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All TopicsForum: Complementary and Holistic Medicine and Treatment → Topic: Pomegranate Juice Interacts With Medications

Topic: Pomegranate Juice Interacts With Medications

Forum: Complementary and Holistic Medicine and Treatment — Complementary medicine refers to treatments that are used WITH standard treatment. Holistic medicine is a term used to describe therapies that attempt to treat the patient as a whole person.

Posted on: Jul 22, 2007 09:14AM

saluki wrote:

I was going online to order some Pomegranate molasses and I ran across this

Pomegranate Juice Interacts With Medications


But a report published in the September 1 2006 issue of the American Journal of Cardiology suggests that we don't know enough about how pomegranate interacts with common medications.

A 48-year-old man was taking ezetimibe (trade name Zetia) 10 mg a day and rosuvastatin (trade name Crestor) 5 mg every other day for 17 months. Both medications are used to treat high cholesterol.

He began drinking pomegranate juice (200 ml twice weekly) and three weeks later, was admitted to emergency with thigh pain and an elevated serum creatine kinase level (138,030 U/L, normal < 200 U/L).

Both are symptoms of rhabdomyolysis, a serious condition that causes the breakdown of muscle fibers and may lead to kidney failure.

Rosuvastatin belongs to a group of medicines called HMG-CoA reductase inhibitors, or 'statins'. Grapefruit juice is known to increase the risk of statin-induced myopathy, but up until now, there was little information about whether pomegranate juice might also increase the risk.

Pomegranate juice and grapefuit juice, are both known to block the cytochrome P450 3A4 enzyme systems in the intestines. By inhibiting these enzymes, the juices may increase blood levels of many medications.
Potential Pomegranate-Drug Interactions

* Antiarrhythmics - Amiodarone (Cordarone), disopyramide (Norpace), quinidine

* Calcium channel blockers - Felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia), nimodipine (Nimotop), nisoldipine (Sular)

* Statins - Atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor)

* Immunosuppressants - Cyclosporine (Sandimmune, Neoral), tacrolimus (Prograf)

* Protease inhibitors - Saquinavir (Fortovase)

However, pomegranate juice may also interact with medications not on this list. The drugs ezetimibe and rosuvastatin are not thought to be broken down by cytochrome P450 3A4.

Based on the limited evidence about the potential drug interactions, it would be wise to talk with your doctor if you use pomegranate products regularly, and to avoid taking pomegranate products within 72 hours of taking the above medications.

Sources

Hidaka M, Okumura M, Fujita K, Ogikubo T, Yamasaki K, Iwakiri T, Setoguchi N, Arimori K. Effects of pomegranate juice on human cytochrome p450 3A (CYP3A) and carbamazepine pharmacokinetics in rats. Drug Metabolism and Disposition. 33.5 (2005):644-8.

Kim H, Yoon YJ, Shon JH, Cha IJ, Shin JG, Liu KH. Inhibitory effects of fruit juices on CYP3A activity. Drug Metabolism and Disposition. 34.4 (2006):521-3.

Sorokin AV, Duncan B, Panetta R, Thompson PD. Rhabdomyolysis associated with pomegranate juice consumption. American Journal of Cardiology. 98.5 (2006):705-6.
Updated: September 19, 2006


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Jul 22, 2007 10:33AM Rosemary44 wrote:

Thanks Susie,

Good find. There goes the pom juice I so love. We have to start drinking the pom juice before we need meds, so we won't need the meds in the first place.
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Jul 25, 2007 01:35PM Rosemary44 wrote:

"but up until now, there was little information about whether pomegranate juice might also increase the risk."

Now that I think about it some more, there still is little information about the risk. One person does not make an entire human research project to see if pom juice interferes with meds to make them stronger.

If it does work that way, we can save money and get lower doses of the drug it effects, and down it with some pom juice. The pom industry needs to respond to this with its own research. I hope they use more than one person.
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Jul 26, 2007 02:34AM Rosemary44 wrote:

http://www.ncbi.nlm.nih.gov/sites/entrez...p;dopt=Abstract

I'm going back to my pom juice again. I had this feeling that if there were more experiences like the one that fellow had, we'd hear all about it right here on these boards.
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Jul 26, 2007 06:10AM saluki wrote:

I wish they would give us the parameters of the studies so we would know how seriously to take this stuff. Particularly how many were in the study.

For me, I'll continue to have my Pomegranate molasses drinks.
I enjoy them (unlike the Kombucha tea. LOL) and they are very refreshing---if they are healthy--
all the better--(I feel the same way about flax seeds).

Susie

Susie, member since Jan. 2003

Dx 12/12/2002, IDC, 2cm, Stage IIb, 0/1 nodes, ER+/PR+, HER2-
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Jul 26, 2007 06:34AM jpann39 wrote:

I love pom juice....what is Pomegranate molasses drinks????

Jule

'Gain strength by the positive and don't be sapped by the negative"

Dx 11/4/2006, IDC, 2cm, Stage II, Grade 1, 0/9 nodes, ER+/PR+, HER2-
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Jul 26, 2007 06:45AM saluki wrote:

Julie, I buy Pomegranate molasses in the middle eastern grocery stores. Its very concentrated and I use it in cooking,
but during the summer. I like to mix it with seltzer water and ice much like a wine spritzer. I find the sweet-tart very refreshing.

Susie

Susie, member since Jan. 2003

Dx 12/12/2002, IDC, 2cm, Stage IIb, 0/1 nodes, ER+/PR+, HER2-
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Jul 26, 2007 06:48AM jpann39 wrote:

Hmmmm, I will have to check to see if I can find a place to get it here...

There is a community about 20 miles away that is entirely vegitarian and I purchase alot of items in their grocery that are not available in other stores here so Im thinking they may have it ....

I really sounds like something I would like....
Thank you for telling me about it.

Any other suggestions for pom use would be appreciated as well...I just enjoy the taste of it so have always drank it...

Jule

'Gain strength by the positive and don't be sapped by the negative"

Dx 11/4/2006, IDC, 2cm, Stage II, Grade 1, 0/9 nodes, ER+/PR+, HER2-
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Jul 26, 2007 07:07AM saluki wrote:

Here is a little blurb about it and if you can't get it in the market amazon carries it.

We quote expert Paula Wolfert, a fine cookbook author: "Pomegranate molasses is an essential ingredient...has a wonderful flavor and a heady aroma, and its thickness and dark color make food look very appealing. It keeps almost indefinitely in the refrigerator. The uses for this thick, tangy, piquant syrup are many. It blends well with walnuts, adds a tart and pungent flavor to beans, sharpens the taste of poultry, gives a clean, tart taste to fish, gives an astringent edge to salads and vegetables, and is a great tenderizer for lamb and pork. It can also be diluted and used for sharp drinks and tart sorbets."

It can be used for sauces or diluted to make pomegranate drinks.

http://www.amazon.com/exec/obidos/search...process=default

Susie, member since Jan. 2003

Dx 12/12/2002, IDC, 2cm, Stage IIb, 0/1 nodes, ER+/PR+, HER2-
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Jul 26, 2007 07:11AM jpann39 wrote:

Thank you so much!!!!

Jule

'Gain strength by the positive and don't be sapped by the negative"

Dx 11/4/2006, IDC, 2cm, Stage II, Grade 1, 0/9 nodes, ER+/PR+, HER2-
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Jul 26, 2007 02:48PM BlindedByScience wrote:

I use the pom molasses on my oatmeal, along with ground flaxseed, walnuts and cinnamon. I also mix it into rice milk smoothies with frozen blueberries and raspberries. It works well mixed into balsamic vinegar for dressing green salads or over chicken salad.

I'm thinking about making my own pomegranate ice cream (well, rice cream) with dark chocolate bits.

I haven't found any studies to show it interferes with Armidex and my estradiol level just tested at <3.
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Jul 26, 2007 04:01PM JoanofArdmore wrote:

QUOTE:"I'm going back to my pom juice again. I had this feeling that if there were more experiences like the one that fellow had, we'd hear all about it right here on these boards. "

Rosemary, me too! I very much dislike taking results of small , possibly inefficient, studies as a holy grail!These alarmists & killjoys, I think, get lists of the latest good things, and do studies to prove them "bad for us".
I was appalled but refused to quit my daily 3 oz of Pom.

You're my hero, Rosemary!
THANKS!!

Still, I continue to continue to pretend, my life will never end, and flowers never bend with the rainfall . Paul Simon

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Jul 27, 2007 12:22AM CaliforniaKate wrote:

I ordered a bottle of pomegranate capsules, and then found out that you can't take them while on tamoxifen. Kate

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Jul 27, 2007 03:25AM Rosemary44 wrote:

Joan,

News like this gets out very slowly, so there must be quite a few people happily taking their statins and having their pom too, like myself. I've been doing this for years. This might have more to do with Crestor then it does with pom. Who's to say?

I'd like to read the full research report too but I don't think we should have to pay for it. The pom industry should just be making it available to whomever asks for a copy. Or just post it on their web site. Pay the copyright fee and let us have it.
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Aug 1, 2007 11:21AM Rosemary44 wrote:

I think that gentleman should dump his crestor and keep the pom juice. Look how pom got blamed for something that crestor is in deep water for:

http://www.injury-help-usa.com/crestor.htm