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Supplement · Grade C

Bergamot Extract (BPF / Bergavit40) and medications.

Every documented pair, every citation. Below: 11 documented pairs grouped by mechanism.

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 load-bearing part. 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 adds to statin myopathy risk through the shared mechanism, can raise levels of calcium channel blockers and some SSRIs, and warrants INR monitoring with anticoagulants.

Below are the 11 documented pairs we have explicitly assessed for Bergamot Extract (BPF / Bergavit40): 4 red and 7 amber. The pairs cluster around 3 mechanisms: CYP3A4 inhibition, CYP-mediated metabolism, and Additive HMG-CoA reductase inhibition. 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

CYP3A4 inhibition

Bergamot is grapefruit-family citrus and can raise ciclosporin blood levels by slowing its clearance. We treat this as a do-not-combine pair outside direct transplant-team supervision.

BNF: Ciclosporin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Bergamot is grapefruit-family citrus and can raise everolimus blood levels by slowing its clearance. We treat this as a do-not-combine pair outside direct transplant-team supervision.

BNF: Everolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Red Sirolimus

Bergamot is grapefruit-family citrus and can raise sirolimus blood levels by slowing its clearance. We treat this as a do-not-combine pair outside direct transplant-team supervision.

BNF: Sirolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Bergamot belongs to the grapefruit-family citrus group and can 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.

BNF: Tacrolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber Amlodipine

Bergamot is grapefruit-family citrus and can raise amlodipine blood levels by slowing its clearance. The clinical impact depends on dose, but flag this to your GP before combining, particularly if your blood pressure is well controlled and you do not want a sudden drop.

BNF: Amlodipine
Amber Felodipine

Bergamot is grapefruit-family citrus and can raise felodipine blood levels significantly. Felodipine is the textbook example of a calcium channel blocker affected by grapefruit-family citrus. Discuss with your GP before combining.

BNF: Felodipine
Amber Nifedipine

Bergamot is grapefruit-family citrus and can raise nifedipine blood levels by slowing its clearance. Discuss with your GP before combining.

BNF: Nifedipine

CYP-mediated metabolism

Amber 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.

BNF: Sertraline

Additive HMG-CoA reductase inhibition

Amber Atorvastatin

Bergamot's active flavonoids inhibit the same liver enzyme atorvastatin targets, so combining them has overlapping mechanisms and no proven additive benefit. There is also a CYP3A4 surface that could slow atorvastatin clearance. Discuss with your GP before combining; in most cases the answer is to choose one or the other.

PMID 20843083 · BNF: Atorvastatin

Bergamot's active flavonoids inhibit the same liver enzyme pravastatin targets, so combining them has overlapping mechanisms and no proven additive benefit. Pravastatin is less affected by grapefruit-family citrus than other statins because it is not CYP3A4-metabolised, so the main concern is the redundant mechanism rather than blood-level effects.

PMID 20843083 · BNF: Pravastatin
Amber Simvastatin

Bergamot's active flavonoids inhibit the same liver enzyme simvastatin targets, so combining them has overlapping mechanisms and no proven additive benefit. The CYP3A4 surface is especially relevant for simvastatin. Discuss with your GP before combining.

PMID 20843083 · BNF: Simvastatin

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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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology
Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.