pomegranate
3 interactions related to pomegranate
pomegranate + statins
Pomegranate inhibits the drug-metabolizing enzyme CYP3A4 in laboratory and animal studies, raising a theoretical concern that it could increase blood levels of CYP3A4-dependent statins such as simvastatin, atorvastatin, and lovastatin. However, controlled human studies - including ones using simvastatin and a sensitive CYP3A4 probe drug - did not find a meaningful effect, so pomegranate should not be treated like grapefruit. Concentrated pomegranate extract supplements warrant more caution than the whole fruit.
pomegranate + warfarin
Pomegranate contains punicalagins and other polyphenols that inhibit the liver enzymes CYP2C9 and CYP3A4 in laboratory and animal studies, which would slow warfarin metabolism. Case reports describe both a raised INR after heavy or newly started pomegranate juice intake and a falling INR after stopping a habitual juice habit. The effect appears to be genuine but infrequent, and consistency of intake matters more than total avoidance.
pomegranate + ace inhibitors
Pomegranate juice modestly lowers blood pressure on its own and can add to the blood-pressure-lowering effect of ACE inhibitors; it also contributes dietary potassium, which may compound the potassium-retaining effect of these drugs.