Q. I have a friend who was diagnosed with mild cognitive impairment last year. Several years ago she began having trouble with numbers and simple math, so she retired from teaching but took on a position as an administrator. She did fine with that until her retirement a couple of years ago.
She takes several drugs, including Detrol, atorvastatin, lisinopril, Namenda, levothyroxine, Aricept and sertraline. She also likes grapefruit juice with breakfast. Could any of these drugs together with the juice be contributing to her cognitive impairment? I’d be grateful for any information you can send.
A. Drugs for bladder control such as tolterodine (Detrol) and oxybutynin (Ditropan) can cause confusion and interfere with memory. Grapefruit can raise blood levels of the cholesterol-lowering drugs atorvastatin, simvastatin and lovastatin. This may lead to overdosing and impaired mental function.
We are sending you our Guides to Drugs and Older People and Grapefruit Interactions. They contain lists of drugs that should be avoided by older people as well as medications that interact with grapefruit. The combination of sertraline, atorvastatin, grapefruit and Detrol could be contributing to your friend’s mental difficulties (International Journal of Clinical Practice, July 2009).
