Pomegranate juice may interact with many drugs

Thread view:

Enable EMail Alerts

Start New Thread

Thread rating:

Matti Narkia - 09 Oct 2006 13:12 GMT

According to the study

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 Metab Dispos. 2005 May;33(5):644-8. Epub 2005 Jan 26.
PMID: 15673597 [PubMed - indexed for MEDLINE]
<http://dmd.aspetjournals.org/cgi/content/full/33/5/644>

pomegranate juice inhibits Cytochrome P450 (CYP) subfamily CYP3A
enzymes. Cytochrome P450 (CYP) is a family of about 60 enzymes. Of
these the subfamily CYP3A (especially the enzyme CYP3A4) is
responsible for the metabolism and clearance of about 50% of all
drugs. Both grapefruit juice and pomegranate juice inhibit CYP3A, and
their inhibition potencies are similar.

A partial list of CYP3A subtrates, i.e. drugs that are metabolized by
subfamily CYP3A enzymes, and whose effects therefore are enhanced by
CYP3A inhibitors such as grapefruit juice and pomegranate juice, is at

<http://medicine.iupui.edu/flockhart/3A457.htm#3A457sub>

Links and references:

Cytochrome P450 3A Subfamily drug interactions
<http://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/acf2ed6.htm>

Drug-Interactions.com
<http://medicine.iupui.edu/flockhart/>

Cytochrome P450
<http://www.mall-net.com/mcs/p450.html>

Cytochrome P450 Enzymes
<http://home.earthlink.net/~cpardee/>

Cytochrome P450 Homepage
<http://drnelson.utmem.edu/CytochromeP450.html>

CYTOCHROME P450
<http://www.medhelp.org/glossary2/new/gls_1530.htm>

Clinically significant drug interactions
What you need to know before writing prescriptions
Michael D. Johnson, PharmD; Gary Newkirk, MD; John R. White Jr, PharmD
VOL 105 / NO 2 / FEBRUARY 1999 / POSTGRADUATE MEDICINE
<http://www.postgradmed.com/issues/1999/02_99/johnson.htm>

Signature

Matti Narkia

Reply to this Message

Juhana Harju - 09 Oct 2006 14:43 GMT

: According to the study
:
[quoted text clipped - 22 lines]
:
: Cytochrome P450 3A Subfamily drug interactions

<http://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/acf2ed6.htm>

: Drug-Interactions.com
: <http://medicine.iupui.edu/flockhart/>
[quoted text clipped - 16 lines]
: VOL 105 / NO 2 / FEBRUARY 1999 / POSTGRADUATE MEDICINE
: <http://www.postgradmed.com/issues/1999/02_99/johnson.htm>

Thanks, Matti, for this posting. This is annoying information and
unfortunately it limits the use of pomegranate juice.

Signature

Juhana

Reply to this Message

Paul Antonik Wakfer - 09 Oct 2006 17:07 GMT

> : According to the study
> :
[quoted text clipped - 51 lines]
> --
> Juhana

I agree with Juhana on this (about both the thanks to Matti and the
negative effects of the information).

With this important additional inhibitor of drug clearance (and there
are many others), it seems to me that the argument that a lower drug
dosage cannot be prescribed because the dosage of inhibitor is not
standardized and with similar effects in all people, is no longer
tenable. After all, the effects of a given dosage of a drug also varies
widely with the individual.

Therefore, it is time for studies to find out, with some reasonable
"ball park" accuracy, what regimen of use of both grapefruit and
pomegranate juice/fruit will require what reduction of dosage of which
drugs, particularly of the more commonly used drugs that are affected.
This is necessary since pomegranate juice in particular (especially for
those who are already in poor enough health to need drugs) is highly
beneficial for prevention and recovery from many maladies. Such studies
could be financed by a consortium of pomegranate and grapefruit
producers who would stand to gain from the results.

--Paul Wakfer

MoreLife for the rational - http://morelife.org
Reality based tools for more life in quantity and quality
The Self-Sovereign Individual Project - http://selfsip.org
Rational freedom by self-sovereignty & social contracting

Reply to this Message

monty1945@lycos.com - 09 Oct 2006 21:35 GMT

The more important question is: how many people are taking drugs that
they do not need to take? Cholesterol lowering drugs, for example, are
a gross distortion of the scientific reality, particularly the way they
are marketed. Only under extreme circumstances would I refrain from
eating antioxidant-rich foods in order to take the kinds of drugs being
sold to a gullible public these days by BirPharm, and by doctors, who,
to a large degree are often little more than legal versions of the
"streetcorner pimp."

Reply to this Message

Matti Narkia - 28 Feb 2007 22:14 GMT

>According to the study
>
[quoted text clipped - 18 lines]
>
><http://medicine.iupui.edu/flockhart/3A457.htm#3A457sub>

There is some new information about pomegranate juice's drug
interactions:

Farkas D, Oleson LE, Zhao Y, Harmatz JS, Zinny MA, Court MH,
Greenblatt DJ.
Pomegranate Juice Does Not Impair Clearance of Oral or Intravenous
Midazolam, a Probe for Cytochrome P450-3A Activity: Comparison With
Grapefruit Juice.
J Clin Pharmacol. 2007 Mar;47(3):286-94.
PMID: 17322140 [PubMed - in process]
<http://jcp.sagepub.com/cgi/content/abstract/47/3/286>

So pomegranate juice does not seem to alter clearance of intravenous
or oral midazolam, whereas grapefruit juice impairs clearance and
elevates plasma levels of oral midazolam.

Signature

Matti Narkia

Reply to this Message