Citrus Break Ingredients & Drug Interactions
by Revive
What is this page for?
First and foremost: checking Citrus Break 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
Citrus Break is a dietary supplement by Revive with 6 active ingredients. Its ingredients are commonly taken for source of vitamin c, digestive complaints, antimicrobial (seed extract).Based on those ingredients, 1,204 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Grapefruit peel oil, Tangerine Peel Oil, Spearmint leaf Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Citrus Break by Revive
Ask about any prescription or over-the-counter medication and we check it for interactions with Citrus Break by Revive — 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 Citrus Break by Revive
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
Citrus Break contains 6 ingredients, all of them active oils extracted from citrus peels and spearmint leaf: grapefruit peel oil, orange peel oil, lemon peel oil, spearmint leaf oil, tangerine peel oil, and mandarin peel oil. There are no inactive ingredients listed for this product.
These are concentrated plant extracts — not the same as eating the whole fruit.
Does it work?
Couldn't assess
The evidence for Citrus Break's effectiveness is not established in our data. Grapefruit peel oil shows insufficient reliable evidence for acne, asthma, atherosclerosis, headache, upper respiratory tract infection, and depression.
Lemon peel oil is similarly unproven for allergic rhinitis, anxiety, respiratory tract infections, high blood pressure, and kidney stones. Spearmint leaf oil has insufficient evidence for age-related cognitive decline, cognitive function, bloating, irritable bowel syndrome, postoperative nausea, and osteoarthritis.
Tangerine peel oil shows insufficient evidence for cancer. In short, we don't have established effectiveness data for any of the conditions these ingredients have been proposed for.
How safe is it?
Well-documented data
Orally, grapefruit and lemon are generally well tolerated in food amounts, though lemon juice taken at medicinal doses (like 60 mL twice daily) has caused heartburn and stomach upset in some trial participants. Spearmint is also well tolerated as food or tea.
However, the safety of concentrated supplements and essential oils — which is what you have in this liquid — has not been well studied. Grapefruit in large amounts has rarely caused serious effects like arrhythmias (irregular heartbeat) and QT prolongation (a heart rhythm abnormality), and some early population research suggests that people who eat a quarter or more of a whole grapefruit daily may have a higher risk of breast cancer, though more evidence is needed.
Allergic reactions are rare but have been reported with citrus and spearmint oils. Pregnancy and lactation safety data are not on file for these ingredients.
Meds to double-check
Major interaction found
Before you take this product, double-check your medications for interactions with grapefruit, lemon, spearmint, and tangerine oils. The biggest concerns are cyclosporine, scopolamine, amiodarone, terfenadine, buspirone, dextromethorphan, and other drugs metabolized by your liver — especially transplant and heart medications.
Also watch for sedating drugs and drugs that stress the liver if you're taking spearmint oil. If you're on itraconazole, tell your pharmacist.
Use the medication checker on this page with your exact prescriptions.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
If you take any prescription medications, especially heart drugs, transplant antirejection drugs, sedatives, antifungals, or any drug metabolized by the liver, check with your pharmacist before starting Citrus Break — the grapefruit oil poses real risks. For most people taking no medications, it's generally well tolerated, but the evidence that it actually works for any health condition isn't established.
Talk to your pharmacist about your specific medicines before you use this product.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 25, 2025.
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 Citrus Break, straight from the product label.
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 Citrus Break by Revive, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Grapefruit peel oil | 0 NP | -- |
| Orange Peel Oil | 0 NP | -- |
| Lemon Peel Oil | 0 NP | -- |
| Spearmint leaf Oil | 0 NP | -- |
| Citrus Break | 60 mg | -- |
| Tangerine Peel Oil | 0 NP | -- |
| Mandarin Peel Oil | 0 NP | -- |
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.
FDA Statement of Identity
Essential Oil Supplement
Formula
100% Pure essential oil 100% pure therapeutic grade essential oil
Precautions
Caution: Possible skin sensitivity. Avoid contact with eyes, inner ears and sensitive areas. Avoid sunlight and UV rays for up to 12 hours after applying.
Keep out of reach of children.
If pregnant or under a doctor's care, consult your physician.
General Statements
Made with love #Gorevive
Formulation
Bottled in the USA
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Citrus Break by Revive 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 Citrus Break by Revive
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Drop(s) Dosage formLiquid Servings per container170 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.
Citrus Break
- › Grapefruit peel oil
- › Orange Peel Oil
- › Lemon Peel Oil
- › Spearmint leaf Oil
- › Tangerine Peel Oil
- › Mandarin Peel Oil
Citrus Break by Revive Drug Interactions
HelloPharmacist Interaction Report
Citrus Break by Revive is a liquid blend of citrus and mint oils, and it does interact with medications.
The most serious concerns come from grapefruit peel oil, which can significantly raise blood levels of several drugs. Grapefruit blocks an enzyme in your gut and liver (cytochrome P450 3A4) that normally clears many medications, so they stay in your body longer and stronger than intended.
Read the full breakdown — every affected drug type, severity by severity
Grapefruit peel oil in this product has Major-severity interactions with oral cyclosporine (used after organ transplant), scopolamine (motion sickness patch), amiodarone (heart rhythm), terfenadine (antihistamine), buspirone (anxiety), dextromethorphan (cough suppressant), and several others — potentially increasing their side effects. It can also decrease blood levels of celiprolol (beta-blocker) and etoposide (chemotherapy), which may weaken their effects.
Lemon peel oil carries a Minor interaction with itraconazole (antifungal), and spearmint leaf oil has Moderate interactions with sedating drugs (CNS depressants) and drugs that stress the liver (hepatotoxic drugs). Tangerine peel oil has Minor interactions with midazolam (sedative) and other CYP3A4 substrates, though human data suggest the effect may be small.
We could not check orange peel oil or mandarin peel oil — no data is on file for those.
Altogether, these interactions span 1,178 individual medications. Use the medication checker on this page with your exact prescriptions, or talk to your pharmacist before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Citrus Break?
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 Citrus Break interact with 1,204 drugs. Click any drug to see the details.
5 of the 6 ingredients in Citrus Break interact with drugs. Each result below shows which ingredient is responsible. Grapefruit peel oil Tangerine Peel Oil Spearmint leaf Oil Orange Peel Oil Lemon Peel Oil
Belladonna, PhenobarbitalBellophen, Susano
How Belladonna, Phenobarbital interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Belladonna, Phenobarbital interactionBellafoline, PhenobarbitalBelladenal, Belladenal-S
How Bellafoline, Phenobarbital interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Bellafoline, Phenobarbital interactionBelzutifanWelireg
How Belzutifan interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP2C19.
Read the full Grapefruit Peel Oil + Belzutifan interactionBenactyzine, MeprobamateDeprol
How Benactyzine, Meprobamate interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Benactyzine, Meprobamate interactionBendamustineBelrapzo, Treanda, Vivimusta
How Bendamustine interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Peel Oil + Bendamustine interactionBendamustine HydrochlorideBendeka
How Bendamustine Hydrochloride interacts with Citrus Break — through 2 ingredients. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP1A2.
Read the full Grapefruit Peel Oil + Bendamustine Hydrochloride interactionSpearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Bendamustine Hydrochloride interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilNadolol (corgard) Moderate
Interaction Summary
Grapefruit juice might decrease blood levels of nadolol, potentially decreasing the clinical effects of nadolol.
Read the full Grapefruit Peel Oil + Bendroflumethiazide, Nadolol interactionBetamethasoneCelestone, Diprolene AF, Diprosone
How Betamethasone interacts with Citrus Break — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Betamethasone interactionGrapefruit Peel OilP-glycoprotein Substrates Minor
Interaction Summary
Grapefruit juice does not seem to affect renal P-glycoprotein (P-gp).
Read the full Grapefruit Peel Oil + Betamethasone interactionBetamethasone DipropionateSernivo
How Betamethasone Dipropionate interacts with Citrus Break — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Betamethasone Dipropionate interactionGrapefruit Peel OilP-glycoprotein Substrates Minor
Interaction Summary
Grapefruit juice does not seem to affect renal P-glycoprotein (P-gp).
Read the full Grapefruit Peel Oil + Betamethasone Dipropionate interactionBetamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora
How Betamethasone Dipropionate, Calcipotriene interacts with Citrus Break — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Betamethasone Dipropionate, Calcipotriene interactionGrapefruit Peel OilP-glycoprotein Substrates Minor
Interaction Summary
Grapefruit juice does not seem to affect renal P-glycoprotein (P-gp).
Read the full Grapefruit Peel Oil + Betamethasone Dipropionate, Calcipotriene interactionBetamethasone ValerateLuxiq
How Betamethasone Valerate interacts with Citrus Break — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Betamethasone Valerate interactionGrapefruit Peel OilP-glycoprotein Substrates Minor
Interaction Summary
Grapefruit juice does not seem to affect renal P-glycoprotein (P-gp).
Read the full Grapefruit Peel Oil + Betamethasone Valerate interactionBetrixabanBevyxxa
How Betrixaban interacts with Citrus Break — through 2 ingredients. Tap an ingredient for the detail:
Orange Peel OilP-glycoprotein Substrates Moderate
Interaction Summary
Sweet orange juice seems to modulate P-glycoprotein (P-gp), which might affect the blood levels of P-gp substrates.
Read the full Orange Peel Oil + Betrixaban interactionGrapefruit Peel OilP-glycoprotein Substrates Minor
Interaction Summary
Grapefruit juice does not seem to affect renal P-glycoprotein (P-gp).
Read the full Grapefruit Peel Oil + Betrixaban interactionBimekizumab-bkzxBimzelx
How Bimekizumab-bkzx interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Bimekizumab-bkzx interactionBinimetinibMektovi
How Binimetinib interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Binimetinib interactionBismuth Subsalicylate, Metronidazole, TetracyclineHelidac
How Bismuth Subsalicylate, Metronidazole, Tetracycline interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Bismuth Subsalicylate, Metronidazole, Tetracycline interactionBortezomibVelcade
How Bortezomib interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Bortezomib interactionBrexanoloneZulresso
How Brexanolone interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Brexanolone interactionBrivaracetamBriviact
How Brivaracetam interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP2C19.
Read the full Grapefruit Peel Oil + Brivaracetam interactionBudesonide, FormoterolSymbicort
How Budesonide, Formoterol interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 2c9 (cyp2c9) Substrates, Budesonide (entocort, Uceris) +1 Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP2C9.
Read the full Grapefruit Peel Oil + Budesonide, Formoterol interactionBupivacaine, MeloxicamZynrelef Kit
How Bupivacaine, Meloxicam interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP2C9.
Read the full Grapefruit Peel Oil + Bupivacaine, Meloxicam interactionButabarbital SodiumButisol Sodium, Sarisol #2
How Butabarbital Sodium interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Butabarbital Sodium interactionButabarbital, Phenobarbital, SecobarbitalS.B.P.
How Butabarbital, Phenobarbital, Secobarbital interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Butabarbital, Phenobarbital, Secobarbital interactionButalbital, Phenobarbital, SecobarbitalTribarb
How Butalbital, Phenobarbital, Secobarbital interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Butalbital, Phenobarbital, Secobarbital interactionButorphanolStadol
How Butorphanol interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Butorphanol interactionCarbenicillin Indanyl SodiumGeocillin
How Carbenicillin Indanyl Sodium interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Carbenicillin Indanyl Sodium interactionCarbimazoleNeo-Mercazole
How Carbimazole interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Carbimazole interactionCarfilzomibKyprolis
How Carfilzomib interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Spearmint Leaf Oil + Carfilzomib interactionCarisoprodolRela, Soma
How Carisoprodol interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP2C19.
Read the full Grapefruit Peel Oil + Carisoprodol interactionCelecoxibCelebrex, Elyxyb
How Celecoxib interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Grapefruit Peel OilCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, grapefruit juice might increase levels of drugs metabolized by CYP2C9.
Read the full Grapefruit Peel Oil + Celecoxib interactionCenobamateXcopri
How Cenobamate interacts with Citrus Break — through 1 ingredient. Tap an ingredient for the detail:
Spearmint Leaf OilCns Depressants Moderate
Interaction Summary
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Read the full Spearmint Leaf Oil + Cenobamate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Citrus Break 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.
Grapefruit peel oil
Amiodarone (Cordarone)
Grapefruit juice can increase blood levels of amiodarone, potentially increasing the effects and adverse effects of amiodarone.
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption of amiodarone. Grapefruit juice increases amiodarone plasma levels by 50% and peak concentration by 84%.
Artemether (Artenam, Paluther)
Grapefruit juice can increase blood levels of oral artemether, potentially increasing the effects and adverse effects of artemether.
Clinical research shows that grapefruit juice increases the levels of oral artemether by 90% to 250% in healthy males.
Benzodiazepines
Grapefruit juice might increase blood levels of some oral benzodiazepines, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice can increase plasma triazolam concentrations. Repeated consumption of grapefruit juice greatly increases triazolam concentrations and prolongs the half-life, probably due to inhibition of cytochrome P450 3A4 (CYP3A4). Some studies show that grapefruit juice, particularly when taken in large quantities, reduces the clearance and increases the maximum blood levels, area under the plasma concentration curve (AUC), and duration of effect of midazolam. However, there is no effect on intravenous midazolam. Grapefruit juice has also been shown to increase the maximum blood levels and duration of effect of diazepam, but the clinical significance of this is not known. This interaction does not appear to occur with alprazolam.
Buspirone (Buspar)
Grapefruit juice can increase blood levels of buspirone, potentially increasing the effects and adverse effects of buspirone.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of buspirone.
Calcium Channel Blockers
Grapefruit juice can increase blood levels of oral calcium channel blockers, potentially increasing the effects and adverse effects of these drugs.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of amlodipine, nifedipine, nisoldipine, verapamil, felodipine, nimodipine, nicardipine, diltiazem, pranidipine, nitrendipine, and manidipine,
This interaction is likely the result of the inhibition of intestinal metabolism of these drugs by CYP3A4, although some research suggests grapefruit may alter plasma drug levels by reducing the rate of gastric emptying. Consuming grapefruit juice 1 liter daily increases steady state concentrations of verapamil by as much as 50%. However, some references dispute the clinical relevance of the interactions with amlodipine, diltiazem, and verapamil. Other research in healthy individuals suggests plasma levels of felodipine and nifedipine are not affected when given intravenously. There is considerable interindividual variability in the effect of grapefruit juice on drug metabolism, which might account for inconsistent study results. In healthy older adults, the hemodynamic response to felodipine plus grapefruit juice might be influenced by altered autonomic regulation. In older healthy adults, a single dose of grapefruit juice and felodipine enhanced the blood pressure-lowering effects of felodipine. However, after a week of grapefruit juice and felodipine (steady state), the hypotensive activity was reduced, possibly due to compensatory tachycardia. Research indicates it is necessary to withhold grapefruit juice for as long as 3 days to avoid interactions with felodipine and nisoldipine.
Carbamazepine (Tegretol)
Grapefruit juice can increase blood levels of carbamazepine, potentially increasing the effects and adverse effects of carbamazepine.
Clinical research shows that grapefruit juice increases absorption and plasma concentrations of carbamazepine.
Carvedilol (Coreg)
Grapefruit juice can increase blood levels of carvedilol, potentially increasing the effects and adverse effects of carvedilol.
Clinical research shows that grapefruit juice increases the bioavailability of a single dose of carvedilol by 16%.
Celiprolol (Celicard)
Grapefruit juice can decrease blood levels of celiprolol, potentially decreasing the clinical effects of celiprolol.
In human research, taking grapefruit juice within two hours of celiprolol appears to decrease absorption and blood levels of celiprolol by approximately 85%. This interaction is due to grapefruit-induced inhibition of organic anion transporting polypeptide (OATP). Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Cisapride (Propulsid)
Grapefruit juice can increase blood levels of cisapride, potentially increasing the effects and adverse effects of cisapride.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cisapride. According to the cisapride prescribing information, grapefruit juice is contraindicated in patients taking cisapride.
Clomipramine (Anafranil)
Theoretically, grapefruit juice might increase blood levels of clomipramine, potentially increasing the effects and adverse effects of clomipramine.
Case reports have shown that clomipramine trough levels increase significantly after the addition of grapefruit juice to the therapeutic regimen.
Clopidogrel (Plavix)
Grapefruit juice can decrease blood levels of the active metabolite of clopidogrel, thereby decreasing the antiplatelet effect of clopidogrel.
Clopidogrel is an antiplatelet prodrug that is metabolized primarily by cytochrome P450 2C19 (CYP2C19) to form the active metabolite. A small clinical study shows that taking grapefruit juice with clopidogrel decreases plasma levels of the active metabolite by more than 80% and impairs the antiplatelet effect of clopidogrel. This effect is possibly due to grapefruit-induced inhibition of CYP2C19.
Cyclosporine (Neoral, Sandimmune)
Grapefruit juice can increase blood levels of oral cyclosporine, potentially increasing the effects and adverse effects of cyclosporine.
Clinical research shows that grapefruit juice increases the absorption and plasma concentrations of cyclosporine. The mechanism of action is unclear. However, there is no effect on intravenous cyclosporine.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Grapefruit juice can increase levels of drugs metabolized by CYP3A4.
Clinical research shows that grapefruit juice can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. When taken orally, effects of grapefruit juice on CYP3A4 levels appear to last at least 48 hours. Grapefruit's ability to inhibit CYP3A4 has even been harnessed to intentionally increase levels of venetoclax, which is metabolized by CYP3A4, in an elderly patient with acute myeloid leukemia who could not afford full dose venetoclax. The lower dose of venetoclax in combination with grapefruit juice resulted in serum levels of venetoclax in the therapeutic reference range of full dose venetoclax and positive treatment outcomes for the patient.
Professional consensus recommends the consideration of patient age, existing medical conditions, additional medications, and the potential for additive adverse effects when evaluating the risks of concomitant use of grapefruit juice with any medication metabolized by CYP3A4. While all patients are at risk for interactions with grapefruit juice consumption, patients older than 70 years of age and those taking multiple medications are at the greatest risk for a serious or fatal interaction with grapefruit juice.
Dextromethorphan (Robitussin Dm, Others)
Grapefruit juice can increase blood levels of dextromethorphan, potentially increasing the effects and adverse effects of dextromethorphan.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism, causing increased dextromethorphan levels.
Estrogens
Grapefruit juice can increase blood levels of estrogens, potentially increasing the effects and adverse effects of estrogens.
Clinical research shows that grapefruit increases the levels of endogenous and exogenous estrogens by inhibiting cytochrome P450 3A4 (CYP3A4) enzymes. Grapefruit juice increases exogenously administered 17-beta-estradiol by about 20% in females without ovaries and ethinyl-estradiol in healthy females.
Etoposide (Vepesid)
Grapefruit juice can decrease blood levels of etoposide, potentially decreasing the clinical effects of etoposide.
Clinical research shows that grapefruit juice decreases the absorption and plasma concentrations of etoposide. There is some evidence that grapefruit juice co-administered with oral etoposide can reduce levels of etoposide by about 26%. Grapefruit juice seems to inhibit organic anion transporting polypeptide (OATP), which is a drug transporter in the gut, liver, and kidney. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Halofantrine
Grapefruit juice can increase blood levels of halofantrine, potentially increasing the effects and adverse effects of halofantrine.
Clinical research shows that grapefruit juice inhibits cytochrome P450 3A4 (CYP3A4) metabolism, which increases halofantrine levels and peak concentration, as well as a marker of ventricular tachyarrhythmia potential.
Hmg-Coa Reductase Inhibitors ("Statins")
Grapefruit juice can increase blood levels of statins that are metabolized by cytochrome P450 3A4 (CYP3A4), potentially increasing the effects and adverse effects of these statins. Additionally, grapefruit juice might interfere with the bioavailability of statins that are substrates of organic anion transporting polypeptides (OATP).
Clinical research shows that grapefruit juice inhibits metabolism and increases absorption and plasma concentrations of statins that are metabolized by CYP3A4. These include lovastatin, simvastatin, and atorvastatin. Keep in mind that there is considerable variability in the effect of grapefruit juice on drug metabolism, so individual patient response is difficult to predict.
Some statins, including pravastatin, fluvastatin, pitavastatin, and rosuvastatin, are not metabolized by CYP3A4. However, grapefruit juice might still affect the bioavailability of these statins. These statins are substrates of OATP. Grapefruit juice can inhibit OATP. Therefore, grapefruit juice may reduce the bioavailability or increase drug levels of these statins depending on the type of OATP. However, grapefruit juice affects OATP for only a short time. Therefore, separating drug administration by at least 4 hours is likely to avoid this interaction.
Methadone (Dolophine)
Grapefruit juice can increase blood levels of methadone, potentially increasing the effects and adverse effects of methadone.
Clinical research shows that grapefruit juice inhibits the metabolism of methadone, increasing methadone levels and peak concentrations. In one case, a 51-year-old male taking methadone 90 mg daily and no other medications was found unresponsive. The patient reported drinking grapefruit juice 500 mL daily for 3 days prior to the event. Methadone is a substrate of cytochrome P450 3A4 (CYP3A4), and grapefruit juice-induced inhibition of CYP3A4 is the likely cause of this interaction.
Methylprednisolone
Grapefruit juice can increase blood levels of methylprednisolone, potentially increasing the effects and adverse effects of methylprednisolone.
Clinical research shows that grapefruit juice can increase the plasma concentration of orally administered methylprednisolone. Grapefruit juice 200 mL three times daily given with methylprednisolone 16 mg increased methylprednisolone half-life by 35%, peak plasma concentration by 27%, and total area under the curve by 75%.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Grapefruit juice can decrease levels of drugs that are substrates of OATP.
In vitro and clinical research show that consuming grapefruit juice inhibits OATP, which reduces the bioavailability of oral drugs that are substrates of OATP. Various clinical studies have shown reduced absorption of OATP substrates when taken with grapefruit, including fexofenadine, acebutolol, aliskiren, celiprolol, levothyroxine, nadolol, and pitavastatin. Grapefruit juice is thought to affect OATP for only a short time. Therefore, separating drug administration and consumption of grapefruit by at least 4 hours is likely to prevent this interaction.
Praziquantel (Biltricide)
Grapefruit juice can increase blood levels of praziquantel, potentially increasing the effects and adverse effects of praziquantel.
Clinical research shows that grapefruit juice can inhibit cytochrome P450 3A4 (CYP3A4) metabolism of praziquantel. Plasma concentrations of praziquantel can increase by as much as 160% when administered with 250 mL of commercially available grapefruit juice.
Qt Interval-Prolonging Drugs
Grapefruit or grapefruit juice, especially if consumed in large amounts, can cause additive QT interval prolongation when taken with QT interval-prolonging drugs, potentially increasing the risk of ventricular arrhythmias.
Clinical research in healthy volunteers shows that drinking 6 liters of grapefruit juice over 6 hours prolonged the QTc by a peak amount of 14 milliseconds (ms). This prolongation was similar to the QT prolongation caused by the drug moxifloxacin. In individuals with long QT syndrome, a smaller dose of grapefruit juice, 1.5 liters, resulted in a greater peak QTc prolongation of about 30 ms. The effect of smaller quantities of grapefruit juice on the QT interval is unclear.
Quetiapine (Seroquel)
Grapefruit juice may increase blood levels of quetiapine, increasing the effects and adverse effects of quetiapine.
Quetiapine is metabolized by cytochrome P450 3A4 (CYP3A4). Grapefruit can inhibit CYP3A4. In one case report, a healthy 28-year-old female with bipolar disorder stabilized on quetiapine 800 mg daily presented with quetiapine toxicity considered to be related to consuming a gallon of grapefruit juice over the past 24 hours.
Quinidine
Grapefruit juice can alter blood levels of quinidine, potentially increasing or decreasing the clinical effects of quinidine.
Clinical research shows that grapefruit juice decreases quinidine absorption, clearance, and metabolism, and prolongs the half-life by about 20%.
Tangerine Peel Oil
Cytochrome P450 3A4 (Cyp3A4) Substrates
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.
Midazolam (Versed)
In vitro, tangeretin, a constituent of tangerine, appears to increase the metabolism of midazolam in human liver microsomes by up to 52%. However, in humans, drinking tangerine juice 200 mL slightly delayed the absorption, but did not affect the metabolism, of midazolam. Theoretically, tangerine juice might increase the metabolism and reduce the effects of midazolam. However, this effect is unlikely.
Spearmint leaf Oil
Cns Depressants
Theoretically, spearmint might alter the sedative effects of CNS depressants.
Animal research suggests that (-)-carvone, a major constituent of spearmint, has sedative effects. However, in humans, chewing spearmint-flavored gum induced arousal effects.
Hepatotoxic Drugs
Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Animal research suggests that drinking spearmint tea for 30 days can increase markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and cause liver degeneration and necrosis, in a dose-dependent manner. This effect has not been reported in humans.
Orange Peel Oil
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.
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.
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.
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.
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.
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.
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.
Lemon Peel Oil
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 Citrus Break, from the product label.
Revive
See all Revive products- Name
- Revive
- Street Address
- 201 California St
- City
- San Francisco
- State
- California
- Web Address
- www.revive-eo.com
Citrus Break by Revive: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Citrus Break’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Grapefruit
Interacts with 991 drugsGrapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for serious interactions with many prescription...
Read the full Grapefruit monograph → Herb & supplement monographSweet Orange
Interacts with 247 drugsSweet 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...
Read the full Sweet 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 → Herb & supplement monographSpearmint
Interacts with 581 drugsSpearmint is a common culinary mint that is generally safe in food and tea amounts. Early research suggests possible benefits for digestion, mild hormone-related issues (such as excess facia...
Read the full Spearmint monograph → Herb & supplement monographTangerine
Interacts with 645 drugsTangerine 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...
Read the full Tangerine monograph →Sources & How We Checked
Citrus Break'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 199 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.
Grapefruit 157 references
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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.
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