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Citrus aurantium (bitter orange) is a plant whose fruit and extracts are used in dietary supplements and traditional medicine. The primary bioactive compound is p-synephrine—a protoalkaloid structurally similar to ephedrine but with different pharmacological properties. Citrus aurantium has been promoted for weight management and sports performance after the ban of ephedra-based products. Its mechanisms include mild stimulation of the cardiovascular system (vasoconstriction and increased heart rate/blood pressure), antioxidant activity via flavonoids (naringin, hesperidin), anti-inflammatory effects through cytokine modulation and COX inhibition[2][5]. It also exhibits antispasmodic and digestive tonic actions; extracts have shown gastroprotective effects in animal models[5]. Bitter orange may inhibit intestinal CYP3A4 enzymes affecting drug metabolism[2][3]. There are safety concerns regarding cardiovascular toxicity when combined with other stimulants or in high doses; adverse events such as arrhythmias or hypertension have been reported mostly with multi-ingredient supplements rather than pure C. aurantium alone[1][2].
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