Drug-grapefruit juice interactions

Author’s reply to Backman and Bakhai

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1078 (Published 26 February 2013)
Cite this as: BMJ 2013;346:f1078

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  1. Munir Pirmohamed, professor of clinical pharmacology1
  1. 1Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3GL, UK
  1. munirp{at}liv.ac.uk

Backman and Bakhai question the clinical importance of drug-grapefruit juice interactions, focusing on statins.1 2 The risk of statin related myopathy is concentration dependent, but not everybody with the same (high) plasma statin concentration develops muscle injury (because susceptibility varies).3 However, anecdotal evidence or the sparseness of case reports cannot prove there is no risk. Drug …

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