Bitter Orange

Are there any interactions with medications?



Medications for depression (MAOIs)
Interaction Rating: Major Do not take this combination.

Bitter orange contains chemicals that stimulate the body. Some medications used for depression can increase these chemicals. Taking bitter orange with these medications used for depression might cause serious side effects including fast heartbeat, high blood pressure, seizures, nervousness, and others.

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.



Midazolam (Versed)
Interaction Rating: Major Do not take this combination.

The body breaks down midazolam (Versed) to get rid of it. Bitter orange can decrease how quickly the body breaks down midazolam (Versed). Taking bitter orange along with midazolam (Versed) might increase the effects and side effects of midazolam (Versed).



Caffeine (Excedrin, Anacin, Vivarin, and others)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Bitter orange is a stimulant. Caffeine is also a stimulant. In combination, they can increase blood pressure and cause the heart to beat rapidly. This can cause serious adverse effects such as heat attack and stroke.



Dextromethorphan (Robitussin DM, and others)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

The body breaks down dextromethorphan (Robitussin DM, others) to get rid of it. Bitter orange might decrease how quickly the body breaks down dextromethorphan (Robitussin DM, others). Taking bitter orange along with dextromethorphan (Robitussin DM, others) might increase the effects and side effects of dextromethorphan (Robitussin DM, others).



Felodipine (Plendil)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Felodipine (Plendil) is used to lower blood pressure. The body breaks down felodipine (Plendil) to get rid of it. Bitter orange might decrease how quickly the body gets rid of felodipine (Plendil). Taking bitter orange along with felodipine (Plendil) might increase the effects and side effects of felodipine (Plendil).



Indinavir (Crixivan)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Indinavir (Crixivan) is used to treat HIV/AIDS. The body breaks down indinavir (Crixivan) to get rid of it. Bitter orange might decrease how quickly the body breaks down indinavir (Crixivan). Taking bitter orange along with indinavir (Crixivan) might increase the effects and side effects of indinavir (Crixivan).



Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Bitter orange might decrease how quickly the liver breaks down some medications. Taking bitter orange along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking bitter orange, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.



Medications that can cause an irregular heartbeat (QT interval-prolonging drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Bitter orange might increase your heart rate. Taking bitter orange along with medications that can cause an irregular heartbeat might cause serious side effects including irregular heartbeat.

Some medications that can cause an irregular heartbeat include amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), ibutilide (Corvert), procainamide (Pronestyl), quinidine, sotalol (Betapace), thioridazine (Mellaril), and many others.



Stimulant drugs
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Bitter orange might also speed up the nervous system. Taking bitter orange along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with bitter orange.

Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.

Dosing considerations for Bitter Orange.

The following dose has been studied in scientific research:

APPLIED TO THE SKIN:
  • For treatment of fungal skin infections: Pure oil of bitter orange has been applied once daily for 1-3 weeks.

Therapeutic Research Faculty copyright

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.