Drug & supplement interaction

Tangerine + Diazepam

Diazepam brand names: Valium, Valium injection, Diastat AcuDial, Valtoco.

Minor Interaction
The bottom line Minor

Tangerine has a minor interaction with Diazepam. In vitro, tangeretin, a constituent of tangerine, induces a 52% increase in the metabolism of midazolam by cytochrome P450 3A4 (CYP3A4).

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

Tangerine and Diazepam

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Diazepam

Diazepam falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Tangerine interacts with.

In vitro, tangeretin, a constituent of tangerine, induces a 52% increase in the metabolism of midazolam by cytochrome P450 3A4 (CYP3A4). This suggests that tangeretin may stimulate CYP3A4 activity. However, in humans, drinking tangerine juice 200 mL slightly delayed the absorption, but did not affect the metabolism, of midazolam, a CYP3A4 substrate. Theoretically, tangerine juice might increase CYP3A4 activity and decrease levels of drugs metabolized by this enzyme. However, this effect is unlikely.
Some drugs metabolized by CYP3A4 include amitriptyline (Elavil), amiodarone (Cordarone), citalopram (Celexa), felodipine (Plendil), lansoprazole (Prevacid), ondansetron (Zofran), prednisone (Deltasone, Orasone), sertraline (Zoloft), sibutramine (Meridia), and many others.
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 CYP3A4 to break down diazepam (Valium), and a compound in tangerine (tangeretin) appeared to speed that enzyme up in a lab dish. In theory, a faster enzyme could clear diazepam a little quicker, which might mean slightly less of the calming, anti-anxiety, or muscle-relaxing effect you're counting on.

The reassuring part is that when researchers tested this in actual people using tangerine juice, it didn't meaningfully change drug metabolism, just slowed absorption a touch. So enjoying tangerines as food is very unlikely to cause a problem. If you take diazepam daily and ever feel it isn't working as well, mention it to your pharmacist or doctor rather than adjusting anything yourself.

References
  1. Backman, J. T., Maenpaa, J., Belle, D. J., Wrighton, S. A., Kivisto, K. T., and Neuvonen, P. J. Lack of correlation between in vitro and in vivo studies on the effects of tangeretin and tangerine juice on midazolam hydroxylation. Clin Pharmacol Ther 2000; 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

Tangerine Also Interacts With Other Medications

Tangerine has 642 minor known drug interactions in our database — the Diazepam 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 Tangerine

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

From our Q&A

Questions About Tangerine or Diazepam

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Tangerine or Diazepam, 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 Diazepam

This page covers Tangerine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diazepam page lists 244 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 Grapefruit (major).

By severity: 9 major · 191 moderate · 44 minor.

Open the Diazepam interaction page

One more smart check

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

We hold 705 real supplement products containing Tangerine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tangerine. Your product may carry other ingredients that interact with Diazepam too, on top of Tangerine — 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 Tangerine and Diazepam 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 Tangerine
Top 25%

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

29 days ago today
Medication Diazepam
Top 5%

#119 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 Tangerine

What is Tangerine?

  • Source of vitamin C
  • Digestive support
  • Aromatherapy and relaxation
  • Cough and phlegm (traditional)
  • Skin and flavoring uses

Tangerine is a sweet citrus fruit that is a good source of vitamin C and other nutrients, and is widely enjoyed as food. While the peel and essential oil are used in traditional medicine and aromatherapy, strong human evidence for specific health benefits beyond basic nutrition is limited. Enjoying tangerines as part of a balanced diet is generally safe for most people.

Read the full Tangerine monograph & all interactions
Medication

About Diazepam

What Is Diazepam Used For?

Brand names: Valium, Valium injection, Diastat AcuDial, Valtoco

  • Diazepam is used to relieve anxiety and to control agitation caused by alcohol withdrawal. It is also used along with other medications to control muscle spasms and spasticity caused by certain neurological disorders such as cerebral palsy (condition that causes difficulty with movement and balance), paraplegia (inability to move parts of the body), athetosis (abnormal muscle contractions), and stiff-man syndrome (a rare disorder with muscle rigidity and stiffness). Diazepam is also used along with other medications to control seizures. Diazepam is in a class of medications called benzodiazepines. It works by calming abnormal overactivity in the brain.

See full Diazepam drug information
Keep checking

Other Drugs & Tangerine

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

0Major
0Moderate
642Minor
2,187No known interaction
Minor

642 interactions

Showing 60 of 642 minor interactions — see all 642 on the Tangerine page.

No interaction 2,187 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 Tangerine and Diazepam Together: Common Questions

Can you take Tangerine with Diazepam?
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 Tangerine and Diazepam 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

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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.