Use of bitter orange is not supported by scientific evidence.
Bitter orange extract contains a chemical called synephrine (a chemical similar to ephedra) and can cause increases in blood pressure and heart rate resulting in heart attacks and strokes, particularly when taken by mouth with caffeine and/or other stimulants. When used on the skin, bitter orange can cause irritation.
Bitter orange can interact with a class of medications called monoamine oxidase inhibitors (e.g., phenelzine, selegiline), causing increased blood pressure. It can decrease blood sugar levels, particularly when taken with other diabetes medications (e.g., metformin).
Bitter orange can increase the levels of certain groups of medications processed by the liver. It can also interact with the following:
- colchicine
- dextromethorphan
- felodipine
- indinavir
- midazolam
- sildenafil
If you are taking any of these medications or herbal products, talk to your health care provider before using bitter orange.
Bitter orange should not be used by people who:
- have a history of headaches
- have high blood pressure
- have a type of glaucoma called narrow-angle glaucoma
- have an irregular heart rate or rhythm
In addition, it should not be taken for at least 2 weeks prior to surgery as it can interfere with heart rate and blood pressure control.
Bitter orange oil used on the skin may increase the risk of sunburn, particularly in light-skinned people.
Before taking any new medications, including natural health products, speak to your physician, pharmacist, or other health care provider. Tell your health care provider about any natural health products you may be taking.