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Pomegranate juice extract is a concentrated preparation derived from the juice of Punica granatum fruit, standardized variably to polyphenols such as ellagitannins (notably punicalagin and punicalin) and anthocyanins. It is marketed as a dietary supplement for antioxidant, anti-inflammatory, cardiometabolic, and general wellness uses. Mechanistically, key constituents exhibit antioxidant and anti-inflammatory effects and have been reported to inhibit cytochrome P450 enzymes CYP3A4 and CYP2C9 in preclinical studies, raising potential for drug–herb interactions; limited human data suggest minimal clinically relevant CYP3A inhibition with single-dose juice, but case observations and preclinical findings indicate possible interactions with drugs metabolized by these enzymes. A randomized clinical study has explored 250 mg twice daily pomegranate extract for 8 weeks in mild-to-moderate allergic asthma, showing improvements in some clinical symptoms and reductions in certain granulocyte counts. Safety data indicate pomegranate juice is generally safe orally; pomegranate extract is possibly safe by mouth or topically, while root/stem/peel are unsafe in large amounts due to toxic constituents. Use during pregnancy and lactation is considered possibly safe for juice; insufficient data exist for extract forms, so caution is advised.
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