Lime

Drug Interactions:

  • DigoxinDigoxin: Based on mechanism of action, fresh lime juice in concentrations above 5% may increase the transport of digoxin across cell membranes according to in vitro studies (22).
  • MannitolMannitol: An in vitro study found 30% concentration of lime juice enhanced the absorption of [(14)C]-mannitol across cell lines by six- and eight-fold (19). Excessive diuresis could occur, leading to electrolyte abnormalities or renal failure.
  • P450 enzyme affecting drugsP450 enzyme affecting drugs: Lime juice may inhibit cytochrome P450 3A4, causing increased drug levels and potentially increasing the risk of adverse effects (20; 21; 15).
  • Photosensitizing drugsPhotosensitizing drugs: Lime oil may increase the risk of phototoxicity (11).

    • Lime/Herb/Supplement Interactions:

  • IronIron: There is conflicting evidence as to whether ascorbic acid in limeade affects iron absorption. One preliminary study (18) indicated that lime increased absorption of iron supplements (18), but a randomized clinical trial showed that ascorbic acid and limeade were not able to increase absorption of iron from food sources in non-pregnant women (18).
  • MannitolMannitol: An in vitro study found 30% concentration of lime juice enhanced the absorption of [(14)C]-mannitol across cell lines by six- and eight-fold (19). Excessive diuresis could occur, leading to electrolyte abnormalities or renal failure.
  • P450 enzyme affecting herbsP450 enzyme affecting herbs: Lime juice inhibits cytochrome P450 3A4, and may cause increased herb or supplement levels, potentially increasing the risk of adverse effects (20; 21; 15).
  • Photosensitizing herbs and supplementsPhotosensitizing herbs and supplements: Lime oil may increase the risk of phototoxicity (11).
  • PsoralensPsoralens: Based on some natural medicine textbooks, concomitant use of herbs and supplements containing psoralens might potentiate effects and adverse reactions (23).

    • Lime/Food Interactions:

  • GrapefruitGrapefruit: Bergamottin is found in both grapefruit and lime juices and concomitant use may result in an additive effect (20). Although bergamottin has not been studied extensively in lime, the concentrations found in lime juice are higher than those found in grapefruit juice. It has been proposed that bergamottin, a furocoumarin, found in grapefruit juice may interact with drugs by competitive inhibition or mechanism-based inactivation.
  • Iron-containing foodsIron-containing foods: There is conflicting evidence as to whether ascorbic acid in limeade affects iron absorption. One preliminary study (18) indicated that lime increased absorption of iron supplements, but a randomized clinical trial showed that ascorbic acid and limeade were not able to increase absorption of iron from food sources in non-pregnant women (18).
  • Red wineRed wine: Consuming red wine concomitantly with lime may cause interactions and cause dose dumping of extended-release felodipine in certain individuals (20).

    • Lime/Lab Interactions:

  • Renal function testsRenal function tests: An in vitro study found 30% concentration of lime juice enhanced the absorption of [(14)C]-mannitol across cell lines by six- and eight-fold (19). Excessive diuresis could occur, leading to electrolyte abnormalities or renal failure.