Pomegranate
Pomegranate

Background

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.
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.

Effectiveness

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Likely effective Effectiveness definitions
Possibly effective Effectiveness definitions
  • High blood pressure. Drinking pomegranate juice daily can lower systolic blood pressure (the top number) by about 5 mmHg. But it doesn't seem to reduce diastolic pressure (the lower number).
Likely ineffective Effectiveness definitions
Possibly ineffective Effectiveness definitions
  • Diabetes. Taking pomegranate by mouth doesn't improve blood sugar in people with diabetes.
  • High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). Taking pomegranate by mouth doesn't seem to lower cholesterol in people with or without high cholesterol.
There is interest in using pomegranate for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.
Insufficient evidence Effectiveness definitions

Dosing & administration

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.

Interactions with pharmaceuticals

Carbamazepine (Tegretol)

Interaction Rating=Minor Be watchful with this combination.

Carbamazepine is broken down by the body. Taking pomegranate might decrease how quickly the body breaks down carbamazepine. This might increase the effects and side effects of carbamazepine.

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)

Interaction Rating=Minor Be watchful with this combination.

Some medications are changed and broken down by the liver. Pomegranate might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

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 change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

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

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Pomegranate might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications for high blood pressure (ACE inhibitors)

Interaction Rating=Moderate Be cautious with this combination.

Pomegranate might lower blood pressure. Taking pomegranate along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Pomegranate might lower blood pressure. Taking pomegranate along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Rosuvastatin (Crestor)

Interaction Rating=Moderate Be cautious with this combination.

Rosuvastatin is broken down by the body. Taking pomegranate might decrease how quickly the body breaks down rosuvastatin. This might increase the effects and side effects of rosuvastatin.

Tolbutamide (Orinase)

Interaction Rating=Minor Be watchful with this combination.

Tolbutamide is broken down by the body. Taking pomegranate might decrease how quickly the body breaks down tolbutamide. This might increase the effects and side effects of tolbutamide.

Warfarin (Coumadin)

Interaction Rating=Moderate Be cautious with this combination.

Warfarin is broken down by the body. Drinking pomegranate juice might decrease how quickly the body breaks down warfarin. This might increase the effects and side effects of warfarin.

Interactions with herbs & supplements

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.

Interactions with foods

There are no known interactions with foods.
Per capsule:
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This monograph was last reviewed on 25/05/2022 20:44:30 and last updated on 31/07/2022 21:25:13. Monographs are reviewed and/or updated multiple times per month and at least once per year.
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