Pomegranate juice does not impair clearance of oral or intravenous Midazolam

A study from the Tufts University School of Medicine published in the Journal of Clinical Pharmacology finds that pomegranate juice does not interact with oral or intravenous medication, contrary to previous information.

Earlier studies suggested that, like grapefruit juice, pomegranate juice may interfere with the metabolism of drugs by inhibiting CYP3A, an enzyme that allows the body to transform and eliminate a drug.

In this study, both pomegranate juice and water, which was used as a control, produced similarly negligible drug interactions. This is the first study using human subjects to test the drug interactions of pomegranate juice, unlike prior studies which were conducted in vitro and in animals.

According to Dr. David Greenblatt, lead researcher and Professor, Department of Pharmacology and Experimental Therapeutics at Tufts University, "Despite the suggestions from other studies, we have found that pomegranate juice does not produce drug interactions. This is the first time drug interactions have been studied in humans, so we are now confident that pomegranate juice is safe for patients taking medications."

The study, entitled "Pomegranate Juice Does Not Impair Clearance of Oral or Intravenous Midazolam", a Probe for Cytochrome P450-3A Activity: Comparison with Grapefruit Juice," published in February 2007, examined pomegranate juice's interaction with the drug midazolam in 15 healthy human volunteers. The drug midazolam was chosen because it is an established test drug used to assess CYP3A activity in healthy human volunteers.

The test drug was administered to the subjects orally and intravenously, and they drank either pomegranate juice, grapefruit juice, or water the night before and the morning of the test. The subjects blood was then analyzed to see whether the enzyme CYP3A was affected by measuring metabolism.

The results were compared among the groups that ingested pomegranate juice, grapefruit juice, and water. The researchers concluded that, like water, pomegranate juice does not alter the clearance of the test drug, suggesting that there is no clinically detectable inhibition of CYP3A activity as there is with grapefruit juice.