Drug & supplement interaction

Pomegranate + Codeine Sulfate

Codeine Sulfate brand name: Codeine Sulfate.

Moderate Interaction
The bottom line Moderate

Pomegranate has a moderate interaction with Codeine Sulfate. Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Pomegranate and Codeine Sulfate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Codeine Sulfate

Codeine Sulfate falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Pomegranate interacts with.

Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
In vitro, pomegranate juice inhibits CYP2D6. However, the clinical significance of this potential interaction in humans is not known.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the twist with codeine: it's a prodrug. Your body has to convert it into morphine using an enzyme called CYP2D6 before you get much pain relief. So anything that slows that enzyme down tends to give you less of the active painkiller, not more.

In lab studies, pomegranate juice has blocked CYP2D6 a bit. If that happened in real life, your codeine might convert less efficiently, meaning weaker pain control. That said, this is only theoretical and based on test-tube work, not human studies, so we honestly don't know if it matters when you actually drink the juice. Enjoying pomegranate as a food is very unlikely to be a problem. If you're leaning on concentrated extracts, just run it by your pharmacist or doctor first.

References
  1. Kim ND, Mehta R, Yu W, et al. Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer. Breast Cancer Res Treat 2002;71:203-17. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • 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.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Pomegranate Also Interacts With Other Medications

Pomegranate has 354 moderate, 567 minor known drug interactions in our database — the Codeine Sulfate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Pomegranate

Covers the 2,830 medications we’ve checked against Pomegranate. Pick one to open its full report.

From our Q&A

Questions About Pomegranate or Codeine Sulfate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Pomegranate or Codeine Sulfate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Codeine Sulfate

This page covers Pomegranate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Codeine Sulfate page lists 144 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 114 moderate · 23 minor.

Open the Codeine Sulfate interaction page

One more smart check

Taking Pomegranate as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4,607 real supplement products containing Pomegranate, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Pomegranate. Your product may carry other ingredients that interact with Codeine Sulfate too, on top of Pomegranate — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Pomegranate and Codeine Sulfate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Pomegranate
Top 5%

#57 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Codeine Sulfate
Top 25%

#475 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Pomegranate

What is Pomegranate?

Pomegranate
  • Heart and blood vessel health
  • Antioxidant support
  • High blood pressure
  • Inflammation
  • Digestive upset
  • Skin health

Pomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support heart health and blood pressure, but the evidence is still limited and not strong enough to call it a proven treatment. As a food it is generally safe, but talk to your pharmacist or doctor before using concentrated extracts, especially if you are pregnant, breastfeeding, or take medications.

Read the full Pomegranate monograph & all interactions
Keep checking

Other Drugs & Pomegranate

Browse every other medication we’ve checked against Pomegranate — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
354Moderate
567Minor
1,908No known interaction
Moderate

354 interactions

Showing 60 of 354 moderate interactions — see all 354 on the Pomegranate page.

Minor

567 interactions

Showing 60 of 567 minor interactions — see all 567 on the Pomegranate page.

No interaction 1,908 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking Pomegranate and Codeine Sulfate Together: Common Questions

Can you take Pomegranate with Codeine Sulfate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Pomegranate and Codeine Sulfate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Codeine Sulfate and Pomegranate?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.