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People’s Pharmacy: Grapefruit juice can boost statin levels

Feb. 28, 2023 Updated Tue., Feb. 28, 2023 at 5:22 p.m.

 (The Spokesman-Review)
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By Joe Graedon, M.S., and Teresa Graedon, Ph.D. King Features Syndicate

Q. I told my endocrinologist that I wanted to stop taking my statin due to reports about serious side effects. He said, “I’ll make you a deal, pal: I’ll cut your dose in half, and you start taking grapefruit juice.” Done deal.

My lipids are all good, and I’m free of statin side effects so far. I’ve had 71 pretty good years. Would it make sense to stop the atorvastatin in favor of red yeast rice and grapefruit juice?

A. Grapefruit juice turbocharges certain statin blood levels by slowing the body’s metabolism of such drugs. For example, a daily glass of this juice boosts simvastatin and lovastatin by 260% if taken at the same time (American Journal of Medicine, January 2016). Even drinking GJ 12 hours later can increase blood levels by 90%.

Atorvastatin interacts less strongly. GJ only increases blood levels by 80%. Cutting your dose in half and adding grapefruit juice would put you back approximately where you started.

Some people are more sensitive to statin side effects than others. Because red yeast rice supplements frequently contain lower amounts of statin compounds such as lovastatin, many individuals can tolerate them even if they have trouble with statins. Since you have not experienced any statin side effects, you may not need to make any adjustments.

Q. After taking just a couple escitalopram pills, I found myself wondering which side of my neck was best for cutting. I had no idea where that disturbing thought came from.

When I told my doctor, he told me to stop taking the drug. Is it possible for antidepressants to trigger suicidal thoughts? What else could I do to shake my depression?

A. Escitalopram (Lexapro), like many similar drugs, comes with this warning: “Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.”

There is controversy about whether antidepressants have this effect on middle-aged individuals as well. Anyone who experiences thoughts of self-harm should follow your example and check with the prescriber immediately.

You can learn more about other strategies for managing depression in our “eGuide to Dealing with Depression.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com. It discusses talk therapy, exercise, light therapy and some supplements.

Q. I have Parkinson’s disease, which has led to 14 years suffering with restless leg syndrome. This keeps me awake at night. I also deal with pain and spasms as soon as I rest.

I take ropinarole for the PD. It is also supposed to help with the RLS, but I haven’t noticed much effect.

The only relief I have had was after my Moderna COVID-19 vaccination. I called it a miracle because the relief was incredible. Sadly, it didn’t last more than a month or so.

I can’t wait to have my booster this year. I’ve got my fingers crossed it will be Moderna again. Have you heard of others reacting this way?

A. Two years ago, we received a message from a reader who had been suffering from RLS for years. After getting the Moderna vaccine, his symptoms disappeared. They eventually came back but at a much lower level.

Since then, we have heard from a number of other readers who have reported reduced RLS symptoms after vaccination. On the other hand, Japanese doctors report one case of RLS developing in an 87-year-old woman after getting the Pfizer vaccine (Neurology and Clinical Neuroscience, May 2022). So far, we have no scientific explanation for this effect.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla., 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”

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