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 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 17 documented pairs we have explicitly assessed for Bergamot Extract (BPF / Bergavit40): 4 red and 13 amber. 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 14 June 2026. Each interaction below is assessed against PubMed-indexed evidence.
CYP3A4 inhibition
Red Does interact with Ciclosporin?
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.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Everolimus?
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.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with 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.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Tacrolimus?
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.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with 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.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does interact with 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.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does 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, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does 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, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Nifedipine?
Bergamot is grapefruit-family citrus and can raise nifedipine blood levels by slowing its clearance. Discuss with your GP before combining.
Evidence: Limited human data, based on case reports and a known mechanism.
CYP-mediated metabolism
Amber Does 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, based on case reports and a known mechanism.
Additive HMG-CoA reductase inhibition
Amber Does interact with 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.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does interact with Pravastatin sodium?
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.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does 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.
Amber Does interact with 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.
Evidence: Limited human data, based on case reports and a known mechanism.
Additive glucose lowering
Amber Does 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, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does 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, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does 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, based on case reports and a known mechanism.
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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