Drug & supplement interaction

Pomegranate + Sulfamethoxazole

Sulfamethoxazole brand name: Gantanol.

Minor Interaction
The bottom line Minor

Pomegranate has a minor interaction with Sulfamethoxazole. Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Pomegranate and Sulfamethoxazole

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

Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

Why this applies to Sulfamethoxazole

Sulfamethoxazole falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Pomegranate interacts with.

Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Some animal and in vitro research shows that pomegranate juice inhibits intestinal, but not hepatic, CYP2C9 isoenzyme activity. However, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the short version: your body uses an enzyme called CYP2C9 to help break down sulfamethoxazole. On paper, pomegranate could slow that enzyme down a bit in the gut, which in theory might let a little more of the antibiotic build up. If that happened, you'd mostly worry about more of the usual sulfamethoxazole side effects, things like nausea, rash, or sun sensitivity.

But here's the reassuring part. While some lab and animal studies hinted at this, actual human studies found that pomegranate juice and extract did not meaningfully change CYP2C9 activity. So this is largely theoretical and rated minor and unlikely. Enjoying pomegranate as a food or juice should be fine. If you're using a concentrated extract, just give your pharmacist or doctor a quick heads-up.

References
  1. Nagata M, Hidaka M, Sekiya H, et al. Effects of pomegranate juice on human cytochrome P450 2C9 and tolbutamide pharmacokinetics in rats. Drug Metab Dispos 2007;35:302-5. PubMed
  2. Hanley MJ, Masse G, Harmatz JS, et al. Pomegranate juice and pomegranate extract do not impair oral clearance of flurbiprofen in human volunteers: divergence from in vitro results. Clin Pharmacol Ther 2012;92(5):651-7. 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 355 moderate, 566 minor known drug interactions in our database — the Sulfamethoxazole 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 Sulfamethoxazole

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 Sulfamethoxazole, 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 Sulfamethoxazole

This page covers Pomegranate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sulfamethoxazole page lists 162 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Para-aminobenzoic Acid (paba) (major), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 134 moderate · 23 minor.

From our pharmacist’s overview on the Sulfamethoxazole page

“Sulfamethoxazole (Gantanol) is a sulfa antibiotic, and a few supplements can genuinely undermine it or harm you while taking it, so this is a list worth reading closely. The supplement PABA can directly block how the antibiotic kills bacteria, and it is one of five major-rated entries among the 162 on file.”

Reviewed by 2 · Jul 18, 2026

Open the Sulfamethoxazole 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 Sulfamethoxazole 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 Sulfamethoxazole 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%

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

29 days ago today
Medication Sulfamethoxazole
Top half

#983 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
355Moderate
566Minor
1,908No known interaction
Moderate

355 interactions

Showing 60 of 355 moderate interactions — see all 355 on the Pomegranate page.

Minor

566 interactions

Showing 60 of 566 minor interactions — see all 566 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 Sulfamethoxazole Together: Common Questions

Can you take Pomegranate with Sulfamethoxazole?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Pomegranate and Sulfamethoxazole interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Sulfamethoxazole 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.