Herb & supplement monograph

Sweet Orange Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Sweet Orange interacts with medications. The heart of this page is the interaction list — every drug Sweet Orange is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Sweet Orange is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Sweet Orange Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, Sweet Orange drug interactions can be clinically meaningful, because well-documented human studies show sweet orange juice changes how much of certain medications the body absorbs. Dozens of the listed interactions are rated major, and the best-studied ones come from actual human research rather than theory.

Interactions deserving the most attention

The strongest concern is with celiprolol, a blood pressure medicine, where large amounts of sweet orange juice cut drug levels by up to 90 percent. Juice also sharply lowered levels of the allergy medicine fexofenadine and the antiparasitic ivermectin, while it raised levels of the cholesterol drug pravastatin. These effects trace mostly to a gut transporter that helps the body absorb certain medications, so separating juice and doses by several hours is often advised for drugs handled this way.

What the rest of the list means

A long interaction list here does not mean every combination is harmful. Most studies used unusually large amounts of juice, and it is unclear whether ordinary servings act the same way. Other entries, such as those involving fortified juice and certain antibiotics, are theoretical or rest on lab findings that human research has not confirmed.

Check your medications against Sweet Orange

Based on HelloPharmacist’s Sweet Orange interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Sweet Orange

247 medications have a known interaction with Sweet Orange, graded by severity. Select any drug for the full evidence-based detail.

48 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Sweet Orange.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Sweet Orange using our pharmacist-reviewed interaction data.

AI summaries are generated from our Sweet Orange interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Sweet Orange combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Sweet Orange affects

Every type of medication (drug category) Sweet Orange is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 7 drug categories Sweet Orange interacts with

Celiprolol (celicard)Ivermectin (stromectol, Others)Organic Anion-transporting Polypeptide Substrates (oatp)Pravastatin (pravachol)Fexofenadine (allegra)P-glycoprotein SubstratesQuinolone Antibiotics

Celiprolol (Celicard)

Consuming sweet orange with celiprolol can decrease oral absorption of celiprolol.
A pharmacokinetic study in healthy volunteers shows that celiprolol levels, after a single dose of 100 mg, are decreased by up to 90% in people who drink sweet orange juice 200 mL three times daily. It's not known if lower consumption of sweet orange juice will have the same effect. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.

Likelihood Likely Evidence B

Ivermectin (Stromectol, Others)

Consuming sweet orange juice with ivermectin can decrease the oral absorption of ivermectin.
A pharmacokinetic study in healthy volunteers shows that taking ivermectin orally with sweet orange juice 750 mL over 4 hours reduces the bioavailability of ivermectin. This effect does not seem to be related to effects on P-glycoprotein. The effect on ivermectin is more pronounced in males compared to females.

Likelihood Likely Evidence B

Organic Anion-Transporting Polypeptide Substrates (Oatp)

Consuming sweet orange juice can decrease oral absorption of OATP substrates. Separate administration by at least 4 hours.
Clinical research shows that consuming sweet orange juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP. For example, sweet orange juice decreases bioavailability of fexofenadine, a substrate of OATP, by about 72% and of celiprolol, another OATP substrate, by up to 90%. Since sweet orange juice seems to affect OATP for a short time, recommend separating drug administration and consumption of sweet orange juice by at least 4 hours.

Likelihood Likely Evidence B

Pravastatin (Pravachol)

Consuming sweet orange juice with pravastatin can increase the absorption of pravastatin.
A small pharmacokinetic study in healthy volunteers shows that consuming sweet orange juice 800 mL over 3 hours, including before, during, and after taking pravastatin 10 mg, increases pravastatin levels by about 149%, without affecting pravastatin elimination. Theoretically this effect might be due to modulation of organic anion transporting polypeptides (OATPs) by sweet orange juice. Sweet orange juice does not seem to affect simvastatin levels, but it is not known if sweet orange affects any of the other statins.

Likelihood Likely Evidence B

Fexofenadine (Allegra)

Consuming sweet orange juice with fexofenadine can decrease oral absorption of fexofenadine.
Clinical research shows that coadministration of sweet orange juice 1200 mL decreases bioavailability of fexofenadine by about 72%. In an animal model, sweet orange juice decreased bioavailability of fexofenadine by 31%. Fexofenadine manufacturer data indicates that concomitant administration of sweet orange juice and fexofenadine results in larger wheal and flare sizes in research models. This suggests that sweet orange reduces the clinical response to fexofenadine. Theoretically, this occurs due to short-term inhibition of organic anion transporting polypeptide (OATP). Recommend separating drug administration and consumption of sweet orange by at least 4 hours.

Likelihood Likely Evidence B

P-Glycoprotein Substrates

Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Animal and in vitro research suggest that orange juice extract inhibits drug efflux by P-gp, increasing absorption and levels of P-gp substrates. In contrast, pharmacokinetic research in humans shows that drinking large amounts of sweet orange juice decreases absorption and levels of the P-gp substrate celiprolol. This suggests that orange juice actually induces drug efflux by P-gp or affects drug levels by another mechanism such as inhibiting the gut drug transporter called organic anion transporting polypeptide (OATP). Until more is known, sweet orange juice should be used cautiously in people taking P-gp substrates.

Likelihood Possible Evidence B

Quinolone Antibiotics

Calcium-fortified sweet orange juice might reduce quinolone absorption.
Calcium binds to quinolones in the gut. Theoretically, the calcium in certain fortified orange juices can also bind to quinolone antibiotics and reduce their absorption and levels.

Likelihood Possible Evidence D

Monograph

Sweet Orange: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Sweet orange is a common citrus fruit that is a good source of vitamin C, fiber, and antioxidants, and is enjoyed as a food worldwide. Its peel and essential oil are used in aromatherapy and traditional remedies, but strong scientific proof for most medicinal claims is limited. The fruit and juice are safe for most people as food, while concentrated oils and extracts deserve more caution.

Scientific name: Citrus sinensis
Family: Rutaceae
Part used: Fruit, peel, and essential oil
Common forms: Fresh fruit, juice, capsules, essential oil, peel extract, aromatherapy oil

People commonly use it for

Vitamin C source
Digestive upset
Stress and relaxation (aromatherapy)
Cold and respiratory support
Antioxidant support

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallLikely safe

Sweet orange fruit and juice are safe as food for most people; concentrated oils and extracts call for more caution.

PregnancyLikely Safe

When sweet orange juice or fruit is used orally in amounts commonly found in foods.

Read the full pregnancy detail

BreastfeedingLikely Safe

When sweet orange juice or fruit is used orally in amounts commonly found in foods.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Sweet orange (Citrus sinensis) is one of the most widely grown fruits in the world. The tree is thought to come from Southeast Asia and is now grown in warm regions across the globe, including the Mediterranean, the Americas, and parts of Asia.

Most people simply eat the fruit or drink its juice. The fruit is a well-known source of vitamin C, along with folate, potassium, and dietary fiber. Varieties include navel, blood, and Jaffa oranges.

Beyond food, the orange peel and essential oil are used in traditional remedies and aromatherapy. The oil, pressed from the peel, gives many products their bright citrus scent and is popular for promoting a sense of calm or freshness.

How it works

Sweet orange contains several compounds that researchers find interesting. The fruit is rich in vitamin C and plant antioxidants called flavonoids (such as hesperidin), which may help protect cells from damage caused by free radicals.

The peel and essential oil contain limonene, a fragrant compound studied in the lab for possible antioxidant and antimicrobial activity. The scent of orange oil is also thought to act through the sense of smell to influence mood and relaxation.

It is important to know that much of this information comes from laboratory and animal studies. These do not always translate into proven benefits in people.

Effectiveness

Does Sweet Orange work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 12 uses evaluated

12 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Sweet Orange, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 12 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Asthma