Bio-Flavonoids Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Bio-Flavonoids against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Bio-Flavonoids is a dietary supplement by Nature's Answer with 3 active ingredients. Its ingredients are commonly taken for joint pain and osteoarthritis, colds and flu, source of vitamin c.Based on those ingredients, 1,082 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Orange Peel Extract, Rose Hip Fruit Extract, Lemon Peel Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Bio-Flavonoids by Nature's Answer
Ask about any prescription or over-the-counter medication and we check it for interactions with Bio-Flavonoids by Nature's Answer — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Bio-Flavonoids by Nature's Answer
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Bio-Flavonoids contains three active ingredients. Rose hip fruit extract and lemon peel extract are whole-plant sources; orange peel extract (also called bitter orange) is a concentrated source of citrus compounds.
The proprietary bioflavonoids blend groups its component ingredients together rather than listing them separately — we've reviewed the three named extracts individually. The product also contains water, glycerin, and alcohol as inactive ingredients that help deliver these actives in liquid form.
Does it work?
Moderate evidence
Rose hip has possibly effective evidence for postoperative pain and osteoarthritis; the data on it for high cholesterol is insufficient to rate. Orange peel and lemon peel extracts have insufficient evidence for the conditions listed in the product facts — allergic rhinitis, hair loss, sexual dysfunction, pre-procedural anxiety, athletic performance, anxiety, respiratory infections, kidney stones, and blood pressure.
The evidence base for these ingredients in those roles is not established in the data we hold.
How safe is it?
Well-documented data
Rose hip is generally well tolerated as a food, but supplement-strength safety data is less studied — the main side effects in trials were flatulence and loose stools, though gastrointestinal upset, headache, and vertigo have been reported rarely. Orange peel extract can raise blood pressure and heart rate, especially when combined with caffeine or other stimulants; serious but rare effects include heart attack, stroke, and irregular heartbeats.
Lemon peel is well tolerated in food amounts, but higher doses can cause heartburn and gastrointestinal upset. Orange peel is not recommended during pregnancy or breastfeeding; rose hip and lemon have insufficient safety data in pregnancy and lactation, so talk with your doctor or pharmacist for personalized advice.
Meds to double-check
Major interaction found
Before taking this product, check with your doctor or pharmacist if you take monoamine oxidase inhibitors (MAOIs) — orange peel carries a Major risk of dangerously high blood pressure. Also confirm you're clear if you take midazolam or other sedatives, blood thinners or antiplatelet drugs, lithium, heart rhythm medications that prolong the QT interval, most chemotherapy drugs, CYP3A4 substrates (a broad group including statins and immunosuppressants), antidiabetes medications, stimulants, or dextromethorphan cough syrup.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
This product is best suited for someone whose doctor has cleared it and who takes no MAOIs, sedatives, heart rhythm medications, or certain chemotherapy drugs. If you take any prescription medication, especially blood thinners, antidiabetes drugs, or anything metabolized by your liver, check your exact medications with the tool on this page before starting.
Orange peel in particular can raise blood pressure and heart rate — be cautious if you have cardiovascular concerns or take stimulants like caffeine. Talk it over with your doctor or pharmacist to see if this product fits your individual situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 22, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Bio-Flavonoids, straight from the product label.
| Brand | Nature's Answer |
|---|---|
| Barcode (UPC) | 083000008382 |
| Net contents | 8 Fluid Ounce(s); 240 mL |
| Market status | On market |
| Date entered into DSLD | Jun 22, 2023 |
| DSLD ID | 295409 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult (18 - 50 Years), Kosher, Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Bio-Flavonoids by Nature's Answer, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Bioflavonoids Extract Blend | 6800 mg | -- |
| Rose Hip Fruit Extract | 0 NP | -- |
| Orange Peel Extract | 0 NP | -- |
| Lemon Peel Extract | 0 NP | -- |
Other ingredients: Water, Purified, Glycerin, Alcohol
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)
Discover Nature's Answer and Trust the Difference... The True Nature of Our Standards goes way beyond the herb...
Nature's Answer Since 1972
Copyright 2019 Nature's Answer
Storage
Store in a cool, dry place.
Formula
K Parve (Kosher)
Bio-Flavonoids from Rose hip, Orange peel & Lemon peel Total herbal equivalent 15,000mg per serving Low Alcohol
Seals/Symbols
K Parve (Kosher)
Formulation
Gluten free
Absolutely no preservatives
FDA Statement of Identity
Herbal Supplement
Suggested/Recommended/Usage/Directions
Suggested use: As a dietary supplement, take 1-3 teaspoonfuls (5-15 mL) once a day in a small amount of water. Shake well.
Precautions
Warning: Keep out of reach of children.
Do not use if safety seal is damaged or missing.
If you are pregnant, nursing, taking any medications, planning any medical procedure or have a medical condition, consult with your healthcare practitioner before use.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Bio-Flavonoids by Nature's Answer label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Bio-Flavonoids by Nature's Answer
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tsp(s) Dosage formLiquid Servings per container16 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Bioflavonoids Extract Blend
Other (inactive) ingredients: Water, Purified, Glycerin, Alcohol. These complete the product’s ingredient list but are not active constituents.
Bio-Flavonoids by Nature's Answer Drug Interactions
HelloPharmacist Interaction Report
Bio-Flavonoids by Nature's Answer contains three active ingredients, and the one with the most significant interaction concerns is orange peel extract.
This ingredient has a Major-severity interaction with monoamine oxidase inhibitors (MAOIs) — older antidepressants and certain blood pressure drugs — because orange peel contains compounds that can trigger a dangerous spike in blood pressure when combined with these medications.
Read the full breakdown — every affected drug type, severity by severity
Orange peel extract also carries Moderate-severity interactions with several drug types: midazolam (a sedative used before procedures), drugs that prolong the QT interval on an EKG (certain heart rhythm and psychiatric medications), CYP3A4 substrates (a large group of drugs your liver breaks down, including many statins, immunosuppressants, and others), antidiabetes drugs, stimulants, dextromethorphan (a cough suppressant), and caffeine. Rose hip fruit extract has Moderate-severity interactions with blood thinners (anticoagulants and antiplatelet drugs), estrogens (including birth control and hormone replacement), lithium, certain chemotherapy drugs, and aluminum-containing antacids; it also carries a Minor interaction with aspirin and warfarin.
Lemon peel extract has a Minor interaction with itraconazole (an antifungal).
Altogether, these interactions span 1,083 individual medications. Use the medication checker on this page to look up your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Bio-Flavonoids?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Bio-Flavonoids interact with 1,082 drugs. Click any drug to see the details.
3 of the 3 ingredients in Bio-Flavonoids interact with drugs. Each result below shows which ingredient is responsible. Orange Peel Extract Rose Hip Fruit Extract Lemon Peel Extract
AmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Stimulant Drugs +1 Major
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Orange Peel Extract + Amphetamine interactionIsocarboxazidMarplan
How Isocarboxazid interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Orange Peel Extract + Isocarboxazid interactionMidazolamNayzilam, Seizalam, Versed
How Midazolam interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMidazolam (versed), Cytochrome P450 3a4 (cyp3a4) Substrates Major
Interaction Summary
Bitter orange might increase blood levels of midazolam.
Read the full Orange Peel Extract + Midazolam interactionMoclobemideManerix, Moclobemide
How Moclobemide interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Orange Peel Extract + Moclobemide interactionOzanimod HydrochlorideZeposia
How Ozanimod Hydrochloride interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractQt Interval-prolonging Drugs, Monoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
Read the full Orange Peel Extract + Ozanimod Hydrochloride interactionPhenelzine SulfateNardil
How Phenelzine Sulfate interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Orange Peel Extract + Phenelzine Sulfate interactionRasagilineAzilect
How Rasagiline interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Orange Peel Extract + Rasagiline interactionSafinamide MesylateXadago
How Safinamide Mesylate interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Orange Peel Extract + Safinamide Mesylate interactionSelegilineCarbex, Eldepryl, Emsam, Zelapar
How Selegiline interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Orange Peel Extract + Selegiline interactionTranylcypromineParnate
How Tranylcypromine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Orange Peel Extract + Tranylcypromine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Rose Hip Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip Fruit Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Rose Hip Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip Fruit Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Orange Peel Extract + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Rose Hip Fruit ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip Fruit Extract + Acenocoumarol interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Rose Hip Fruit ExtractAnticoagulant/antiplatelet Drugs, Aspirin Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip Fruit Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Bio-Flavonoids — through 2 ingredients. Tap an ingredient for the detail:
Rose Hip Fruit ExtractAnticoagulant/antiplatelet Drugs, Aspirin Moderate
Interaction Summary
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Read the full Rose Hip Fruit Extract + Acetaminophen, Aspirin, Caffeine interactionOrange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +1 Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Orange Peel Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractStimulant Drugs, Caffeine +1 Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Orange Peel Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Orange Peel Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Orange Peel Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Orange Peel Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractStimulant Drugs, Caffeine +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Orange Peel Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +1 Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Orange Peel Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Bio-Flavonoids — through 1 ingredient. Tap an ingredient for the detail:
Orange Peel ExtractStimulant Drugs, Caffeine +1 Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Orange Peel Extract + Acetaminophen, Caffeine, Pyrilamine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Bio-Flavonoids with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Orange Peel Extract
Midazolam (Versed)
Bitter orange might increase blood levels of midazolam.
One small clinical study shows that bitter orange juice can increase midazolam levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4). Theoretically, bitter orange might increase the risk of midazolam-related adverse effects.
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.
Antidiabetes Drugs
Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Some clinical research shows that drinking a tea containing bitter orange and Indian snakeroot reduces fasting and postprandial glucose levels in patients with type 2 diabetes who are using antidiabetes drugs. However, it is unclear if these effects are due to bitter orange, Indian snakeroot, or the combination. An animal study also shows that p-synephrine in combination with gliclazide , a sulfonylurea, causes an additional 20% to 44% decrease in glucose levels when compared with gliclazide alone.
Caffeine
Bitter orange might increase blood pressure and heart rate when taken with caffeine.
Small clinical studies show that taking bitter orange in combination with caffeine can increase blood pressure and heart rate in otherwise healthy normotensive adults. Theoretically, this might increase the risk of serious cardiovascular adverse effects.
Colchicine
Bitter orange might affect colchicine levels.
Colchicine is a substrate of P-glycoprotein and cytochrome P450 3A4 (CYP3A4). Bitter orange has been reported to inhibit CYP3A4 and increase levels of CYP3A4 substrates. However, one small clinical study in healthy adults shows that drinking bitter orange juice 240 mL twice daily for 4 days and taking a single dose of colchicine 0.6 mg on the 4th day decreases colchicine peak serum levels by 24%, time to peak serum level by 1 hour, and overall exposure to colchicine by 20%. The clinical significance of this finding is unclear.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Small clinical studies suggest that single or multiple doses of freshly squeezed bitter orange juice 200-240 mL can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. However, the extent of the effect of bitter orange on CYP3A4-mediated drug interactions is unknown. Some evidence suggests that bitter orange selectively inhibits intestinal CYP3A4, but not hepatic CYP3A4. Its effect on P-glycoprotein, which strongly overlaps with CYP3A4 interactions, is unclear. One small clinical study shows that drinking 8 ounces of freshly squeezed bitter orange juice has no effect on cyclosporine, which seems to be more dependent on hepatic CYP3A4 and P-glycoprotein than intestinal CYP3A4.
Dextromethorphan (Robitussin Dm, Others)
Bitter orange might increase blood levels of dextromethorphan.
One small clinical study shows that bitter orange juice increases dextromethorphan levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for dextromethorphan-related adverse effects.
Felodipine (Plendil)
Bitter orange might increase blood levels of felodipine.
One small clinical study shows that bitter orange juice increases felodipine levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for felodipine-related adverse effects.
Indinavir (Crixivan)
Bitter orange might increase blood levels of indinavir.
One small clinical study shows that bitter orange juice slightly increases indinavir levels, but this effect is likely to be clinically insignificant. Bitter orange selectively inhibits intestinal cytochrome P450 3A4 (CYP3A4); however, the metabolism of indinavir seems to be more dependent on hepatic CYP3A4. The effect of bitter orange on other protease inhibitors has not been studied.
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.
Sildenafil (Viagra)
Bitter orange juice might increase blood levels of sildenafil.
A small clinical study in healthy adult males shows that drinking freshly squeezed bitter orange juice 250 mL daily for 3 days and taking a single dose of sildenafil 50 mg on the 3rd day increases the peak plasma concentration of sildenafil by 18% and the overall exposure to sildenafil by 44%. Theoretically, this may be due to inhibition of cytochrome P450 3A4 by bitter orange.
Stimulant Drugs
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Bitter orange appears to have stimulant effects.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
In vitro research shows that octopamine, a constituent of bitter orange, weakly inhibits CYP2D6 enzymes. This effect has not been reported in humans.
Rose Hip Fruit Extract
Alkylating Agents
Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of alkylating agents but might also reduce the oxidative damage caused by certain alkylating agents.
Rose hip contains vitamin C. The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. Further, some animal research suggests that the antioxidant effects of rose hip might attenuate cyclophosphamide-induced testicular toxicity. More evidence is needed to determine what effect, if any, antioxidants found in rose hip, such as vitamin C, have on the effectiveness and adverse effects of chemotherapy.
Aluminum
Theoretically, rose hip might increase the amount of aluminum absorbed from aluminum compounds.
Rose hip contains vitamin C. Theoretically, vitamin C increases the absorption of aluminum. Concomitant use might increase aluminum absorption, but the clinical significance of this is unknown. Administer rose hip two hours before or four hours after antacids.
Anticoagulant/Antiplatelet Drugs
Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that a constituent of rose hip, rugosin E, can induce platelet aggregation. This has not been shown in humans. Theoretically, concomitant use of rose hip might reduce the effectiveness of antiplatelet or anticoagulant drugs.
Antitumor Antibiotics
Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of antitumor antibiotics.
Rose hip contains the antioxidant vitamin C. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics. In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.
Estrogens
Theoretically, rose hip might increase blood levels of estrogens.
Rose hip contains vitamin C. Increases in plasma estrogen levels of up to 55% have occured under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.
Lithium
Theoretically, rose hip might increase blood levels of lithium.
Rose hip is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, rose hip might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Aspirin
Theoretically, rose hip might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and aspirin is unlikely.
Warfarin (Coumadin)
Theoretically, rose hip might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Rose hip contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption. This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time. Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant. The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and warfarin is unlikely.
Lemon Peel Extract
Itraconazole (Sporanox)
Theoretically, taking itraconazole capsules or tablets with a beverage containing lemon might increase the levels and clinical effects of itraconazole.
In one case report, dissolving itraconazole tablets in a small amount of specific beverages containing lemon prior to administration increased the level of itraconazole in a lung transplant patient. In this case, the increased bioavailability was desirable and was likely due to improved tablet dissolution in the acidic beverage.
Brand information
Manufacturer and brand details for Bio-Flavonoids, from the product label.
Nature's Answer
See all Nature's Answer products- Name
- Nature's Answer
- Street Address
- 85 Commerce Drive
- City
- Hauppauge
- State
- NY
- ZipCode
- 11788
- Phone Number
- (800) 439-2324
- Web Address
- www.naturesanswer.com
Bio-Flavonoids by Nature's Answer: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Bio-Flavonoids’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Rose Hip
Interacts with 213 drugsRose hip is the vitamin C–rich fruit of the wild rose, used traditionally for colds and joint pain. A standardized rose hip powder has some research support for easing osteoarthritis symptom...
Read the full Rose Hip monograph → Herb & supplement monographBitter Orange
Interacts with 957 drugsBitter orange is a citrus fruit whose extracts contain synephrine, a mild stimulant often added to weight-loss and energy supplements. Evidence that it works for weight loss or performance i...
Read the full Bitter Orange monograph → Herb & supplement monographLemon
Interacts with 1 drugLemon is a common citrus fruit that is a good source of vitamin C and citric acid, and it is widely used in food, drinks, and home remedies. While it can support hydration and a healthy diet...
Read the full Lemon monograph →Sources & How We Checked
Bio-Flavonoids's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 73 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Rose Hip 24 references
- Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
- Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Andersson U, Berger K, Hogberg A, et al. Effects of rose hip intake on risk markers of type 2 diabetes and cardiovascular disease: a randomized, double-blind, cross-over investigation in obese persons. Eur J Clin Nutr 2012;66:585-90. PubMed
- Rein, E., Kharazmi, A., and Winther, K. A herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis--a double-blind, placebo-controlled, randomised trial. PubMed
- Winther, K., Apel, K., and Thamsborg, G. A powder made from seeds and shells of a rose-hip subspecies (Rosa canina) reduces symptoms of knee and hip osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial. Scand J Rheumatol. 2005;34
- Teng, C. M., Kang, Y. F., Chang, Y. L., Ko, F. N., Yang, S. C., and Hsu, F. L. ADP-mimicking platelet aggregation caused by rugosin E, an ellagitannin isolated from Rosa rugosa Thunb. Thromb.Haemost. 1997;77(3):555-561. DOI
- Seifi M, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Khodaie L, Mirghafourvand M. The effect of Rosa (L. Rosa canina) on the incidence of urinary tract infection in the puerperium: a randomized placebo-controlled trial. Phytother Res 2018;32(1):76-83
- Parandin R, Ghowsi M, Dadbod A. Protective effects of hydroalcoholic extract of Rosa canina L. fruit on cyclophosphamide-induced testicular toxicity in mice. Avicenna J Phytomed 2023;13(1):7-17.
Bitter Orange 47 references
- Penzak SR, Jann MW, Cold JA, et al. Seville (sour) orange juice: synephrine content and cardiovascular effects in normotensive adults. J Clin Pharmacol 2001;41:1059-63. PubMed
- Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
- Calapai G, Firenzuoli F, Saitta A, et al. Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: A preliminary report. Fitoterapia 1999;70:586-92. DOI
- Keogh AM, Baron DW. Sympathomimetic abuse and coronary artery spasm. Br Med J 1985;291:940.
- Malhotra S, Bailey DG, Paine MF, Watkins PB. Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther 2001;69:14-23. PubMed
- 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. . PubMed
- Colker CM, Kalman DS, Torina GC, et al. Effects of Citrus aurantium extract, caffeine, and St. John's wort on body fat loss, lipid levels, and mood states in overweight healthy adults. Curr Ther Res 1999;60:145-153. DOI
- Penzak SR, Acosta EP, Turner M, et al. Effect of Seville orange juice and grapefruit juice on indinavir pharmacokinetics. J Clin Pharmacol 2002;42:1165-70. PubMed
- Edwards DJ, Fitzsimmons ME, Schuetz EG, et al. 6',7'-Dihydroxybergamottin in grapefruit juice and Seville orange juice: effects on cyclosporine disposition, enterocyte CYP3A4, and P-glycoprotein. Clin Pharmacol Ther 1999;65:237-44. PubMed
- Di Marco MP, Edwards DJ, Wainer IW, Ducharme MP. The effect of grapefruit juice and seville orange juice on the pharmacokinetics of dextromethorphan: the role of gut CYP3A and P-glycoprotein. Life Sci 2002;71:1149-60. PubMed
- 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.
- Nykamp DL, Fackih MN, Compton AL. Possible association of acute lateral-wall myocardial infarction and bitter orange supplement. Ann Pharmacother 2004;38:812-6. PubMed
- Fugh-Berman A, Myers A. Citrus aurantium, an ingredient of dietary supplements marketed for weight loss: Current status of clinical and basic Research. Exp Biol Med 2004;229:698-704.
- Suzuki O, Matsumoto T, Oya M, Katsumata Y. Oxidation of synephrine by type A and type B monoamine oxidase. Experientia 1979;35:1283-4. PubMed
- 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.. PubMed
- Firenzuoli F, Gori L, Galapai C. Adverse reaction to an adrenergic herbal extract (Citrus aurantium). Phytomedicine 2005;12:247-8. PubMed
- Bouchard NC, Howland MA, Greller HA, et al. Ischemic stroke associated with use of an ephedra-free dietary supplement containing synephrine. Mayo Clin Proc 2005;80:541-5. PubMed
- Haller CA, Benowitz NL, Jacob P 3rd. Hemodynamic effects of ephedra-free weight-loss supplements in humans. Am J Med 2005;118:998-1003.. PubMed
- Bui LT, Nguyen DT, Ambrose PJ. Blood pressure and heart rate effects following a single dose of bitter orange. Ann Pharmacother 2006;40:53-7. PubMed
- Min B, Cios D, Kluger J, White CM. Absence of QTc-interval-prolonging or hemodynamic effects of a single dose of bitter-orange extract in healthy subjects. Pharmacotherapy 2005;25:1719-24. PubMed
- Gange CA, Madias C, Felix-Getzik EM, et al. Variant angina associated with bitter orange in a dietary supplement. Mayo Clin Proc 2006;81:545-8. PubMed
- Jordan S, Murty M, Pilon K. Products containing bitter orange or synephrine: suspected cardiovascular adverse reactions. Canadian Adverse Reaction Newsletter 2004;14:3-4.
- Burke J, Seda G, Allen D, Knee TS. A case of severe exercise-induced rhabdomyolysis associated with a weight loss dietary supplement. Mil Med 2007;172:656-8. PubMed
- Gray, S. and Woolf, A. D. Citrus aurantium used for weight loss by an adolescent with anorexia nervosa. J Adolesc.Health 2005;37(5):414-415. PubMed
- Haller, C. A., Duan, M., Jacob, P., III, and Benowitz, N. Human pharmacology of a performance-enhancing dietary supplement under resting and exercise conditions. Br J Clin Pharmacol 2008;65(6):833-840. PubMed
- Thomas, J. E., Munir, J. A., McIntyre, P. Z., and Ferguson, M. A. STEMI in a 24-year-old man after use of a synephrine-containing dietary supplement: a case report and review of the literature. Tex.Heart Inst.J 2009;36(6):586-590.
- Campbell-Tofte, J. I., Molgaard, P., Josefsen, K., Abdallah, Z., Hansen, S. H., Cornett, C., Mu, H., Richter, E. A., Petersen, H. W., Norregaard, J. C., and Winther, K. Randomized and double-blinded pilot clinical study of the safety and anti-diabetic ef
- Seifert, J. G., Nelson, A., Devonish, J., Burke, E. R., and Stohs, S. J. Effect of acute administration of an herbal preparation on blood pressure and heart rate in humans. Int J Med Sci 2011;8(3):192-197. PubMed
- Stohs, S. J., Preuss, H. G., Keith, S. C., Keith, P. L., Miller, H., and Kaats, G. R. Effects of p-synephrine alone and in combination with selected bioflavonoids on resting metabolism, blood pressure, heart rate and self-reported mood changes. Int J Med
- Wason, S., DiGiacinto, J. L., and Davis, M. W. Effects of grapefruit and Seville orange juices on the pharmacokinetic properties of colchicine in healthy subjects. Clin Ther 2012;34(10):2161-2173. PubMed
- Kaats, G. R., Miller, H., Preuss, H. G., and Stohs, S. J. A 60day double-blind, placebo-controlled safety study involving Citrus aurantium (bitter orange) extract. Food Chem Toxicol. 2013;55:358-362.
- Calapai, G., Firenzuoli, F., Saitta, A., Squadrito, F. R., Arlotta, M., Costantino, G., and Inferrera, G. Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: a preliminary report. Fitoterapia 12-1-1999;70(6):586-592. DOI
- Colker, C., Kalman, D., and Torina, G. Effects of Citrus aurantium extract, caffeine, and St. John's Wort on body fat loss, lipid levels, and mood states in overweight healthy adults. Curr Ther Res 1999;60:145-153. DOI
- Shara M, Stohs SJ. Safety evaluation of Bitter orange extract (p-synephrine) in healthy volunteers. J.Amer.Coll.Nutr. 2011;30:358.
- Lynch B. Review of the safety of p-synephrine and caffeine. Intertek-Cantox Report, 2013;1-20.
- Smith TB, Staub BA, Natarajan GM, et al. Acute myocardial infarction associated with dietary supplements containing 1,3-dimethylamylamine and Citrus aurantium. Tex Heart Inst J 2014;41(1):70-2. PubMed
- Shara M, Stohs SJ, Mukattash TL. Cardiovascular safety of oral p-synephrine (bitter orange) in healthy subjects: a randomized placebo-controlled cross-over clinical trial. Phytother Res. 2016;30(5):842-7.
- Liu Y, Santillo MF. Cytochrome P450 2D6 and 3A4 enzyme inhibition by amine stimulants in dietary supplements. Drug Test Anal. 2016;8(3-4):307-10. PubMed
- Abdelkawy KS, Donia AM, Turner RB, Elbarbry F. Effects of Lemon and Seville Orange Juices on the Pharmacokinetic Properties of Sildenafil in Healthy Subjects. Drugs R D. 2016 Sep;16(3):271-278. PubMed
- Gutiérrez-Hellín J, Salinero JJ, Abían-Vicen J, Areces F, Lara B, Gallo C, et al. Acute consumption of p-synephrine does not enhance performance in sprint athletes.J. Appl Physiol Nutr Metab. 2016;41(1):63-9. doi: 10.1139/apnm-2015-0299.
- Jung YP, Earnest CP, Koozehchian M, et al. Effects of ingesting a pre-workout dietary supplement with and without synephrine for 8 weeks on training adaptations in resistance-trained males. J Int Soc Sports Nutr. 2017;3;14:1. doi: 10.1186/s12970-016-0158- PubMed
- Jung YP, Earnest CP, Koozehchian M, et al. Effects of acute ingestion of a pre-workout dietary supplement with and without synephrine on resting energy expenditure, cognitive function and exercise performance. J Int Soc Sports Nutr. 2017;14:3. doi: 10.118
- Vatsavai LK, Kilari EK. Interaction of p-synephrine on the pharmacodynamic and pharmacokinetics of gliclazide in animal models. J Ayurveda Integr Med 2017; S0975-9476(16)30487-9. doi: 10.1016/j.jaim.2017.04.010.
- Ratamess NA, Bush JA, Stohs SJ, et al. Acute cardiovascular effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine in human subjects: A placebo-controlled, double-blind study. Phytother Res. 2018;32(1):94-102.
- Gutiérrez-Hellín J, Ruiz-Moreno C, Del Coso J. Acute p-synephrine ingestion increases whole-body fat oxidation during 1-h of cycling at Fatmax. Eur J Nutr. 2019 Nov 5. PubMed
- Karimzadeh Z, Azizzadeh Forouzi M, Tajadini H, Ahmadinejad M, Roy C, Dehghan M. Effects of lavender and Citrus aurantium on pain of conscious intensive care unit patients: a parallel randomized placebo-controlled trial. J Integr Med 2021:S2095-4964(21)000 PubMed
- Koncz D, Tóth B, Bahar MA, Roza O, Csupor D. The Safety and Efficacy of Citrus aurantium (Bitter Orange) Extracts and p-Synephrine: A Systematic Review and Meta-Analysis. Nutrients 2022;14(19):4019. PubMed
Lemon 2 references
- Ruggenenti P, Caruso MR, Cortinovis M, et al. Fresh lemon juice supplementation for the prevention of recurrent stones in calcium oxalate nephrolithiasis: A pragmatic, prospective, randomised, open, blinded endpoint (PROBE) trial. EClinicalMedicine 2021;4 PubMed
- Umemura K, Katada Y, Nakagawa S, et al. Improved absorption of itraconazole tablet by co-administration with lemon beverages in a lung transplant recipient: A case report. J Infect Chemother 2022;28(8):1203-1207. PubMed
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