sorry just in case u don't know those facts about pomegranate???

المساهمات : 6 تاريخ التسجيل : 08/12/2008

Food/Drug Interactions

Drugs whose metabolism is altered by grapefruit because of its CYP3A4 enzymatic inhibition will be affected to an even greater degree by pomegranate. Quetiapine (Seroquel), for intance, is extensively metabolized by the CYP3A4 enzyme.

pomegranatecould inhibit CYP3A-mediated drug metabolism.

The ability ofpomegranate to inhibit the carbamazepine 10,11-epoxidase activityof CYP3A

This is, of course, the same enzyme process that is inhibited by grapefruit juice, but new evidence now shows that pomegranate juice has an even more dramatic effect on drugs metabolized this way.

Pomegranate juice particularly affects the absorption of carbamazepine Tegretol, by inhibiting CYP3A

which means that other anticonvulsants (lamotrigine, valproic acid, oxcarbamazepine, etc.) may be affected in the same way. also the effects of ingesting pomegranate will affect drug metabolism for three days, no matter when the drug dose is taken in relation to the pomegranate. In fact, evidence suggests that both pomegranate and starfruit have a much larger effect on this metabolization process than does grapefruit . These are significant drug interactions that should be monitored closely in anyone taking these medications.

Pomegranate juice may have additive angiotensin-converting enzyme (ACE) inhibitor effects. Blood pressure and potassium levels should be monitored. ACE inhibitors include captopril (Capoten®), enalapril (Vasotec®), lisinopril (Prinivil®, Zestril®), ramipril (Altace®), and others. Pomegranate juice was shown to decrease serum angiotensin converting enzyme (ACE) activity and lower blood pressure in elderly hypertensive (high blood pressure) patients.

Theoretically, concomitant use with pomegranate juice may cause additive antihypertensive (blood pressure lowering) effects; use with caution.

Theoretically, concomitant use with pomegranate juice may cause additive antihypertensive (blood pressure lowering) effects; use with caution.

Interactions with Herbs and Dietary Supplements

The fruit husk and root/stem bark of pomegranate contain up to 28% and 25% tannins, respectively, compared to 12.9% in black tea and 22.2% in green tea. The tannin content of various herbs may interact with iron, forming non-absorbable complexes. Some have concluded that if herbs containing tannins are consumed at mealtime, non-absorbable complexes will form with iron, zinc, and copper. Concern has been raised that tannins may affect the administration of iron supplementation products. It is unknown to what extent the amount of tannin in pomegranate may affect iron absorption clinically. Until more is known, patients who need iron supplementation should be advised to separate administration times of these two compounds by one to two hours.

Pomegranate juice may have antihypertensive (blood pressure lowering) effects. Theoretically, concurrent use of pomegranate juice with other herbs and supplements that decrease blood pressure, such as danshen, ginger, and Panax ginseng may increase risk of hypotension (low blood pressure).

Theoretically, herbs that contain high percentages of tannins (such as pomegranate) may cause precipitation of constituents of other herbs. Caution is advised.

One pomegranate delivers approximately 40% of an adult's daily vitamin C requirement. In theory, large doses of pomegranate in combination with vitamin C supplements may result in additive effects or side effects.

Contraindications:
Pomegranate should not be used by pregnant and nursing women, and overuse (many times the recommended dosage) may cause cramps, vomiting and diarrhea. Pomegranate fruit should not be taken if you have diarrhea, and in Traditional Chinese Medicine (TCM), Pomegranate fruit should not be taken with oil or fats when used to treat parasite infections. Some people who are allergic to Pomegranate are also allergic to other fruits, pollen or nuts. Although only under discussion, the potent mix of antioxidants may interfere with a range of cholesterol drugs, such as Crestor and Lipitor, as well as some high-blood-pressure medications, causing drop in blood pressure; thus, it is wise to consult a physician if you are taking these medications.

Side effects:

In general, pomegranate may be safe. However, side effect or adverse event of pomegranate did happen in the past.
Spanish care-providers presented a non-atopic 85-year-old woman, with a late-onset recidivant tongue angio-edema
due to pomegranate intake

Dried pomegranate peel may contain aflatoxin, which is a potent hepatocarcinogen (may cause liver cancer) and toxin. Pomegranate root and stem contain pellertierine, and overdoses by mouth can cause strychnine-like effects in the form of reflex arousal that can escalate to paralysis. At high amounts, people may experience vomiting including bloody emesis (vomit), followed by dizziness, chills, vision disorders, collapse and possibly death due to respiratory failure. Avoid in patients with hypertension (high blood pressure) and hypotension (low blood pressure).

Pomegranate has been reported to cause nausea, vomiting, transient total blindness, hypersensitivity characterized by urticaria ("hives"), rhinorrhea (nasal discharge), red itchy eyes, and dyspnea (difficulty breathing).

In theory, the high tannin content may also cause liver toxicity or carcinogenicity. Use cautiously in patients with liver dysfunction and in patients on hepatotoxic drugs. Large amounts of aflatoxin B-1 may be present in dried pomegranate peel. Aflatoxin is a known carcinogen that is a pathogenetic agent of hepatocarcinoma.

Potential health benefits

In preliminary laboratory research and human pilot studies, juice of the pomegranate was effective in reducing heart disease risk factors, including LDL oxidation, macrophage oxidative status, and foam cell formation. all of which are steps in atherosclerosis and cardiovascular disease.

Pomegranate juice has also been shown to reduce systolic blood pressure by inhibiting serum angiotensin-converting enzyme, may inhibit viral infections, and may have antibacterial effects against dental plaque.

Containing polyphenols which inhibit estrogen synthesis, pomegranate seed oil was effective against proliferation of breast cancer cells in vitro.

Clinical trial rationale and activity

Metabolites of pomegranate juice ellagitannins localize specifically in the prostate gland, colon, and intestinal tissues of mice. leading to clinical studies of pomegranate juice or fruit extracts for efficacy against several diseases.

In 2008, 17 clinical trials were underway to examine the effects of pomegranate juice consumption on diseases shown below

prostate cancer

prostatic hyperplasia

diabetes

lymphoma

rhinovirus infection

common cold

oxidative stress in hemodialysis

atherosclerosis

coronary artery disease