citrus
2 interactions related to citrus
blood orange + simvastatin
Blood orange (Citrus sinensis var.) is a sweet orange and does not contain the furanocoumarins (such as bergamottin and 6',7'-dihydroxybergamottin) that drive the grapefruit-statin interaction. Reviews of citrus furanocoumarin content place blood orange among the sweet oranges that are essentially free of clinically significant CYP3A4-inhibiting compounds, so it is not expected to meaningfully affect simvastatin levels.
pomelo + simvastatin
Pomelo (Citrus maxima) contains furanocoumarins that inhibit intestinal CYP3A4, the enzyme that breaks down simvastatin during first-pass absorption. With that enzyme suppressed, more simvastatin reaches the bloodstream, raising the risk of muscle-related side effects. This is the same mechanism behind the well-established grapefruit-simvastatin interaction, since pomelo is the parent species of grapefruit and shares its furanocoumarins.