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Grapefruit and simvastatin — GPhC CRA MCQ

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ModerateDrug InteractionsGrapefruit and simvastatinGPhC CRA

A patient taking simvastatin 40mg nightly asks whether a daily glass of grapefruit juice is acceptable. He has recently had muscle aches. What is the most important interaction to flag?

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Correct answer: B — Grapefruit juice can increase simvastatin levels and myopathy risk

Grapefruit juice inhibits intestinal CYP3A4 and can increase simvastatin exposure. Muscle symptoms raise concern for statin-associated myopathy and should be assessed. The patient should avoid grapefruit and seek advice about the symptoms.

Reference: BNF