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Pomegranate


What is it?

Pomegranate is a tree. Various parts of the tree and fruit are used to make medicine.

Pomegranate is used for many conditions, but so far, there isn’t enough scientific evidence to rate pomegranate as effective for any of them. We do know, though, that pomegranate does not seem to be effective for reducing the symptoms of chronic obstructive lung disease (COPD) or improving breathing in people with this condition.

Pomegranate is used for conditions of the heart and blood vessels, including high blood pressure, congestive heart failure (CHF), heart attack, “hardening of the arteries” (atherosclerosis), and high cholesterol. It is also used for conditions of the digestive tract, including diarrhea, dysentery, and tapeworm and other intestinal parasites.

Some people use pomegranate for flu, swelling of the lining of the mouth (stomatitis), gum disease, erectile dysfunction (ED), diabetes and a complication called acidosis, bleeding, and HIV disease. It is also used for preventing prostate cancer, obesity, and weight loss. Some women use pomegranate to cause an abortion.

Pomegranate is used as a gargle for sore throat, and it is applied to the skin to treat hemorrhoids.

Pomegranate (Punica granatum) is unique among plants. The only other plant that is closely related is a small tree commonly known as the pomegranate tree or Socotran pomegranate (Punica protopunica) and grows only on the Socotra island in Yemen.

Pomegranate has been used for thousands of years to treat a wide variety of diseases. It is in Greek, Hebrew, Buddhist, Islamic, and Christian mythology and writings. It is described in records dating from around 1500 BC as a treatment for tapeworm and other parasites.

Many cultures use pomegranate as a folk medicine. Pomegranate is native to Iran. It is primarily cultivated in Mediterranean counties, parts of the United States, Afghanistan, Russia, India, China, and Japan. You’ll see pomegranate in some royal and medical coats of arms.

How effective is it?

Natural Medicines Comprehensive Database 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.

The effectiveness ratings for POMEGRANATE are as follows:

Possibly ineffective for...

  • Chronic lung disease (chronic obstructive pulmonary disease, COPD). Drinking pomegranate juice does not seem to improve symptoms or breathing in people with COPD.

Insufficient evidence to rate effectiveness for...

  • High cholesterol (hyperlipidemia). Some studies show pomegranate seems to lower total cholesterol and “bad” (LDL) cholesterol. But other studies find no benefit.
  • High blood pressure (hypertension). One research study suggests that drinking 50 mL of pomegranate juice daily for up to 1 year can lower systolic blood pressure (the top number) by 5% to 21%. But drinking pomegranate juice doesn’t seem to affect diastolic pressure (the lower number). However, other research shows no effect on blood pressure when study subjects drink 240 mL of pomegranate juice daily for 3 months. Additional research is needed to sort this out.
  • “Hardening of the arteries” (atherosclerosis). Preliminary evidence suggests drinking pomegranate juice might help to keep the arteries in the neck (carotid arteries) clear of the build-up of fatty deposits.
  • Gum disease. There is some evidence that painting the gum with pomegranate fruit peel extract in combination with gotu kola extract might improve gum disease.
  • Prostate cancer. Early research findings suggest that drinking pomegranate juice might slow the progress of prostate cancer.
  • Heart disease. Some preliminary research shows that drinking pomegranate juice might improve blood flow to the heart. But drinking pomegranate juice does not seem to prevent narrowing of blood vessels in the heart (stenosis). Also, there isn’t enough information to know if drinking pomegranate juice helps to prevent heart disease-related events such as heart attack.
  • Intestinal worm infestations.
  • Obesity and weight loss.
  • Fungal mouth infections.
  • Diarrhea.
  • Dysentery.
  • Sore throat.
  • Hemorrhoids.
  • Menopausal symptoms.
  • Other conditions.
More evidence is needed to rate pomegranate for these uses.

How does it work?

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Pomegranate contains a variety of chemicals that might have antioxidant effects. Some preliminary research suggests that chemicals in pomegranate juice might slow the progression of atherosclerosis (hardening of the arteries) and possibly fight cancer cells. But it is not known if pomegranate has these effects when people drink the juice.

Are there safety concerns?

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Pomegranate juice is LIKELY SAFE for most people. Most people do not experience side effects. Some people can have allergic reactions to pomegranate fruit.

When applied to the skin or gum, pomegranate is rated POSSIBLY SAFE. Some people have experienced sensitivity to pomegranate including itching, swelling, runny nose, and difficulty breathing.

Pomegranate is POSSIBLY UNSAFE when the root and stems are taken by mouth. The root contains a poison.

Special precautions & warnings:

Pregnancy and breast-feeding: Pomegranate juice is POSSIBLY SAFE for pregnant and breast-feeding women. But it is not known if other forms of pomegranate, such as pomegranate extract, are safe. If you use pomegranate, stick with the juice during pregnancy or breast-feeding. Check with your healthcare provider first.

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.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Carbamazepine (Tegretol)
Carbamazepine (Tegretol) is broken down by the body. Drinking pomegranate juice might decrease how fast the body breaks down carbamazepine (Tegretol). This might increase the effects and side effects of carbamazepine (Tegretol).

Medications changed by the body (Cytochrome P450 2C9 (CYP2C9) substrates
Some medications are changed and broken down by the body. Pomegranate might decrease how quickly the body breaks down some medications. Taking pomegranate along with some medications that are changed by the body 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 body.

Some medications that are changed by the body include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), and S-warfarin (Coumadin).

Medications changed by the body (Cytochrome P450 2D6 (CYP2D6) substrates)
Some medications are changed and broken down by the body. Pomegranate might decrease how quickly the body breaks down some medications. Taking pomegranate along with some medications that are changed by the body 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 body.

Some medications that are changed by the body include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), fluoxetine (Prozac), ondansetron (Zofran), tramadol (Ultram), and others.

Medications changed by the body (Cytochrome P450 3A4 (CYP3A4) substrates)
Some medications are changed and broken down by the body. Drinking pomegranate juice might decrease how quickly the body breaks down some medications. Drinking pomegranate juice and taking some medications that are broken down by the body can increase the effects and side effects of some medications. Before drinking pomegranate juice, talk to your healthcare provider if you are taking any medications that are changed by the body.

Some medications changed by the body 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)
Pomegranate juice seems to lower blood pressure. Taking pomegranate juice 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), lisinopril (Prinivil, Zestril), ramipril (Altace), and others.

Medications for high blood pressure (Antihypertensive drugs)
Pomegranate seems to lower 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)
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).

Tolbutamide (Orinase)
Tolbutamide (Orinase) is broken down by the body. Drinking pomegranate juice might decrease how fast the body breaks down tolbutamide (Orinase). This might increase the effects and side effects of tolbutamide (Orinase).

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

Are there interactions with herbs and supplements?

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Herbs and supplements that might lower blood pressure
Pomegranate seems to decrease blood pressure. Taking pomegranate along with other herbs and supplements that might lower blood pressure might cause your blood pressure to go too low. Some of these products include danshen, ginger, Panax ginseng, turmeric, valerian, and others.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The appropriate dose of pomegranate depends on several factors such as the user's age, health, and several other conditions. At this time, there is not enough scientific information to determine an appropriate range of doses for pomegranate. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Other names

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Anardana, Dadim, Dadima, Extrait de Feuille de Grenade, Extrait de Grenade, Extrait de Polyphénol de Grenade, Feuille de Grenade, Fleur de Grenade, Fruit du Grenadier, Fruit of the Dead, Granada, Grenade, Grenadier, PE, PLE, Pomegranate Extract, Pomegranate Flower, Pomegranate Fruit, Pomegranate Leaf, Pomegranate Leaf Extract, Pomegranate Polyphenol Extract, Pomme Grenade, Punica granatum, Roma, Shi Liu Gen Pi, Shi Liu Pi.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Pomegranate page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/392.html.

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