marmalade

seville orange + atorvastatin

Seville (bitter) orange contains the same furanocoumarins as grapefruit, including bergamottin and 6',7'-dihydroxybergamottin, which irreversibly inhibit intestinal CYP3A4. A landmark crossover study showed Seville orange juice raised felodipine AUC by 76%, comparable to grapefruit, and atorvastatin shares the same CYP3A4 metabolic pathway, raising the risk of statin-induced myopathy.