Lovastatin Niacin, Grapefruit | Lovastatin Drug Interactions

Since statin drugs (including lovastatin) are mostly metabolized via CYP3A4, grapefruit juice with its components flavanoid naringin (or furanoccoumarin bergamottin) would inhibit CYP3A4 leading to a in decrease in metabolic clearance of lovastatin and thus increasing its plasma concentrations. There are drug interactions of lovastatin with fibrates including gemfibrozil, niacin, or ciclosporin and hence, lovastatin at doses higher than 20 mg per day should not be used together with these drugs as risk of rhabdomyolysis is significantly increased.

Other drugs found to reduce the lovastatin elimination include erythromycin, ketoconazole, itraconazole, clarithromycin, telithromycin, cyclosporine, nefazodone and protease inhibitors such as indinavir and ritonavir.