Garcinia Cambogia Medication Interactions, Contraindications, Safety, Effectiveness and Use in Pregnancy and Lactation.

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Garcinia cambogia (Malabar tamarind) is a fruit tree found in the evergreen and semi-evergreen forests of southwest India. The fruit of this tree resembles a small pumpkin and comes in a red, orange, or yellow variety. This fruit ripens during the rainy season, and the rind contains large amounts of hydroxycitric acid (HCA). The dried fruit rinds have been used for centuries as a flavoring agent.  


In Ayurvedic medicine, Garcinia is used to promote general health. It has also been used for rheumatism and bowel symptoms — an oral rinse containing G. cambogia has been used by veterinarians to treat mouth diseases in cattle.


HCA, which is related to citric acid, is a common ingredient in weight loss products. G. cambogia is available as a weight-loss supplement, either alone or mixed with other ingredients.   


Garcinia Cambogia Dose

Doses of Garcinia cambogia extract in clinical trials ranged from 1500 to 4667 mg per day. The supplement offered by Sunshine Nutraceuticals contains 700 mg Garcinia cambogia extract, and the recommended dose is one capsule by mouth twice daily 20-30 minutes before a meal with eight ounces of water.

Garcia Cambogia Side Effects

Side effects of Garcinia Cambogia are generally mild and include:

  • Dry mouth
  • Headache
  • Diarrhea
  • Dizziness
  • Nausea

Since Garcinia Cambogia is not centrally active, it should not cause anxiety, hypertension, or problems with sleep. 

Garcinia Cambogia in Pregnancy and Lactation

In my professional opinion, Garcinia cambogia should not be used by pregnant women or those who are breast-feeding. We do not have sufficient evidence to assure its safety; therefore, the risks outweigh the benefits.


Garcinia Cambogia Medication Interactions

Antidepressant Drugs and Serotonergic drugs

There has been a case report of serotonin syndrome being caused by a combination of Garcinia extract and escitalopram (Lexapro). The patient was re-challenged with sertraline (Zoloft) and again experienced serotonin syndrome.1

For this reason, caution should be exercised when taking G. Cambogia with any antidepressant medication. Monitor for signs and symptoms of serotonin syndrome.  These include:

  • Headache
  • Agitation
  • Restlessness
  • Confusion
  • Shivering
  • Increased heart rate
  • High blood pressure
  • Dilated pupils
  • Loss of muscle coordination
  • Muscle rigidity
  • Muscle Twitching
  • Heavy sweating
  • Diarrhea
  • Goose bumps

Serotonin syndrome may also occur when G. Cambogia is taken with other drugs that have serotonergic properties such as:

  • Tramadol (Ultram)
  • Pentazocine (Talwin)
  • Dextromethorphan (present in some OTC cough and cold preparations) 

Anti-diabetic agents

G. cambogia may increase the hypoglycemic effects of anti-diabetic agents. It is suggested that blood sugars be closely monitored when using both Garcinia and anti-diabetic medications. 

Statins and other hepatotoxic medications

There was a case report of rhabdomyolysis being caused following the ingestion of an herbal medicine containing G. Cambogia.2Caution is recommended when administering statins with other medications which may cause rhabdomyolysis.

Use caution when combining Garcinia with other drugs that negatively affect the liver. Some examples include

  • Acetaminophen (Tylenol)
  • Amiodarone (Cordarone)
  • Carbamazepine (Tegretol)
  • Isoniazid (INH)
  • Methotrexate (Rheumatrex)

Safety of Garcinia Cambogia

According to the TRC Natural Medicines Research Collaboration, Garcinia Cambogia gets a “possibly unsafe” grade. This is due to numerous case reports of liver toxicity. Most of these reports were the result of combination products that included G. Cambogia as one of the ingredients. There were at least two reports where the patient was taking Garcinia alone. Although the casualty was likely or probable, this is still concerning.


Effectiveness of Garcinia Cambogia


There is conflicting evidence regarding the effects of Garcinia on treating obesity. Some studies show a significant weight loss while others do not. As mentioned in some of my previous posts, I prefer to consult meta-analyses when available. One such study was published by Onakpoya, et al in 2011 in the Journal of Obesity. 


The investigators of this meta-analysis did not believe the studies were of sufficient length to assess the effects of HCA on body weight. These studies ranged from two to twelve weeks. There were also different strains of Garcinia used in the studies. We are unsure what impact this might have on bioavailability. 


Finally, there was a difference in caloric intake in the various studies. 


Calories eaten ranged from 1,000 kcal, to as high as 3,009 kcal per day. This would certainly have an impact on weight loss.


The conclusion of this meta-analysis was that Garcinia extracts generate weight loss on the short term. 


They point out that the effect is small, and is not statistically significant when only rigorous random controlled trials are considered.3

Garcinia Cambogia Contraindications

The only known contraindication at this time, according to Lexicomp (accessed 1/12/2020), is a known allergy or hypersensitivity to any components of Garcinia Cambogia.

After researching Garcinia cambogia, many questions remain. 

Can this supplement be effective for weight loss long-term?

Does Garcinia cambogia cause liver damage or contribute to increased liver enzymes in some patients?

Is this supplement safe and effective?

The answers to the above questions cannot be answered until new research is available.  The current studies were of insufficient length and not well designed.  The liver damage side effect must be examined more closely before I can recommend starting this supplement for weight loss.

As I have explained in the past, the best way to lose weight is to eat whole foods, avoid fast food, drink plenty of water, and exercise.  You will feel substantially better if you follow these simple rules.  Supplements can help reduce hunger but exercise and proper food intake will get you much better results. 

At this time, my recommendation is to use Garcinia cambogia only if you have had success with it in the past.  If you have had no negative effects and have lost weight, it may be a reasonable option.


I will continue to research this supplement.  As new research is available, I will decide whether to keep it, or remove it from our product line.

If you want a safer alternative, I recommend our Keto Ultra supplement.  This contains raspberry ketones, African mango, green tea extract, caffeine, apple cider vinegar, kelp and grape seed extract.  You can order this supplement below.

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Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

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