Noni Capsule Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Noni Capsule 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
Noni Capsule is a dietary supplement by Esmond Natural with 4 active ingredients. Its ingredients are commonly taken for general wellness and energy, inflammation and joint pain, immune support.Based on those ingredients, 1,162 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Pomegranate, Noni, Mangosteen. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Noni Capsule by Esmond Natural
Ask about any prescription or over-the-counter medication and we check it for interactions with Noni Capsule by Esmond Natural — 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 Noni Capsule by Esmond Natural
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
Full disclosure
This capsule contains 4 ingredients total. The three active ones are noni fruit, mangosteen (the tropical fruit), and raspberry — each included for their traditional and nutritional profiles.
Noni and pomegranate are known for their potassium content, which matters if you take blood pressure or kidney medications. The capsule itself is made from gelatin and magnesium stearate, which are standard inactive ingredients used as a binder and flow agent.
Does it work?
Moderate evidence
The evidence for what noni, mangosteen, and pomegranate actually do is limited. Pomegranate shows some promise for lowering blood pressure (possibly effective for hypertension), but the data on cholesterol and blood sugar control point toward it being ineffective.
For noni, evidence is insufficient to rate its effects on asthma, heart disease, athletic performance, burns, or cancer. Mangosteen is possibly effective for gum inflammation (periodontitis), but evidence is insufficient for other uses like hair loss or Alzheimer's disease.
We hold no effectiveness data for raspberry in this product.
How safe is it?
Well-documented data
Noni is generally well tolerated in moderate amounts, but there are two serious concerns. First, rare cases of liver damage and liver failure have been reported — it's unclear whether noni itself or contaminants in noni products caused this, but it's something to watch for.
Second, noni's high potassium content is a real issue if you have kidney disease or take medications that raise potassium. The most common side effects are nausea and abdominal discomfort.
Mangosteen extracts have caused tiredness, headache, dizziness, constipation, and nausea in some trial participants, though causation wasn't confirmed. Pomegranate is generally well tolerated as a fruit or juice; at higher supplement doses, diarrhea and flatulence occurred in a small percentage of people.
Noni has been traditionally used to cause abortion, so it should not be used during pregnancy. Mangosteen and pomegranate do not have enough safety information for pregnancy, so talk with your doctor before using them while pregnant or breastfeeding.
We hold no pregnancy/lactation data for raspberry.
Meds to double-check
Moderate interaction found
Before taking this product, check with your own doctor or pharmacist if you take any blood pressure medications (ACE inhibitors, ARBs, antihypertensives, or potassium-sparing diuretics) — noni's potassium content and blood-pressure-lowering effect pose a real risk. Blood thinners like warfarin need a conversation too, because both noni and pomegranate can interfere with them.
If you take seizure medications (phenytoin or carbamazepine), liver-processed drugs (CYP2D6, CYP2C9, or CYP3A4 substrates), ranitidine, rosuvastatin, donepezil, or any liver-support medication, check first. Do not start without talking it over.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.
This product may appeal to people looking for botanical antioxidants, but the evidence for most of its ingredients is limited. If you take any medication — especially for blood pressure, heart rhythm, blood clotting, seizures, or kidney function — you need to check with your own doctor or pharmacist before starting, because the interactions are real and some are serious.
If you have liver disease or kidney disease, flag this with your healthcare provider. The product is generally well tolerated, but watch for nausea, upset stomach, or signs of liver trouble (yellowing skin or eyes, dark urine).
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2024.
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 Noni Capsule, straight from the product label.
| Brand | Esmond Natural |
|---|---|
| Barcode (UPC) | 0641399088622 |
| Net contents | 90 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Aug 22, 2024 |
| DSLD ID | 315910 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Noni Capsule by Esmond Natural, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Noni | 800 mg | -- |
| Mangosteen | 20 mg | -- |
| Raspberry | 40 mg | -- |
| Pomegranate | 30 mg | -- |
Other ingredients: Gelatin, Magnesium Stearate
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.
Formulation
May support overall healthy and well-being.
Immune Support Antioxidant Support
Esmondnatural Integrated health
Precautions
Warning: If you are pregnant, nursing or taking any medications, consult your doctor before use.
Discontinue use and consult your doctor if any adverse reactions occur.
Keep out of reach of children.
Tamper resistant: Do not use if imprinted seal under cap is broken or missing.
As a reminder, discuss the supplements and medications you take with your health care providers.
Storage
Store in a dry place and avoid excessive heat.
Seals/Symbols
GMP
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General Statements
Herbal health Since 1994
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: For adults, take two (2) capsules daily, preferably with meals.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Noni Capsule by Esmond Natural 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 Noni Capsule by Esmond Natural
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container45 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.
Noni
Interacts with542 drugs
Noni is a tropical fruit used widely in folk medicine and sold mostly as a juice or supplement, but solid human evidence for its many claimed benefits...
Noni monograph & interactionsMangosteen
Interacts with125 drugs
Mangosteen is a tropical fruit whose rind is rich in plant compounds called xanthones that act as antioxidants. While it is popular in juices and supp...
Mangosteen monograph & interactionsRaspberry
Pomegranate
Interacts with922 drugs
Pomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support hear...
Pomegranate monograph & interactionsOther (inactive) ingredients: Gelatin, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Noni Capsule by Esmond Natural Drug Interactions
HelloPharmacist Interaction Report
Esmond Natural's Noni Capsule contains noni, mangosteen, and pomegranate — three ingredients with documented interactions.
The most serious concern is a Moderate-severity risk of high potassium levels (hyperkalemia) through noni's high potassium content when combined with blood pressure medications like ACE inhibitors, ARBs, or potassium-sparing diuretics; this same mechanism applies to all three drug types. Noni also carries Moderate risk with blood pressure-lowering drugs (antihypertensives), drugs metabolized by your liver (hepatotoxic drugs), blood thinners like warfarin, and the seizure medication phenytoin — through different mechanisms.
Mangosteen presents a Moderate risk with blood thinners (anticoagulant/antiplatelet drugs) due to effects on platelet function. Pomegranate adds Moderate-severity interactions with blood pressure drugs, certain cholesterol medications (CYP2D6 substrates and rosuvastatin), blood thinners, ACE inhibitors, and drugs processed through specific liver pathways (CYP2D6 and CYP2C9 substrates); it also carries Minor risks with a seizure medication (carbamazepine) and another class of liver-metabolized drugs (CYP3A4 substrates).
Noni carries a Minor interaction with ranitidine (an acid-reflux drug). We could not check raspberry for interactions — no data is on file for it.
Altogether, these interactions span 1,163 individual medications. Before starting this product, run your exact medications through the search tool below or talk with your own pharmacist or doctor.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Noni Capsule?
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 Noni Capsule interact with 1,162 drugs. Click any drug to see the details.
3 of the 4 ingredients in Noni Capsule interact with drugs. Each result below shows which ingredient is responsible. Pomegranate Noni Mangosteen
FosaprepitantEmend Injection, Focinvez
How Fosaprepitant interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Fosaprepitant interactionFosnetupitant, Palonosetron (iv)Akynzeo
How Fosnetupitant, Palonosetron (iv) interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Fosnetupitant, Palonosetron (iv) interactionFostemsavir TromethamineRukobia
How Fostemsavir Tromethamine interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Fostemsavir Tromethamine interactionFutibatinibLytgobi
How Futibatinib interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Futibatinib interactionGanaxoloneZtalmy
How Ganaxolone interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Ganaxolone interactionGepironeExxua
How Gepirone interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Gepirone interactionGilteritinib FumarateXospata
How Gilteritinib Fumarate interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Gilteritinib Fumarate interactionGlasdegibDaurismo
How Glasdegib interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Glasdegib interactionGlecaprevir, PibrentasvirMavyret
How Glecaprevir, Pibrentasvir interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Glecaprevir, Pibrentasvir interactionGlimepirideAmaryl
How Glimepiride interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate + Glimepiride interactionGlipizideGlucotrol, Glucotrol XL
How Glipizide interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate + Glipizide interactionGlipizide, MetforminMetaglip
How Glipizide, Metformin interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate + Glipizide, Metformin interactionGlycopyrrolate, Indacaterol MaleateUtibron
How Glycopyrrolate, Indacaterol Maleate interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Glycopyrrolate, Indacaterol Maleate interactionHydrocortisoneAlkindi Sprinkle, Alphaderm, Calmurid HC, Carmol HC cream, Cortef, Dioderm +8 more
How Hydrocortisone interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Hydrocortisone interactionHydroxyzineAtarax, Ucerax, Vistaril
How Hydroxyzine interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Hydroxyzine interactionIbrexafungerp CitrateBrexafemme
How Ibrexafungerp Citrate interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Ibrexafungerp Citrate interactionIdelalisibZydelig
How Idelalisib interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Idelalisib interactionIfosfamideIfex
How Ifosfamide interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Ifosfamide interactionImatinibGleevec
How Imatinib interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Imatinib interactionIndacaterolArcapta Neohaler, Onbrez Breezhaler
How Indacaterol interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Indacaterol interactionIndinavirCrixivan
How Indinavir interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Indinavir interactionIndomethacinIndo-Lemmon, Indocin, Indocin SR, Indomethagan, Tivorbex
How Indomethacin interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Read the full Pomegranate + Indomethacin interactionInfigratinibTruseltiq
How Infigratinib interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Infigratinib interactionIrinotecanCamptosar, Onivyde
How Irinotecan interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Irinotecan interactionIrinotecan Hydrochloride
How Irinotecan Hydrochloride interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Irinotecan Hydrochloride interactionIsavuconazonium Sulfate
How Isavuconazonium Sulfate interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Isavuconazonium Sulfate interactionIsavuconazonium Sulfate (iv)Cresemba
How Isavuconazonium Sulfate (iv) interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Isavuconazonium Sulfate (iv) interactionIsavuconazonium Sulfate (oral)Cresemba
How Isavuconazonium Sulfate (oral) interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Isavuconazonium Sulfate (oral) interactionIstradefyllineNourianz
How Istradefylline interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Istradefylline interactionIvabradineCoralan, Corlanor, Corlentor, Procoralan
How Ivabradine interacts with Noni Capsule — through 1 ingredient. Tap an ingredient for the detail:
PomegranateCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Read the full Pomegranate + Ivabradine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Noni Capsule 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.
Pomegranate
Ace Inhibitors (Aceis)
Theoretically, taking pomegranate with ACEIs might increase the risk of adverse effects.
Pomegranate juice is thought to have ACE inhibitor-like effects.
Antihypertensive Drugs
Theoretically, taking pomegranate with antihypertensive drugs might increase the risk of hypotension.
Consuming pomegranate juice can modestly lower blood pressure.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2D6.
In vitro, pomegranate juice inhibits CYP2D6. However, the clinical significance of this potential interaction in humans is not known.
Rosuvastatin (Crestor)
Theoretically, taking pomegranate with rosuvastatin might increase the risk of adverse effects.
In one case, a patient taking rosuvastatin 5 mg every other day in combination with ezetimibe 10 mg daily developed rhabdomyolysis after drinking pomegranate juice 200 mL twice weekly for 3 weeks. This patient had a history of elevated creatine kinase levels while not receiving any statin treatment. This suggests a possible underlying myopathy and predisposition to rhabdomyolysis.
Warfarin (Coumadin)
Theoretically, pomegranate might increase warfarin levels and increase the risk of bleeding. Also, discontinuing regular consumption of pomegranate juice might decrease warfarin levels.
In one case report, a patient had a stable, therapeutic bleeding time, as measured by international normalized ratio (INR), while taking warfarin in combination with pomegranate juice 2-3 times per week. The patient became subtherapeutic within about 10 days after discontinuing pomegranate juice, which required a warfarin dose increase. In another case report, a patient with a stable INR for over one year presented with an INR of 14. The patient noted no changes to medications or diet but did report consuming around 3 liters of pomegranate juice over the previous week. The patient's INR stabilized upon moderation of pomegranate juice consumption. The mechanism of this potential interaction is unclear.
Carbamazepine (Tegretol)
Theoretically, taking pomegranate with carbamazepine might increase the risk of adverse effects, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice may inhibit cytochrome P450 3A4 (CYP3A4) metabolism of carbamazepine and increase levels of carbamazepine by 1.5 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP3A4, but might not inhibit hepatic CYP3A4. However, some human research suggests that pomegranate does not significantly inhibit CYP3A4 drug metabolism in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP2C9.
Some animal and in vitro research shows that pomegranate juice inhibits intestinal, but not hepatic, CYP2C9 isoenzyme activity. However, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, pomegranate might increase levels of drugs metabolized by CYP3A4, but most research suggests this interaction is unlikely to be clinically significant.
Pomegranate contains several polyphenols that have individually been shown to inhibit CYP3A4. However, there is contradictory evidence about the effect of whole pomegranate juice on CYP3A4 activity. In vitro, pomegranate juice significantly inhibits the CYP3A4 enzyme, with comparable inhibition to grapefruit juice. In an animal model, pomegranate juice inhibits CYP3A4 metabolism of carbamazepine and increases levels of carbamazepine by 1.5 times; however, in human volunteers, drinking a single glass of pomegranate juice 240 mL or taking 200 mL daily for 2 weeks does not significantly affect levels of the CYP3A4 substrate midazolam after oral or intravenous administration. Another study in healthy volunteers shows that consuming pomegranate juice 300 mL three times daily for three days also does not significantly affect levels of simvastatin, a CYP3A4 substrate This suggests that pomegranate is unlikely to significantly affect levels of CYP3A4 substrates in humans.
Tolbutamide (Orinase)
Theoretically, pomegranate might increase levels of tolbutamide, although research suggests this interaction is unlikely to be clinically significant.
Animal research shows that pomegranate juice inhibits the cytochrome P450 2C9 (CYP2C9) metabolism of tolbutamide. Pomegranate juice increased tolbutamide levels by 1.2 times without prolonging the elimination half-life. This suggests that pomegranate juice inhibits intestinal CYP2C9, but might not inhibit hepatic CYP2C9. Despite this evidence, clinical research shows that neither pomegranate juice nor pomegranate extract have a significant effect on CYP2C9 activity in humans. This interaction does not appear to be clinically significant in humans.
Noni
Ace Inhibitors (Aceis)
Theoretically, combining noni and ACE inhibitors might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with ACE inhibitors, which can also increase potassium levels.
Angiotensin Receptor Blockers (Arbs)
Theoretically, combining noni and ARBs might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with ARBs, which can also increase potassium levels.
Antihypertensive Drugs
Theoretically, noni may increase the risk of hypotension when used in combination with antihypertensive drugs.
Preliminary clinical research suggests that drinking noni juice can reduce blood pressure in individuals with hypertension.
Hepatotoxic Drugs
Theoretically, taking noni with hepatotoxic drugs might increase the risk of liver damage.
There is concern that noni might cause hepatotoxicity in some patients. Advise patients against combining noni with potentially hepatotoxic drugs.
Phenytoin (Dilantin)
Theoretically, taking noni fruit juice concomitantly with phenytoin may lower phenytoin levels and increase the risk of seizures.
In one case report, an adult taking phenytoin for partial seizures experienced low serum phenytoin levels while taking noni juice 90-200 mL daily. Serum phenytoin levels increased after decreasing noni juice consumption; similarly, serum phenytoin levels decreased after increasing noni juice consumption. Some researchers believe noni juice may induce cytochrome P450 2C9 enzymes, which would decrease phenytoin levels, but this has not been well studied. Patients may need additional monitoring when starting or stopping noni juice supplementation.
Potassium-Sparing Diuretics
Theoretically, combing noni and a potassium-sparing diuretic might increase the risk of hyperkalemia.
Noni juice contains significant amounts of potassium, about 6 mEq/100 mL juice. This may increase the risk for hyperkalemia when used in conjunction with potassium-sparing diuretics, which can also increase potassium levels.
Warfarin (Coumadin)
Theoretically, taking noni juice concomitantly with warfarin might decrease the effectiveness of warfarin.
In one case, a 41-year-old patient stabilized on warfarin had a decreased international normalized ratio (INR) following consumption of a specific commercial noni juice product (Noni juice 4 Everything). While the patient was still taking noni juice, an increase in warfarin dose did not produce an increase in INR. However, it should be noted that this particular product contained extracts and derivatives from more than 115 components, many of which contained vitamin K. Furthermore, vitamin K was listed as a separate ingredient of the product, suggesting that the product was possibly fortified with vitamin K. It has not been verified that noni fruit alone contains a significant amount of vitamin K or interacts with warfarin.
Ranitidine (Zantac)
Taking noni fruit with ranitidine might increase the levels and clinical effects of ranitidine.
Clinical evidence shows that taking an aqueous extract of noni fruit 30 minutes prior to taking a single oral dose of ranitidine can increase the rate of absorption and plasma concentration of ranitidine.
Mangosteen
Anticoagulant/Antiplatelet Drugs
Theoretically, concomitant use of mangosteen with anticoagulant or antiplatelet drugs may increase the risk of bleeding.
In vitro and animal research shows that gamma-mangostin, a constituent of mangosteen, is a potent and competitive antagonist of the serotonin 2A (5-HT2A) receptor. Antagonism of the 5-HT2A receptor is believed to reduce platelet aggregation.
Donepezil (Aricept)
Theoretically, concomitant use of mangosteen with donepezil might increase the effects of donepezil.
Animal research shows that concomitant use of an aqueous extract of mangosteen pericarp with donepezil increases brain concentrations of donepezil at 4 hours by 64% without associated effects on systemic exposure.
Brand information
Manufacturer and brand details for Noni Capsule, from the product label.
Esmond Natural
See all Esmond Natural products- Name
- Esmond Natural Inc.
- City
- Irwindale
- State
- CA
- ZipCode
- 91706
- Web Address
- www.esmondnatural.com
Noni Capsule by Esmond Natural: 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 Noni Capsule’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Noni
Interacts with 542 drugsNoni is a tropical fruit used widely in folk medicine and sold mostly as a juice or supplement, but solid human evidence for its many claimed benefits is limited. While moderate juice intake...
Read the full Noni monograph → Herb & supplement monographMangosteen
Interacts with 125 drugsMangosteen is a tropical fruit whose rind is rich in plant compounds called xanthones that act as antioxidants. While it is popular in juices and supplements for inflammation, immune support...
Read the full Mangosteen monograph → Herb & supplement monographPomegranate
Interacts with 922 drugsPomegranate is a nutrient-rich fruit that is high in antioxidants and is widely enjoyed as food and juice. Early research suggests it may support heart health and blood pressure, but the evi...
Read the full Pomegranate monograph →Sources & How We Checked
Noni Capsule'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 49 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.
Noni 16 references
- Mueller BA, Scott MK, Sowinski KM, Prag KA. Noni juice (Morinda citrifolia): hidden potential for hyperkalemia? Am J Kidney Dis 2000;35:310-2. PubMed
- Millonig G, Stadlmann S, Vogel W. Herbal hepatotoxicity: acute hepatitis caused by a Noni preparation (Morinda citrifolia). Eur J Gastroenterol Hepatol 2005;17:445-7. PubMed
- Stadlbauer V, Fickert P, Lackner C, et al. Hepatotoxicity of NONI juice: report of two cases. World J Gastroenterol 2005;11:4758-60. PubMed
- Carr ME, Klotz J, Bergeron M. Coumadin resistance and the vitamin supplement "Noni". Am J Hematol 2004;77:103. PubMed
- Jensen CJ, Westendorf J, Wang MY, Wadsworth DP. Noni juice protects the liver. Eur J Gastroenterol Hepatol 2006;18:575-7. PubMed
- Yuce B, Gulberg V, Diebold J, Gerbes AL. Hepatitis induced by noni juice from morinda citrifolia: a rare cause of hepatotoxicity or the tip of the iceberg? Digestion 2006;73:167-70.
- Koch E, Biber A. Treatment of rats with the Pelargonium sidoides extract EPs 7630 has no effect on blood coagulation parameters or on the pharmacokinetics of warfarin. Phytomedicine 2007;14 Suppl 6:40-5. PubMed
- Yu EL, Sivagnanam M, Ellis L, Huang JS. Acute hepatotoxicity after ingestion of Morinda citrifolia (noni berry) juice in a 14-year-old boy. J Pediatr Gastroenterol Nutr 2011;52:222-4.
- Stadlbauer V, Weiss S, Payer F, Stauber RE. Herbal does not at all mean innocuous: the sixth case of hepatotoxicity associated with morinda citrifolia (noni). Am J Gastroenterol 2008;103:2406-7. PubMed
- López-Cepero Andrada JM, Lerma Castilla S, Fernández Olvera MD, Amaya Vidal A. [Hepatotoxicity caused by a noni (Morinda citrifolia) preparation]. [Article in Spanish] Rev Esp Enferm Dig 2007;99:179-81.
- Nima S, Kasiwong S, Ridtitid W, et al. Gastrokinetic activity of Morinda citrifolia aqueous fruit extract and its possible mechanism of action in human and rat models. J Ethnopharmacol. 2012;142(2):354-61. PubMed
- Issell, B. F., Gotay, C. C., Pagano, I., and Franke, A. A. Using quality of life measures in a Phase I clinical trial of noni in patients with advanced cancer to select a Phase II dose. J.Diet.Suppl 2009;6(4):347-359. PubMed
- Palu AK, Santiago RA West B Kaluhiokalani N Jensen J. The Effects of Morillda citrifolia L. Noni on High Blood Pressure: A Mechanistic Investigation and Case Study. ACS SYMPOSIUM SERIES 993 2008;
- Jiménez-Encarnación E, Ríos G, Muñoz-Mirabal A, Vilá LM. Euforia-induced acute hepatitis in a patient with scleroderma. BMJ Case Rep 2012;2012. PubMed
- Bussmann RW, Hennig L, Giannis A, Ortwein J, Kutchan TM, Feng X. Anthraquinone Content in Noni (Morinda citrifolia L.). Evid Based Complement Alternat Med. 2013;2013:208378.
- Yu-Chan Kang, Ming-Hong Chen, Shung-Lon Lai. Potentially Unsafe Herb-drug Interactions Between a Commercial Product of Noni Juice and Phenytoin- A Case Report. Acta Neurol Taiwan. 2015 Jun;24(2):43-6.
Mangosteen 6 references
- Chairungsrilerd N, Furukawa K, Ohta T, et al. Histaminergic and serotonergic receptor blocking substances from the medicinal plant Garcinia mangostana. Planta Med 1996;62:471-2.
- Wong LP, Klemmer PJ. Severe lactic acidosis associated with juice of the mangosteen fruit Garcinia mangostana. Am J Kidney Dis 2008;51:829-33. PubMed
- Furukawa, K., Chairungsrilerd, N., Ohta, T., Nozoe, S., and Ohizumi, Y. [Novel types of receptor antagonists from the medicinal plant Garcinia mangostana]. Nippon Yakurigaku Zasshi 1997;110 Suppl 1:153P-158P. PubMed
- Chairungsrilerd, N., Furukawa, K., Tadano, T., Kisara, K., and Ohizumi, Y. Effect of gamma-mangostin through the inhibition of 5-hydroxy-tryptamine2A receptors in 5-fluoro-alpha-methyltryptamine-induced head-twitch responses of mice. Br J Pharmacol. 1998
- Suthammarak W, Numpraphrut P, Charoensakdi R, et al. Antioxidant-enhancing property of the polar fraction of mangosteen pericarp extract and evaluation of its safety in humans. Oxid Med Cell Longev 2016;2016:1293036. PubMed
- Bae M, Han SY, Kim ES, et al. Effect of Water Extract of Mangosteen Pericarp on Donepezil Pharmacokinetics in Mice. Molecules 2021;26(17):5246. PubMed
Pomegranate 27 references
- Igea JM, Cuesta J, Cuevas M, et al. Adverse reaction to pomegranate ingestion. Allergy 1991;46:472-4. DOI
- Gaig P, Bartolome B, Lleonart R, et al. Allergy to pomegranate (Punica granatum). Allergy 1999;54:287-8.
- Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis 2001;158:195-8. PubMed
- Valsecchi R, Reseghetti A, Leghissa P, et al. Immediate contact hypersensitivity to pomegranate. Contact Dermatitis 1998;38:44-5. PubMed
- Esmaillzadeh A, Tahbaz F, Gaieni I, et al. Concentrated pomegranate juice improves lipid profiles in diabetic patients with hyperlipidemia. J Med Food 2004;7:305-8. PubMed
- Aviram M, Rosenblat M, Gaitini D, et al. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr 2004;23:423-33. DOI
- Hidaka M, Okumura M, Fujita K, et al. Effects of pomegranate juice on human cytochrome p450 3A (CYP3A) and carbamazepine pharmacokinetics in rats. Drug Metab Dispos 2005;33:644-8. PubMed
- Loren DJ, Seeram NP, Schulman RN, Holtzman DM. Maternal dietary supplementation with pomegranate juice is neuroprotective in an animal model of neonatal hypoxic-ischemic brain injury. Pediatr Res 2005;57:858-64. PubMed
- Kim ND, Mehta R, Yu W, et al. Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer. Breast Cancer Res Treat 2002;71:203-17. PubMed
- Sorokin AV, Duncan B, Panetta R, Thompson PD. Rhabdomyolysis associated with pomegranate juice consumption. Am J Cardiol 2006;98:705-6. PubMed
- Farkas D, Oleson LE, Zhao Y, et al. Pomegranate juice does not impair clearance of oral or intravenous midazolam, a probe for cytochrome P450-3A activity: comparison with grapefruit juice. J Clin Pharmacol 2007;47:286-94. PubMed
- Yeo C, Shon J, Liu K, et al. The effects of pomegranate juice on the pharmacokinetics of simvastatin in healthy Korean subjects (PI-63). Clin Pharmacol Ther 2006;79:23.
- Farkas D, Greenblatt DJ. Influence of fruit juices on drug disposition: discrepancies between in vitro and clinical studies. Expert Opin Drug Metab Toxicol 2008;4:381-93.
- Nagata M, Hidaka M, Sekiya H, et al. Effects of pomegranate juice on human cytochrome P450 2C9 and tolbutamide pharmacokinetics in rats. Drug Metab Dispos 2007;35:302-5. PubMed
- Komperda KE. Potential interaction between pomegranate juice and warfarin. Pharmacotherapy 2009;29:1002-6. PubMed
- Gangemi S, Mistrello G, Roncarolo D, et al. Pomegranate-dependent exercise-induced anaphylaxis. J Investig Allergol Clin Immunol 2008;18:491-2.
- Misaka S, Nakamura R, Uchida S, et al. Effect of 2 weeks' consumption of pomegranate juice on the pharmacokinetics of a single dose of midazolam: an open-label, randomized, single-center, 2-period crossover study in healthy Japanese volunteers. Clin Ther PubMed
- Jarvis S, Li C, Bogle RG. Possible interaction between pomegranate juice and warfarin. Emerg Med J 2010;27:74-5. PubMed
- Esmaillzadeh, A., Tahbaz, F., Gaieni, I., Alavi-Majd, H., and Azadbakht, L. Cholesterol-lowering effect of concentrated pomegranate juice consumption in type II diabetic patients with hyperlipidemia. Int J Vitam.Nutr Res 2006;76(3):147-151. PubMed
- Forest, C. P., Padma-Nathan, H., and Liker, H. R. Efficacy and safety of pomegranate juice on improvement of erectile dysfunction in male patients with mild to moderate erectile dysfunction: a randomized, placebo-controlled, double-blind, crossover study PubMed
- Wright, H. and Pipkin F. B. Pomegranates (Punica granatum), kiwifruit (Actinidia deliciosa) and blood pressure: a pilot study. Proceedings of the Nutrition Society 2008;67(8):1.
- Sohrab G, Sotoodeh G, Siasi F, et al. Effect of pomegranate juice consumption on blood pressure in type 2 diabetic patients. Iranian Journal of Endocrinology and Metabolism 2008;9:399-405, 470.
- Enrique E, Utz M, De Mateo JA, et al. Allergy to lipid transfer proteins: cross-reactivity among pomegranate, hazelnut, and peanut. Ann Allergy Asthma Immunol 2006;96(1):122-3. PubMed
- Hanley MJ, Masse G, Harmatz JS, et al. Pomegranate juice and pomegranate extract do not impair oral clearance of flurbiprofen in human volunteers: divergence from in vitro results. Clin Pharmacol Ther 2012;92(5):651-7. PubMed
- Paller CJ, Ye X, Wozniak PJ, et al. A randomized phase II study of pomegranate extract for men with rising PSA following initial therapy for localized prostate cancer. Prostate Cancer Prostatic Dis 2013;16(1):50-5. PubMed
- Park SJ, Yeo CW, Shim EJ, et al. Pomegranate juice does not affect the disposition of simvastatin in healthy subjects. Eur J Drug Metab Pharmacokinet 2016;41(4):339-44. PubMed
- Ross MM, Cherkerzian S, Mikulis ND, et al. A randomized controlled trial investigating the impact of maternal dietary supplementation with pomegranate juice on brain injury in infants with IUGR. Sci Rep. 2021;11(1):3569. 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