Pomegranate
Summary
Pomegranate juice and extracts are rich in polyphenols. Meta-analyses find modest drops in blood pressure (grade C) and small shifts in some cardiometabolic markers, but no clear effect on cholesterol. A placebo-controlled trial found no slowing of PSA rise after prostate cancer treatment. NCCIH considers the juice safe; the FTC ruled POM Wonderful's disease claims deceptive.
Key facts
- Blood pressure (C), cardiometabolic markers (C), cholesterol (no effect, C), PSA doubling time (no effect)[4][5][6][7]
- NCCIH: juice or extract may help reduce blood pressure but needs confirmation; no clear effects on lipids[1]
- Case reports describe unstable INR in people on warfarin who drank pomegranate juice[10]
- Pomegranate juice did not change midazolam clearance in a pharmacokinetic study[9]
- In 2013 the FTC ruled that POM Wonderful juice and POMx ads made deceptive disease claims[2]
- 6 graded human outcomes on this page
- October 10, 2026
How it works
ProposedPomegranate is rich in polyphenols, mainly ellagitannins, which the gut converts to urolithins; a trial before prostate surgery found more urolithin A in prostate tissue with pomegranate. Antioxidant and blood-vessel effects are proposed but not established in people.[13][8]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
At a glance: strongest evidence per outcome
| Outcome | Grade | Effect | Strongest evidence | Rows |
|---|---|---|---|---|
| Metabolic markers | Grade C | Improved | Meta-analysis of 53 trials · n = 2,306 · 2025 | 1 row |
| Blood pressure | Grade C | Improved | Meta-analysis of 14 trials · n = 573 · 2023 | 1 row |
| Cholesterol | Grade C | No effect | Meta-analysis of 12 trials · n = 545 · 2016 | 1 row |
| Cognition | Grade D | Mixed | RCT · n = 261 · 2020 | 1 row |
| Prostate | Grade D | No effect | RCT · n = 98 · 2013 | 2 rows |
Every graded row
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Cardiometabolic risk factors | Improved | Grade C | Meta-analysis · n = 2,306 · 2025 Adults in 53 RCTs Form: Pomegranate juice, extract and other forms · Dose: Varied across trials · Duration: Varied across trials Small standardized reductions in body weight, BMI, systolic and diastolic pressure, fasting glucose and total cholesterol, and a rise in HDL. LDL, triglycerides, HbA1c, insulin resistance, waist and liver enzymes did not change. | 40617711 (opens PubMed)Source [5] |
| Blood pressure (pomegranate juice) | Improved | Grade C | Meta-analysis · n = 573 · 2023 Adults in 14 clinical trials Form: Pomegranate juice · Dose: Varied; strongest effect with 300 mL/day or less · Duration: Varied; effect seen in trials of 2 months or less Systolic blood pressure fell 5.0 mmHg versus control. In trials of 2 months or less, systolic fell 4.6 and diastolic 2.9 mmHg; more than 300 mL/day did not lower systolic pressure significantly, and the benefit was not seen in longer trials. | 37461211 (opens PubMed)Source [4] |
| Blood lipids | No effect | Grade C | Meta-analysis · n = 545 · 2016 Adults in 12 placebo-controlled RCTs Form: Pomegranate juice and other forms · Dose: Varied across trials · Duration: Varied across trials No significant effect on total, LDL or HDL cholesterol or triglycerides; the amount of juice consumed was not linked to lipid changes. | 26857863 (opens PubMed)Source [6] |
| Memory in middle-aged and older adults | Mixed | Grade D | RCT · n = 261 · 2020 Adults aged 50–75 without dementia Form: Pomegranate juice versus a matched drink without pomegranate polyphenols · Dose: 8 oz (236.5 mL) a day · Duration: 12 months One visual-memory learning score held steady with juice while it declined with placebo (effect size 0.45); the other visual and verbal memory measures did not differ. 61 participants dropped out. | 31711104 (opens PubMed)Source [8] |
| PSA levels in advanced prostate cancer | No effect | Grade D | RCT · n = 98 · 2013 Men with prostate cancer and PSA of 5 ng/mL or more (68% castration-resistant) Form: Pomegranate juice · Dose: 500 mL/day for 4 weeks, then 250 mL/day for 4 weeks (both groups) · Duration: 8 weeks No differences from placebo in PSA kinetics or pain scores; no grade 3 or higher toxicity. | 24069070 (opens PubMed)Source [12] |
| PSA doubling time after primary therapy for prostate cancer | No effect | No effect | RCT · n = 183 · 2015 Men with rising PSA after surgery or radiation for prostate cancer Form: Pomegranate liquid extract (plus a small juice arm) · Dose: Not stated in the abstract · Duration: Not stated in the abstract Median PSA doubling time lengthened in every group, placebo included (11.1 to 15.6 months on placebo), with no significant difference between extract, juice and placebo. Men with the MnSOD AA genotype had a larger increase on extract (subgroup finding). | 26169045 (opens PubMed)Source [7] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Pomegranate juice | Varies[1][4][8] | No human absorption data in our sources.[1] | NCCIH: believed safe; some people get digestive symptoms.[1] | Blood pressure and memory trials (about 240 mL/day) |
| Standardized pomegranate extract (e.g., POMx) | Varies[7][11] | No human absorption data in our sources.[11] | No clinically significant toxicity over up to 18 months; diarrhea in 13.5% at 3 g/day versus 1.9% at 1 g/day.[11] | Prostate trials (1–3 g/day) |
| Root, stem and peel preparations | Varies[1] | No human absorption data in our sources.[1] | NCCIH: may not be safe in large amounts because they contain potentially harmful substances.[1] | Traditional preparations; not studied in the trials here |
Studied doses
Doses studied in human trials ranged from 1 to 3 g/day of pomegranate extract for up to 18 months. Juice trials used about 240 mL (8 oz) a day for a year, and blood-pressure trials up to and above 300 mL a day.[11][8][4]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
Medicines
- WarfarinCase reportCase reports describe unstable INR in people on warfarin who drank pomegranate juice (in one, INR fell after the juice was stopped); a causal link is possible but unproven.[10]
- Midazolam and other CYP3A-metabolized drugsPK studyPomegranate juice (8 oz) did not change oral or intravenous midazolam clearance in 13 volunteers, unlike grapefruit juice.[9]
Who should be careful
- Pomegranate allergy
- Allergic reactions to pomegranate have been reported.[1]
- Root, stem or peel products
- These parts may not be safe in large amounts because they contain potentially harmful substances.[1]
- Warfarin users
- Case reports link pomegranate juice to unstable INR; INR checks after changing juice habits are a reasonable precaution.[10]
- Pregnancy and breastfeeding
- Drinking the juice may be safe; little is known about extracts or other plant parts.[1]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
Safety
Juice is considered safe and extracts may be safe.
How to read the label
- Label dose vs clinical doseExtract trials used 1 or 3 g/day of POMx; juice trials used about 240 mL (8 oz) a day.[11][8]
- Juice vs supplementsNCCIH notes that many studies used pomegranate juice rather than dietary supplements.[1]
- Health claimsThe FTC found that POM Wonderful ads for juice and POMx made unsupported heart disease, prostate cancer and erectile dysfunction claims.[2]
Cost per studied dose, without the sales pitch
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Cost per studied dose
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Frequently asked questions
Does pomegranate juice lower blood pressure?
Modestly. A meta-analysis of 14 trials found systolic pressure about 5 mmHg lower, mainly with up to 300 mL a day in trials of up to 2 months.[4]
Does pomegranate lower cholesterol?
A meta-analysis of 12 trials found no significant effect on cholesterol or triglycerides, and NCCIH says no clear lipid effects have been shown.[6][1]
Does pomegranate slow prostate cancer?
In 183 men with rising PSA after prostate cancer surgery or radiation, pomegranate extract did not slow PSA rise more than placebo.[7]
Does pomegranate juice improve memory?
In a 12-month trial in 261 adults aged 50–75, one visual-learning score held steady versus a decline on placebo; other memory tests did not differ.[8]
Does pomegranate interact with warfarin?
Case reports describe INR changes in people on warfarin who drank pomegranate juice; a causal link has not been proven.[10]
Is pomegranate safe?
NCCIH says the juice is believed safe and extract may be safe; root, stem and peel may not be safe in large amounts, and allergies occur.[1]
Sources
- [1]Pomegranate: Usefulness and Safety (last updated April 2025). National Center for Complementary and Integrative Health (NCCIH), 2025. fact-sheet
- [2]FTC Commissioners Uphold Trial Judge Decision that POM Wonderful, LLC; Stewart and Lynda Resnick; Others Deceptively Advertised Pomegranate Products by Making Unsupported Health Claims (January 16, 2013). U.S. Federal Trade Commission, 2013. safety-communication
- [3]The effects of pomegranate consumption on blood pressure in adults: A systematic review and meta-analysis.. Phytother Res, 2024. meta-analysis
- [4]Impact of pomegranate juice on blood pressure: A systematic review and meta-analysis.. Phytother Res, 2023. meta-analysis
- [5]Impacts of supplementation with pomegranate on cardiometabolic risk factors: A systematic review and dose-response meta-analysis.. Nutr Metab Cardiovasc Dis, 2025. meta-analysis
- [6]Lipid profile changes after pomegranate consumption: A systematic review and meta-analysis of randomized controlled trials.. Phytomedicine, 2016. meta-analysis
- [7]A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer.. Prostate Cancer Prostatic Dis, 2015. RCT
- [8]Randomized placebo-controlled study of the memory effects of pomegranate juice in middle-aged and older adults.. Am J Clin Nutr, 2020. RCT
- [9]Pomegranate juice does not impair clearance of oral or intravenous midazolam, a probe for cytochrome P450-3A activity: comparison with grapefruit juice.. J Clin Pharmacol, 2007. PK-study
- [10]Potential interaction between pomegranate juice and warfarin.. Pharmacotherapy, 2009. observational
- [11]A randomized phase II study of pomegranate extract for men with rising PSA following initial therapy for localized prostate cancer.. Prostate Cancer Prostatic Dis, 2013. RCT
- [12]Daily Pomegranate Intake Has No Impact on PSA Levels in Patients with Advanced Prostate Cancer - Results of a Phase IIb Randomized Controlled Trial.. J Cancer, 2013. RCT
- [13]A review of pomegranate in prostate cancer.. Prostate Cancer Prostatic Dis, 2017. review
What changed
- First draft. Every PMID checked against NCBI E-utilities esummary (title and year taken from the record) and abstracts read for the cited rows.
- Adversarial review pass: every evidence row re-read against its PubMed abstract. Official sources opened before citing: NCCIH Pomegranate fact sheet (April 2025) and the FTC January 2013 POM Wonderful decision press release. Industry ties: POM Wonderful funded the phase II POMx trial and several authors were paid by or worked for it (PMC3549301); investigators in the US prostate program had prior POM Wonderful research support (PMID 28440320); Biotta AG partly funded the 2013 advanced prostate cancer trial; funding for the 2015 and 2020 trials is not stated in PubMed. Retraction, expression-of-concern, erratum and withdrawn checks on all 11 PMIDs: none flagged. Page set indexable. Independent browser review (4 parallel reviewers, every evidence row checked against its abstract and official sources on the Vercel preview) found: no factual errors; drug-interaction key fact split so warfarin and midazolam each carry their own citation.