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Grapefruit and simvastatin — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsGrapefruit and simvastatinGPhC CRA

A patient taking simvastatin 40 mg at night asks whether a daily grapefruit drink is safe. They have been stable on the statin for several months. 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 — Increased simvastatin exposure and myopathy risk

Grapefruit juice inhibits intestinal CYP3A4 and can increase simvastatin concentrations. The key concern is statin toxicity, including muscle symptoms. In this scenario, the correct option is increased simvastatin exposure and myopathy risk. The other options are plausible but do not address the key clinical, legal or safety issue as directly. This aligns with UK pharmacy practice guidance cited in the reference field.

Reference: BNF; Stockley's Drug Interactions