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Bitter orange

What is it?

Bitter orange is an herbal medicine that is used for loss of appetite and upset stomach. It has also been used to improve sleep. Bitter orange may be added to other herbs and supplements to help lose weight.

Other names for bitter orange include: Aurantii percarpium and Bitter orange peel.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

  • are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
  • are pregnant or plan to become pregnant while using this medicine
  • are breast feeding
  • have any other health problems, such as high blood pressure or heart or blood vessel disease

Dosage:

Talk with your caregiver about how much bitter orange you should take. The amount depends on the strength of the medicine and the reason you are taking bitter orange. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Do not take bitter orange without talking to your doctor first if you are taking:

  • cyclosporine (Neoral(R), Sandimmune(R))
  • felodipine (Plendil(R))
  • ivacaftor (Kalydeco(R)) (11)
  • midazolam (Versed(R))
  • saquinavir (Fortovase(R), Invirase(R))
  • Medicines used for depression or Parkinson's disease (monoamine oxidase inhibitors (MAOIs), examples: isocarboxazid (Marplan(R)); moclobemide (Manerix(R)); phenelzine (Nardil(R)); selegiline (Deprenyl(R), Eldepryl(R)); tranylcypromine (Parnate(R)))
  • Medicines used as decongestants or diet aids (examples: pseudoephedrine; phenylpropanolamine; ephedrine; phenylephrine)
  • linezolid (Zyvox(R)) (10)

Warnings:

  • Before taking bitter orange, tell your doctor if you are pregnant or breast feeding
  • Before taking, tell your doctor if you have any heart problems

Side Effects:

Stop taking your medicine right away and talk to your doctor if you have any of the following side effects. Your medicine may be causing these symptoms which may mean you are allergic to it.

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, or rash.

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

  • Crushing, tightness, or heaviness in your chest. This pain may spread to your neck, jaw, shoulders, back, or left arm.
  • Belching, burping, or a burning feeling under your breast bone.
  • Sweating.
  • Nausea (upset stomach) and vomiting (throwing up).
  • Feeling weak, light-headed, or dizzy (10)
  • Taking too much bitter orange or taking it for too long may make your skin sensitive to the sun and burn easy.

References:

1. Blumenthal, Busse, Goldberg, et al: The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. The American Botanical Council, Austin, TX; 1998.

2. Blumenthal M, Goldberg A, Brinckman J (eds): Herbal Medicine: Expanded Commission E Monographs. American Botanical Council, Austin, TX; 2000: 287-289.

3. Calapi G, Firenzuoli F, Saiita A et al: Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: a preliminary report. Fitoterapia 1999; 70:586-592.

4. Colker CM, Kalman DS, Torina GC et al: Effects of Citrus aurantium extract, caffeine, and St. John's Wort on body fat, lipid levels, and mood states in overweight adults. Curr Ther Res 1999; 60:145-153.

5. Hou YC, Hsiu SL, Tsao CW et al: Acute intoxication of cyclosporin caused by coadministration of decoctions of the fruits of Citrus aurantium and the Pericarps of Citrus grandis. Planta Med 2000; 66(7):653-655.

6. Malhotra S, Bailey DG, Paine MF et al: Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther 2001; 69(1): 14-23.

7. Nykamp D, Fackih M & Compton A: Possible association of acute lateral-wall myocardial infarction and bitter orange supplement. Ann Pharmacother 2004; 5(38).

8. Penzak SR, Jann MW, Cold JA et al: Seville (sour) orange juice: synephrine content and cardiovascular effects in normotensive adults. J Clin Pharmacol 2001; 41(10):1059-1063.

9. Gilman AG, Rall TW, Nies AS, et alGilman AG, Rall TW, Nies AS, et al (Eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th. Macmillan Publishing Co, New York, NY, 1990.

10. Product Information: Zyvox(R) IV injection, oral tablets, oral suspension, linezolid IV injection, oral tablets, oral suspension. Pharmacia & Upjohn Company, New York, NY, 2008.

11. Product Information: Kalydeco(R) oral tablets, ivacaftor oral tablets. Vertex Pharmaceuticals, Cambridge, MA, 2012.


Last Updated: 8/4/2017
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