Bergamot Extract (BPF / Bergavit40) and medications.
Bergamot Extract (BPF / Bergavit40) is classified as a optimise supplement in the Distil database, evidence Grade C. The page below lists every medication we have explicitly assessed it against.
Bergamot extract, sold as the standardised polyphenolic fraction or Bergavit40, is taken to lower LDL cholesterol and triglycerides. Its flavonoids brutieridin and melitidin are structural analogues of statins and inhibit HMG-CoA reductase, the same enzyme statins target, so the mechanism is real. The clinical picture is Grade C and uncertain. Meta-analyses report large LDL drops, but the study base is small and heterogeneous, and a 2025 RCT found no LDL effect at four months, so the true effect size is probably overstated in single-arm work. Position it as adjunctive support for mild to moderate high cholesterol, never a statin substitute, with established cases referred to a GP. The interactions are the part that matters most. It is a hard exclusion with tacrolimus, ciclosporin, sirolimus and everolimus, because its furocoumarins inhibit CYP3A4 like grapefruit and can push immunosuppressant levels toxic. It is a hard exclusion on antiretroviral therapy for HIV for the same reason: grapefruit juice doubled the amount of the protease inhibitor saquinavir absorbed in a controlled human study, and HIV regimens are deliberately tuned to hold a steady drug level, so shifting it either way risks resistance or side effects. It can add to statin myopathy risk through the shared mechanism, so we leave it out for anyone already taking a statin, though your GP can still combine them deliberately; it can also raise levels of calcium channel blockers, may change levels of some SSRIs, and may warrant INR monitoring with warfarin.
Below are the 23 documented pairs we have explicitly assessed for Bergamot Extract (BPF / Bergavit40): 9 severe and 14 caution. The pairs cluster around 4 mechanisms: CYP3A4 inhibition, CYP-mediated metabolism, Additive HMG-CoA reductase inhibition, and Additive glucose lowering. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Last reviewed 27 August 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
CYP3A4 inhibition
Severe Does Bergamot Extract (BPF / Bergavit40) interact with Ciclosporin?
Bergamot is grapefruit-family citrus and may raise ciclosporin blood levels by slowing its clearance. We treat this as a do-not-combine pair outside direct transplant-team supervision.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does Bergamot Extract (BPF / Bergavit40) interact with Everolimus?
Bergamot is grapefruit-family citrus and may raise everolimus blood levels by slowing its clearance. We treat this as a do-not-combine pair outside direct transplant-team supervision.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does Bergamot Extract (BPF / Bergavit40) interact with Sirolimus?
Bergamot is grapefruit-family citrus and may raise sirolimus blood levels by slowing its clearance. We treat this as a do-not-combine pair outside direct transplant-team supervision.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does Bergamot Extract (BPF / Bergavit40) interact with Tacrolimus?
Bergamot belongs to the grapefruit-family citrus group and may slow how the body clears tacrolimus, which may push tacrolimus blood levels higher than intended. We treat this as a do-not-combine pair outside direct transplant-team supervision.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Amlodipine?
Bergamot is a citrus fruit related to grapefruit and contains bergamottin, one of the compounds behind grapefruit's effect on medicines, so it may raise amlodipine blood levels a little. Amlodipine is among the calcium-channel blockers least affected by grapefruit, but flag bergamot to your GP before combining, particularly if your blood pressure is already well controlled.
Evidence: Limited human data, from small studies or case reports.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Felodipine?
Bergamot is a citrus fruit related to grapefruit and contains bergamottin, one of the compounds behind grapefruit's effect on medicines, so it may raise felodipine blood levels. Felodipine is among the calcium-channel blockers most affected by grapefruit, so speak to your GP before combining, and watch for dizziness, flushing, headache or ankle swelling.
Evidence: Limited human data, from small studies or case reports.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Lacidipine?
Bergamot is grapefruit-family citrus and could raise lacidipine blood levels by slowing its clearance. Flag this to your GP before combining, particularly if your blood pressure is well controlled.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Lercanidipine hydrochloride?
Bergamot is grapefruit-family citrus and could raise lercanidipine blood levels by slowing its clearance. Lercanidipine is known to be sensitive to grapefruit, so flag this to your GP before combining, particularly if your blood pressure is well controlled.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Nifedipine?
Bergamot is a citrus fruit related to grapefruit and contains bergamottin, one of the compounds behind grapefruit's effect on medicines, so it may raise nifedipine blood levels. Speak to your GP before combining, and watch for dizziness, flushing, headache, a racing pulse or ankle swelling.
Evidence: Limited human data, from small studies or case reports.
CYP-mediated metabolism
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Efavirenz?
Bergamot is grapefruit-family citrus, and while it may have some effect on efavirenz levels the overlap is small, so the sensible step is to tell your HIV team before starting it rather than to avoid it outright. Efavirenz is cleared mainly by a liver enzyme that bergamot is not known to affect, and efavirenz speeds up the one enzyme bergamot does act on, so any effect tends to be limited. No study has tested bergamot with efavirenz, or with any HIV medicine, in people, so this is a precaution based on mechanism rather than a measured effect.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Sertraline?
Bergamot can affect liver enzymes that help clear sertraline from the body, which could shift sertraline blood levels in either direction. Flag this to your GP before combining.
Evidence: Limited human data, from small studies or case reports.
Additive HMG-CoA reductase inhibition
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Atorvastatin?
Bergamot's active flavonoids act on the same liver enzyme atorvastatin targets, so the two cholesterol-lowering effects tend to add together. In a trial using a different statin, bergamot on top of the statin lowered LDL further, so this is a real additive effect rather than a pointless one. That is why it is a decision to make with your GP: stacking the two unplanned can overshoot your cholesterol target and makes it harder to judge what your statin dose alone is doing. There is also a CYP3A4 surface that could slow atorvastatin clearance.
Evidence: Limited human data, from small studies or case reports.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Pravastatin sodium?
Bergamot's active flavonoids act on the same liver enzyme pravastatin targets, so the two cholesterol-lowering effects tend to add together. Pravastatin is less affected by grapefruit-family citrus than other statins because it is not CYP3A4-metabolised, so the question here is the added cholesterol-lowering rather than a change in drug levels. Tell your GP if you take both, so your dose and your cholesterol are reviewed together.
Evidence: Limited human data, from small studies or case reports.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Rosuvastatin calcium?
Bergamot's active flavonoids lower LDL cholesterol through the same liver pathway rosuvastatin acts on, so combining them adds to the cholesterol-lowering effect. A clinical trial showed bergamot added to rosuvastatin lowered LDL more than rosuvastatin alone. This can be intentional under medical supervision, but tell your GP before combining so your dose and cholesterol levels can be reviewed together rather than the two effects stacking unplanned.
Evidence: Supported by human study data.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Simvastatin?
Bergamot's active flavonoids act on the same liver enzyme simvastatin targets, so the two cholesterol-lowering effects tend to add together. In a trial using a different statin, bergamot on top of the statin lowered LDL further, so the effect is real rather than pointless. The CYP3A4 surface matters more for simvastatin than for most statins. Discuss with your GP before combining.
Evidence: Limited human data, from small studies or case reports.
Additive glucose lowering
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Gliclazide?
Bergamot can lower blood sugar on its own, and gliclazide already lowers it, so taking the two together may add up and could push your glucose too low. The combination can be manageable, but monitor your blood glucose, especially in the first few weeks, and tell your GP, who may need to adjust the gliclazide dose.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Glimepiride?
Bergamot can lower blood sugar on its own, and glimepiride already lowers it, so the two together may add up and could push your glucose too low. Monitor your blood glucose, especially when you start bergamot or change the dose, and tell your GP, who may need to adjust the glimepiride.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Bergamot Extract (BPF / Bergavit40) interact with Metformin?
Bergamot can lower blood sugar on its own, and metformin also lowers it, so the two may add up. The combination is generally manageable because metformin rarely causes very low glucose by itself, but monitor your blood sugar when you start bergamot and tell your GP.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
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How the checker decides
Every result has a source
Each pair we have assessed is cited to a published study (PMID) or the British National Formulary, so you can read the source yourself.
Four kinds of answer
Severe, caution, no known interaction, and not yet assessed. A pair we have not assessed is never shown as clear.
- Severe
- Caution
- No known interaction
- Not yet assessed
Nothing in our data is not a clearance
When nothing in our data records a problem with a pair, the result says no known interaction at typical doses, which is not a clearance: your pharmacist or GP can check the pair against your full medical history.
A full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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