Bitter Orange - Zeposia (Ozanimod Hydrochloride) Interaction
Herbal: Bitter Orange
Also Known As: Citrus aurantium, Aurantii Fructus, Aurantium, Bigarade, Chisil, Kijitsu, Marmalade Orange, Meta-Synephrine, Naranja Amarga, Neroli Oil, Norsynephrine, Octopamine, Orange Amère, Seville Orange, Shangzhou Zhiqiao, Sour Orange, Synephrine, Zhi Ke, Zhi Qiao, Zhi Shi
Drug: Ozanimod Hydrochloride
Brand names:
Zeposia
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Ozanimod Hydrochloride is classified as belonging to the following category: Qt Interval-Prolonging Drugs
Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
One case report suggests that taking bitter orange in combination with other stimulants such as caffeine might prolong the QT interval in some patients.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Nasir JM, Durning SJ, Ferguson M, et al. Exercise-induced syncope associated with QT prolongation and ephedra-free Xenadrine. Mayo Clin Proc 2004;79:1059-62..
Interaction Details
Ozanimod Hydrochloride is classified as belonging to the following category: Monoamine Oxidase Inhibitors (Maois)
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Bitter orange contains tyramine, octopamine, and synephrine, which are MAO substrates.
Interaction Rating
Likelihood of Occurrence
ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
References
- Pellati F, Benvenuti S, Melegari M, Firenzuoli F. Determination of adrenergic agonists from extracts and herbal products of Citrus aurantium L. var. amara by LC. J Pharm Biomed Anal 2002;29:1113-9. .
- Visentin V, Morin N, Fontana E, et al. Dual action of octopamine on glucose transport into adipocytes: inhibition via beta3-adrenoceptor activation and stimulation via oxidation by amine oxidases. J Pharmacol Exp Ther 2001;299:96-104.
- Suzuki O, Matsumoto T, Oya M, Katsumata Y. Oxidation of synephrine by type A and type B monoamine oxidase. Experientia 1979;35:1283-4.
Bitter Orange Overview
Bitter orange, also known as Seville orange or sour orange, is a type of citrus fruit that is native to Southeast Asia. It is closely related to the sweet orange, but has a much more bitter and sour flavor.
Bitter orange is a rich source of vitamin C and other nutrients, including calcium, potassium, and folate. It is also a good source of antioxidants.
Bitter orange has been used in traditional medicine for a number of purported health benefits, including improved digestion, improved immune function, and reduced inflammation.
Bitter orange also contains synephrine, a compound similar in structure to ephedrine. Synephrine is thought to have stimulant effects and is often used to increase energy, improve athletic performance, and as a weight loss supplement. When used as a dietary supplement, the dosage is typically standardized by its synephrine content.
Ozanimod Hydrochloride Overview
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Ozanimod is used to treat adults with relapsing forms of multiple sclerosis (MS; a disease in which the nerves do not function properly and people may experience weakness, numbness, loss of muscle coordination, and problems with vision, speech, and bladder control) including clinically isolated syndrome (CIS; nerve symptom episodes that last at least 24 hours), relapsing-remitting forms (course of disease where symptoms flare up from time to time), or secondary progressive forms (course of disease where relapses occur more often). It is also used to treat ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) in adults. Ozanimod is in a class of medications called sphingosine l-phosphate receptor modulators. It works by decreasing the action of immune cells that may cause nerve damage.
Bitter Orange - More Interactions
Bitter Orange interacts with 911 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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