blood pressure (amlodipine, diltiazem, verapamil), and drugs such as benzodiazepines, warfarin, ciclosporin, tacrolimus, fexofenadine, sildenafil, and certain HIV therapies.
- Grapefruit can inhibit intestinal CYP3A4 and transporter proteins like P‑gp, leading to higher systemic drug concentrations and risks such as muscle breakdown or kidney damage.
- Patients are advised to read medication leaflets for grapefruit warnings and to avoid grapefruit throughout treatment unless their clinician advises otherwise.
- Guidance notes differences within drug classes, with simvastatin requiring strict avoidance, limited intake sometimes permitted with atorvastatin, and other statins generally not thought to be affected.