Like grapefruit, sweet orange (citrus sinensis) juice may
Inhibit OATP. Tangerines are related to the sweet orange
And may also have an interaction. Separation of the fruit or
Juice from statin administration by 4 hours may be advisable.
St John’s wort induces CYP3A4. There are noted
major interactions between statins and St. John’s wort, and
this combination should be avoided. St. John’s wort
mediates P-gp. It will decrease metabolism of simvastatin
and possibly atorvastatin, but not likely pravastatin, fluvastatin,
or rosuvastatin. Red yeast rice is a popular nonprescription
treatment for hyperlipidemia. Red yeast rice has
varying amounts of monacolin K (similar to lovastatin).
Products are not standardized and no red yeast rice product
Should be given to a patient taking a prescription statin.