• Bitter orange, Seville orange, Sour orange
Citrus aurantium is the Latin name for a fruit called Seville orange, or bitter orange. The juice, peel, and essential oil have all been used medicinally. Traditionally uses include digestive problems, epilepsy, fatigue, insomnia, infections, respiratory problems, skin problems, and many other uses. As a flavoring, essence of bitter orange is found in the drinks Triple Sec and Cointreau.
What is Citrus aurantium Used for Today?
Citrus aurantium juice and peel contain the stimulant chemical synephrine as well as related stimulants such as octopamine, tyramine, N-methyltyramine, and hordeline. On this basis, Citrus aurantium has been widely marketed as a weight-loss product
The only published
Besides synephrine and other stimulants, whole
peel contains including citral, limonene, and several
Many Citrus aurantium products are made from the juice and/or concentrated extracts of the peel and are said to contain a fixed percentage of synephrine or total amines. A typical recommended dosage of such products ranges from 100–150 mg two to three times daily. However, these doses may be unsafe.
Most of the safety concerns regarding citrus aurantium relate to its stimulant constituents.
The drug synephrine is known to produce many unpleasant and possibly dangerous side effects, including headache, agitation, rapid heart rate, and heart palpitations. In some people, it can cause
, kidney damage, increased pressure in the eye, and reduced blood circulation to the heart and the extremities. The other stimulant amines in
may increase such effects. There is one case report of a heart attack that appears possibly related to use of a citrus aurantium supplement,
Synephrine can also interact with numerous medications and other drugs, including stimulants (e.g.,
The peel and essential oil of
may cause photosensitivity (increased tendency to react to sun exposure). For this reason, combination treatment with drugs that cause the same side effect (such as
juice can alter the way that the liver processes various medications, potentially raising or lowering their levels.
In particular, the drugs
Safety in young children, pregnant or nursing women, or people with severe liver or kidney disease has not been established.
Interactions You Should Know About
If you are taking
- Drugs in the MAO inhibitor
1. Colker CM, Kalman DS, Torina GC, et al. Effects of Citrus aurantium extract, caffeine, and St. John's wort on body fat loss, lipid levels, and mood states in overweight healthy adults. Curr Ther Res . 1999;60:145–153.
10. Edwards DJ, Fitzsimmons ME, Schuetz EG, et al. 6',7'-Dihydroxybergamottin in grapefruit juice and Seville orange juice: effects on cyclosporine disposition, enterocyte CYP3A4, and P-glycoprotein. Clin Pharmacol Ther . 1999;65:237–44.
11. Malhotra S, Bailey DG, Paine MF, Watkins PB. Seville orange juice–felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther . 2001;69:14–23.
12. Hou YC, Hsiu SL, Tsao CW, Wang YH, Chao PD. Acute intoxication of cyclosporin caused by coadministration of decoctions of the fruits of Citrus aurantium and the Pericarps of Citrus grandis . Planta Med . 2000;66:653–5.
13. Malhotra S, Bailey DG, Paine MF, Watkins PB. Seville orange juice-felodipine interaction: comparison with dilute grapefruit juice and involvement of furocoumarins. Clin Pharmacol Ther . 2001;69:14–23.
Last reviewed April 2009 by EBSCO CAM Review Board
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