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Pomegranate (Punica granatum) is a small fruit-bearing tree. The fruit is commonly eaten as a food and has also been used medicinally in various cultures.

Pomegranate contains chemicals that might have antioxidant effects. One pomegranate delivers almost 30 mg of vitamin C. Other chemicals in pomegranate juice might slow hardening of the arteries and possibly fight cancer cells.

People use pomegranate for high blood pressure, athletic performance, heart disease, diabetes, and many other conditions, but there is no good scientific evidence to support most of these uses. There is also no good evidence to support using pomegranate for COVID-19.

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When taken by mouth: Pomegranate fruit and fruit juice are likely safe for most people. Most people don't experience side effects and it's been used safely for up to 3 years. Pomegranate fruit and seed extract are possibly safe. Some people have experienced allergic reactions, including itching, swelling, runny nose, and difficulty breathing.

The root, stem, and peel of pomegranate are possibly unsafe when used in large amounts. They contain poisonous chemicals.

When applied to the skin: Pomegranate extract is possibly safe. Some people might have allergic reactions.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Pomegranate fruit and fruit juice are possibly safe when used during pregnancy or when breast-feeding. But there isn't enough reliable information to know if other forms of pomegranate, such as pomegranate extract, are safe to use. Stay on the safe side and stick with pomegranate fruit or juice.

Allergies to plants: People with plant allergies seem to be more likely to have an allergic reaction to pomegranate.

Surgery: Pomegranate might affect blood pressure. This might interfere with blood pressure control during and after surgery. Stop taking pomegranate at least 2 weeks before a scheduled surgery.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Pomegranate might decrease how quickly the liver breaks down some medications. Taking pomegranate along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking pomegranate talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), fluoxetine (Prozac), ondansetron (Zofran), tramadol (Ultram), and others.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Interaction Rating=Minor Be watchful with this combination.

There has been some concern that drinking pomegranate juice might decrease how quickly the liver breaks down some medications. However, scientific research shows that drinking pomegranate juice probably does not cause an important interaction with medications. Until more is known, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include amlodipine (Norvasc), diltiazem (Cardizem), verapamil (Verelan, Calan, others), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase), alfentanil (Alfenta), fentanyl (Sublimaze), midazolam (Versed), ondansetron (Zofran), propranolol (Inderal), and many others.

Medications for high blood pressure (ACE inhibitors)

Interaction Rating=Moderate Be cautious with this combination.

Pomegranate juice seems to decrease blood pressure. Taking pomegranate juice along with medications for high blood pressure might cause your blood pressure to be too low.
Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Pomegranate seems to decrease blood pressure. Taking pomegranate along with medications for high blood pressure might cause your blood pressure to go too low.
Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.

Rosuvastatin (Crestor)

Interaction Rating=Moderate Be cautious with this combination.

Rosuvastatin (Crestor) is broken down by the body in the liver. Drinking pomegranate juice might decrease how quickly the liver breaks down rosuvastatin (Crestor). This might increase the effects and side effects of rosuvastatin (Crestor).

Herbs and supplements that might lower blood pressure: Pomegranate might lower blood pressure. Taking it with other supplements that have the same effect might cause blood pressure to drop too much. Examples of supplements with this effect include andrographis, casein peptides, L-arginine, niacin, and stinging nettle.

There are no known interactions with foods.

Pomegranate juice has most often been used by adults in doses of 50-240 mL by mouth daily for up to 3 months. Pomegranate fruit extract has been used in doses of up to 3 grams by mouth daily for up to 18 months. Speak with a healthcare provider to find out what dose might be best for a specific condition.

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