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Grapefruit with simvastatin — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsGrapefruit with simvastatinGPhC CRA

A patient collecting simvastatin 40mg at night asks whether they can continue drinking grapefruit juice each morning. They have no muscle symptoms. What would you advise the patient?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Avoid grapefruit juice because it can increase simvastatin exposure

Grapefruit juice inhibits intestinal CYP3A4 and can increase simvastatin levels. This increases the risk of statin-associated muscle toxicity. The patient should avoid grapefruit products or discuss a statin less affected by this interaction.

Reference: BNF