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The latest NHS guidance for anyone taking atorvastatin includes a 'red flag' key fact users should be aware of regarding a certain type of drink. Atorvastatin is a widely prescribed medication in the UK. It's a commonly used treatment for preventing heart disease.

Atorvastatin is part of a group of drugs known as statins. It's used to reduce cholesterol levels if you've been told you have high cholesterol and to help prevent heart problems like heart attack and stroke. Doctors might also prescribe atorvastatin if you have a family history of heart issues, or if you have a chronic health problem like type 1 or type 2 diabetes or rheumatoid arthritis.

According to the NHS, atorvastatin is available only on prescription. It comes as tablets, including chewable tablets for people who have difficulty swallowing. You'll usually take atorvastatin once a day. There are five types of statins available on prescription in the UK:

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The health service also urges anyone taking atorvastatin to avoid drinking too much of a certain fruit juice due to the risks it can cause. "It's best not to have too much grapefruit juice when taking atorvastatin," it said.

"Try not to drink more than a litre of grapefruit juice a day. Too much of it can increase the level of atorvastatin in your blood. This can increase the risk of side effects." It adds: "A doctor may advise you to avoid it completely or only consume small quantities."

Drinking a lot of grapefruit juice (over a litre a day) can change how atorvastatin works. It raises the amount of atorvastatin in your bloodstream and your risk of side effects.

Common side effects include feeling sick (nausea) or indigestion, headaches, nosebleeds, sore throat, constipation or farting (flatulence) and diarrhoea. Serious side effects include unexplained muscle pain, tenderness, weakness or cramps, the whites of your eyes turning yellow, skin rash with pink or red blotches, severe stomach pain, shortness of breath and double vision.

You can report any suspected side effect using the Yellow Card safety scheme. Visit the Yellow Card website for more information about reporting side effects. It is important to check the leaflet inside any medication package before taking it.

Grapefruit contains compounds known as furanocoumarins that inhibit an enzyme (CYP3A4) in your intestines from breaking down atorvastatin. This means more of the medicine gets into your blood. When there's more of it, it works like a much bigger dose, which can really increase the chances of serious muscle pain, damage (rhabdomyolysis), and harm to your kidneys.

Grapefruit prevents atorvastatin from being broken down, which can result in higher, possibly harmful levels in the body. Higher levels can lead to serious side effects, like severe muscle breakdown (rhabdomyolysis).

Even though having a lot of grapefruit regularly is risky, a small glass of juice now and then might be fine for some people, but it's safer to stay away from it. There may also be similar issues with Seville oranges, limes, and pomelos.

A statement on the website reads: "You may be told to avoid eating and drinking grapefruit while taking certain statins. This is because it can increase the amount of statin in your blood, which can increase the risk of side effects.

"Do not eat or drink grapefruit if you're taking simvastatin. If you take atorvastatin, you can have grapefruit and grapefruit juice, but have it only occasionally and not a large quantity. If you take another type of statin, grapefruit is not thought to be a problem."

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