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Grapefruit and simvastatin — GPhC CRA MCQ

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EasyDrug InteractionsGrapefruit and simvastatinGPhC CRA

A patient taking simvastatin 40 mg at night says he drinks grapefruit juice every morning. He asks whether this matters because he feels well. What is the most important interaction to flag?

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

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

Grapefruit juice can inhibit metabolism of simvastatin and increase the risk of muscle toxicity. Feeling well does not exclude future adverse effects. The patient should avoid grapefruit juice and report unexplained muscle pain, tenderness or weakness. Changing the time of day does not reliably avoid the interaction.

Reference: BNF