When should you avoid pomegranate juice?

Pomegranate juice has become a popular health drink in recent years due to its many potential health benefits. It’s loaded with antioxidants, vitamins, and minerals. However, there are some times when you should avoid drinking pomegranate juice.

If you’re on certain medications

Pomegranate juice can interact with some common medications. The juice contains a high level of polyphenol antioxidants. These compounds can impact how some medications are broken down and metabolized in your body.

Here are some of the medications that don’t mix well with pomegranate juice:

• Blood thinners like warfarin (Coumadin) – Pomegranate juice can enhance the effects of these drugs, increasing your risk of bleeding.
• Blood pressure medications – Drinking pomegranate juice may strengthen the effects of ACE inhibitors like captopril (Capoten) and angiotensin II receptor blockers like losartan (Cozaar).
• Statins used to lower cholesterol – Pomegranate can raise the levels of statin drugs in your blood, increasing your risk of side effects like muscle damage.
• Erectile dysfunction drugs – Pomegranate may increase levels of erectile dysfunction drugs like sildenafil (Viagra), causing low blood pressure.
• Immunosuppressants – Pomegranate can reduce the concentration of immunosuppressant medications like cyclosporine, potentially leading to organ transplant rejection.

If you take any of these medications, talk to your doctor before adding pomegranate juice to your diet. They may recommend avoiding it completely or limiting your intake.

If you’re pregnant

Pregnant women should exercise caution with pomegranate juice. There isn’t extensive research on the safety of pomegranate consumption during pregnancy.

Some preliminary studies in animals have found that pomegranate extract may affect hormones like estrogen in the body. This raises concerns that it could potentially impact pregnancy. More research is needed.

Also, pomegranate juice is relatively high in natural sugar content. Pregnant women are generally advised to minimize added sugars. Too much can increase the risk of excess weight gain.

If you’re pregnant, it’s best to avoid drinking pomegranate juice daily. Focus on proven beverages like water, milk, and juices with less natural sugar like grapefruit or orange juice.

If you have diabetes or blood sugar issues

Pomegranate juice is relatively high in carbohydrates and natural sugar. An 8 oz (240 ml) glass contains about:

• 21 grams of sugar
• 29 grams of carbs

This is almost as much sugar as a can of soda.

Here’s how the carb and sugar content of 8 oz (240 ml) of pomegranate juice compares:

Beverage	Carbs (g)	Sugar (g)
Pomegranate juice	29	21
Apple juice	28	24
Cranberry juice	32	31
Orange juice	21	20
Coca-cola	27	27

For people with diabetes, prediabetes, or those watching their blood sugar for other reasons, drinking large amounts of pomegranate juice can cause undesirable spikes. It’s best to avoid drinking it routinely and stick to lower sugar options.

If you have diarrhea

Some compounds in pomegranate juice may have mild laxative effects for some people. There have been isolated reports of people experiencing loose stools or diarrhea after drinking pomegranate juice.

The fruit sugars fructose and sorbitol appear to be poorly absorbed in some individuals, drawing water into the intestines and promoting bowel movements. Pomegranate juice is relatively high in fructose.

If you already have diarrhea, drinking pomegranate juice could make it worse. It’s better to avoid it until you recover.

If you have a salicylate sensitivity

Pomegranates naturally contain high levels of salicylate, a type of plant compound. People who react negatively to salicylate may experience adverse effects from pomegranate juice.

Symptoms of salicylate sensitivity can include:

• Hives or itching
• Asthma or breathing difficulties
• Runny nose
• Headaches
• Digestive distress

If you know you’re sensitive to salicylates, it’s best to avoid pomegranate juice as well as supplements and extracts.

If you’re taking antibiotics

Some research indicates that compounds in pomegranate, like ellagic acid, may have antibacterial effects in the body. There’s concern that consuming pomegranate products could potentially reduce the effectiveness of certain antibiotics.

If you’re currently taking antibiotics, it’s wisest to avoid pomegranate juice until you finish your course of medication. You want the antibiotics to work optimally to treat the underlying infection.

Once you’re done with the antibiotics, you can resume pomegranate juice in moderation if desired.

If you have iron-deficiency anemia

Pomegranate juice contains small amounts of antioxidants called polyphenols. These compounds can inhibit iron absorption and bind with iron in food, making less available to be absorbed.

People with iron-deficiency anemia need to maximize their iron intake from food and supplements. Consuming pomegranate juice may hinder this process.

If you have low iron levels or anemia, check with your doctor before adding pomegranate juice to your diet.

If you take antidepressants

Some research indicates that pomegranate juice may inhibit an enzyme system in your body known as cytochrome P450 (CYP450). This enzyme metabolizes many drugs.

By inhibiting CYP450, pomegranate juice can increase blood levels of some antidepressants, potentially causing negative side effects.

Some of the antidepressants that may be impacted include:

• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Venlafaxine (Effexor)

If you take any antidepressants, check with your doctor before consuming pomegranate juice regularly.

If you have low blood pressure

Some early research shows that drinking pomegranate juice may slightly reduce blood pressure levels in people with normal and high blood pressure.

However, for those who already have low blood pressure, pomegranate juice may drive blood pressure lower. Symptoms of low blood pressure include:

• Dizziness
• Fainting
• Fatigue
• Nausea
• Clammy skin
• Depressed mood

To avoid these undesirable effects, people with chronically low blood pressure should use caution with pomegranate juice until more is known.

If you have kidney issues

In most cases, pomegranate juice is safe to consume in moderation. However, people with serious kidney problems like kidney failure requiring dialysis may want to avoid it.

Compounds in pomegranate juice may accumulate in people with impaired kidney function. They are unable to efficiently filter and excrete these compounds.

Impaired kidney function can also lead to excess potassium in the blood. Pomegranate juice is relatively high in potassium, containing about 13% of the RDI per cup (240 ml).

If your kidneys are severely compromised, it’s best to avoid drinking pomegranate juice.

Conclusion

Pomegranate juice has many health benefits for most people, however, there are some circumstances where it’s better to avoid it. If you take certain medications, have diabetes, diarrhea, anemia, kidney problems or low blood pressure, pomegranate juice may exacerbate those conditions.

Pregnant women and people with salicylate sensitivity or who are on antibiotics should also use caution and first check with their doctor before drinking pomegranate juice regularly.

In most cases, drinking pomegranate juice occasionally or in moderation is not a concern. But certain populations should be aware of potential interactions and side effects before incorporating it into their diet.