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why can't you drink grapefruit with zocor or simvastatin:

The risk of myopathy and rhabdomyolysis is increased by high levels of statin activity in plasma. Simvastatin is metabolized by the cytochrome P450 isoform 3A4. Certain drugs which inhibit this metabolic pathway can raise the plasma levels of simvastatin and may increase the risk of myopathy. These include itraconazole, ketoconazole, and other antifungal azoles, the macrolide antibiotics erythromycin and clarithromycin, and the ketolide antibiotic telithromycin, HIV protease inhibitors, the antidepressant nefazodone, or large quantities of grapefruit juice ( > 1 quart daily).

Talk to your doctor. Talk to you pharmacist. Also see the related link below.

Do not take this medicine with any of the following medications:

•antibiotics like chloroquine, clarithromycin, erythromycin, grepafloxacin, pentamidine, sparfloxacin, troleandomycin

•arsenic trioxide

•cisapride

•droperidol

•halofantrine

•haloperidol

•medicines for irregular heart beat like amiodarone, bretylium, disopyramide, dofetilide, procainamide, quinidine, sotalol

•pimozide

•ranolazine

•rasagiline

•selegiline

•sertindole

•ziprasidone

This medicine may also interact with the following medications:

•alcohol

•alfuzosin

•antibiotics like gatifloxacin, gemifloxacin, levofloxacin, mefloquine, moxifloxacin, ofloxacin, telithromycin

•antihistamines for allergy, cough and cold

•desipramine

•MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

•medicines for blood pressure

•medicines for depression, anxiety, or psychotic disturbances

•medicines for irregular heart beat like flecainide, propafenone

•medicines for nausea or vomiting like dolasetron, ondansetron, palonosetron

•medicines for seizures like carbamazepine, phenobarbital, phenytoin

•medicines for sleep

•medicines for sleep during surgery

•medicines to numb the skin

•muscle relaxers

•narcotic medicines for pain

•octreotide

•peginterferon Alfa-2b

•phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

•rifampin, rifapentine

•some medcines for cancer like dasatinib, lapatinib, sunitinib

•some medicines for HIV like delavirdine, didanosine, efavirenz, nevirapine

•St. John's wort

•tacrolimus

•tramadol

•vardenafil

•vorinostat

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

* Atorvastatin is an HMG CoA reductase inhibitor. Atorvastatin blocks the production of cholesterol (a type of fat) in the body. * Atorvastatin is used to reduce the amounts of LDL (bad) cholesterol, total cholesterol, triglycerides (another type of fat), and apolipoprotein B (a protein needed to make cholesterol) in your blood. Atorvastatin is also used to increase the level of HDL (good) cholesterol in your blood. These actions are important in reducing the risk of hardening of the arteries, which can lead to heart attacks, stroke, and peripheral vascular disease. * Atorvastatin may also be used for purposes other than those listed in this medication guide. * Do not take atorvastatin without first talking to your doctor if you have liver disease. * Before taking atorvastatin, tell your doctor if you ** drink alcoholic beverages, ** have a chronic muscular disease, ** require major surgery, or ** have a blood disorder. * You may not be able to take atorvastatin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. * Atorvastatin is in the FDA pregnancy category X. This means that atorvastatin is known to cause birth defects if it is taken during pregnancy. Do not take atorvastatin if you are pregnant or could become pregnant during treatment. * It is not known whether atorvastatin passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. * Take atorvastatin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. * Take each dose with a full glass of water. * Atorvastatin can be taken with or without food. * Atorvastatin is usually taken once a day. Try to take your dose at the same time each day. Follow your doctor's instructions. * Your doctor may want to monitor your liver function with blood tests before starting treatment with atorvastatin, at twelve weeks after both the start of your treatment and any increase in dose, and periodically (every 6 months) thereafter. Depending on the results of these tests, your doctor can determine how much monitoring you will require. * Grapefruit and grapefruit juice may interact with atorvastatin. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. * Eat a low-fat, low-cholesterol diet. To realize beneficial effects from atorvastatin, avoid fatty, high-cholesterol foods. * It is important to take atorvastatin regularly to get the most benefit. * Do not stop taking atorvastatin without first talking to your doctor. Atorvastatin may need to be taken on a long-term basis for the treatment of high cholesterol. * Your doctor may want you to have blood tests or other medical evaluations during treatment with atorvastatin to monitor progress and side effects. * Store atorvastatin at room temperature away from moisture and heat. * Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. * Seek emergency medical attention if an overdose is suspected. * The symptoms of an atorvastatin overdose are not known. * Alcohol and atorvastatin can both be damaging to the liver. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for liver problems can be determined. * Grapefruit and grapefruit juice may interact with atorvastatin. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. * Rare cases of muscle problems and liver problems have been associated with the use of atorvastatin and other similar medicines. Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if accompanied by a fever or flulike symptoms or yellowing of the skin or eyes, abdominal pain, unexplained fatigue, dark colored urine or pale colored stools. These may be early symptoms of muscle or liver problems. * If you experience any of the following serious side effects, stop taking atorvastatin and seek emergency medical attention or contact your doctor immediately: ** an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); ** decreased urine or rust-colored urine; or ** blurred vision. * Other, less serious side effects may be more likely to occur. Continue to take atorvastatin and talk to your doctor if you experience ** headache; ** upset stomach or flatulence; or ** a rash. * Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. * alcohol-containing beverages * antacids * barbiturates (examples: phenobarbital, butalbital, primidone) * birth control pills * bosentan * carbamazepine * certain antibiotics such as clarithromycin, erythromycin, or troleandomycin * colestipol * cyclosporine * diltiazem * fenofibrate * gemfibrozil * grapefruit juice * herbal medicines such as St. John's Wort or Went Yeast/Red Rice Yeast * imatinib, STI-571 * medicines for fungal infections (examples: fluconazole, itraconazole, ketoconazole, voriconazole) * medicines for treating HIV infection * niacin * nefazodone * oxcarbazepine * phenytoin * pioglitazone * rifampin, rifabutin, or rifapentine * telithromycin * verapamil