Vytorin and "certain foods"

[DW]

I'm a 60 year old male on Vytorin for about a year. The ads always warn about adverse effects from "certain other foods."

What the heck are these certain other foods? Thanks.

[sos_group_owner]

Hi DW,

The only food I could find mentioned in the DPI (Drug Package Insert):
"Grapefruit Juice: Grapefruit juice contains one or more components that inhibit CYP3A4 and can increase the plasma concentrations of drugs metabolized by CYP3A4." The quantity they refer to is 1 guart or more.

And of course they want you to adhere to the typical low fat low cholesterol, the worst thing you can do to your body. Consuming cholesterol does not cause elevated cholesterol and low fat drives down your good HDL. Most that adhere to the LF - LC diet usually comsume high carbs which causes elevated triglycerides.

DPI from Merck:
ww.vytorin.com/vytorin/shared/documents/vytorin_pi.pdf

You might want to read all 19 pages and then decide if you want to continue taking Vytorin.

Fran

[flacorps]

I believe the grapefruit juice is [i]binary[/i] (meaning it's made up of two chemical that act synergistically).

One set of chemicals is the furanocoumarins such as epoxybergamottin and bergamottin ... these chemicals inhibity important parts of the P450 enzyme system, specifically the CYP3A4 pathways that clear a huge percentage of drugs from the human body.

The other are the flavonoids that inhibit P-glycoprotein ... this is a method of clearing drugs through the kidneys, and is the only method left for the body when the P450 system is shut down.

Grapefruit juice will close both escape routes. But many other things will close one or the other, and thus in combination they will re-create the grapefruit juice effect.

I speak from experience, because I was a heavy drinker of LaCroix lemon and lime sparkling waters, which I drank as a substitute for soda pop. The problem is that they lack citric acid, which breaks down furanocoumarins, and to give them their flavors they use natural flavorings made from the peels of the fruits, which are where all the furanocoumarins are found (because they are natural bug repellants/deterrants/pesticides built into the plants). This stuff can build up in the liver bigtime, though ordinarily once there it does nothing but keep P450 out of commission, and most of the time P450 isn't terribly important ... until you start taking a drug.

And what would then happen was on occasion I would drink orange juice ... which contains flavonoids but not furanocoumarins. It would close off the kidneys as a way for the drugs to get out.

And what had been a chronic mild overdose would suddenly turn into a raging overdose (thankfully, this is Lescol, one of the milder statins that doesn't interact too much).

And I would then develop black pigment stones (presumably from liver damage and/or hemoytic anemia) that would clog my gallbladder and give me pancreatitis, etc. It was rough.

I also wound up with low testosterone that did not resolve itself after I quit taking the statin, so now I'm on HRT, maybe for the rest of my life.

Don't assemble the same combination I did.