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Moderate evidenceHeart & metabolic

Pomegranate Extract

Pomegranate consistently produces a small blood pressure reduction of a few mmHg in pooled trials. Claims about prostate cancer, atherosclerosis reversal and erectile function are not supported by adequate evidence.

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What the science says

  • Lowers blood pressure Moderate evidence

    A 2017 meta-analysis of randomised controlled trials found pomegranate juice reduced systolic blood pressure by about 4.9 mmHg and diastolic by about 2.2 mmHg, with the systolic effect independent of dose and duration. A 2024 systematic review and meta-analysis of pomegranate consumption broadly confirmed a modest systolic reduction. Effects are small and clearest in people with elevated baseline pressure.

  • Slows prostate cancer PSA progression Limited evidence

    Early single-arm studies reported lengthened PSA doubling time, generating substantial hype. The subsequent randomised, placebo-controlled trial in men with rising PSA after primary therapy found no significant difference between pomegranate extract and placebo. The initial signal was almost certainly regression to the mean and lack of a control arm.

  • Improves endothelial function and carotid intima-media thickness Limited evidence

    A small Israeli study reported reduced carotid intima-media thickness over 1-3 years, but the trial was small, poorly controlled and never independently replicated. Larger endothelial-function trials have given mixed results.

  • Improves exercise performance Limited evidence

    A handful of small trials report improved blood flow and time to exhaustion with roughly 1,000 mg/day of extract, but sample sizes are typically under 20 and results conflict. Do not expect a nitrate-like ergogenic effect.

Dosage & safety

Studied doseBlood pressure trials used 150-500 mL/day of pomegranate juice or 500-1,500 mg/day of standardised extract (often standardised to 30-40% punicalagins or ~250 mg ellagic acid equivalents), for 2 weeks to 18 months. Juice delivers substantial sugar (roughly 30 g per 250 mL), which matters for anyone managing glucose or weight — extract avoids this. Effects on blood pressure appear within 2-4 weeks.
SafetyWell tolerated; mild gastrointestinal upset is the main complaint, and allergic reactions to pomegranate are rare but documented. Pomegranate juice inhibits intestinal CYP3A4 in vitro and has been reported to interact with statins, carbamazepine and ciclosporin, though the clinical significance appears smaller than with grapefruit. It may modestly potentiate antihypertensives and, given weak antiplatelet activity, warrants caution with warfarin — case reports of raised INR exist. The high sugar content of juice is a genuine consideration for people with diabetes. Standardised extracts have limited long-term safety data beyond 12 months.

How to take it

TimingTiming does not matter; blood pressure effects appear after 2-4 weeks of daily use.
With food?With food, which is how most trials dosed it and reduces stomach upset.
Worth knowingThe extract avoids the roughly 30 g of sugar in a 250 mL glass of juice, which matters if you are managing glucose or weight.

Interactions

With medications

  • warfarin

    Case reports describe raised INR with pomegranate juice, and pomegranate has weak antiplatelet activity. do not start it without telling your prescriber, and have INR checked

  • statins, carbamazepine and ciclosporin

    Pomegranate juice inhibits intestinal CYP3A4 and can raise levels of these drugs, though less strongly than grapefruit. talk to your doctor before combining

  • blood-pressure medication

    Modest additive blood-pressure lowering. monitor blood pressure when starting

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does pomegranate lower blood pressure?

Modestly, with moderate evidence: a meta-analysis found pomegranate juice reduced systolic blood pressure by about 4.9 mmHg and diastolic by about 2.2 mmHg. Effects are clearest in people with elevated blood pressure.

Does pomegranate extract help prostate cancer?

No: early uncontrolled studies suggested slower PSA rise, but a randomised placebo-controlled trial in men with rising PSA found no significant difference between pomegranate extract and placebo.

Is pomegranate juice or extract better?

Blood pressure trials used either 150-500 mL/day of pomegranate juice or 500-1,500 mg/day of standardised extract. The extract avoids the roughly 30 g of sugar in a 250 mL glass of juice, which matters if you manage glucose or weight.

Does pomegranate interact with medications?

Pomegranate juice can raise levels of statins, carbamazepine and ciclosporin through CYP3A4 inhibition, though less strongly than grapefruit, and case reports describe raised INR with warfarin. Talk to your doctor before combining them.

Scientific references

Where to buy

Vitacost, Pomegranate Extract, 300 Capsules (250 mg per Capsule)

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