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Bitter Orange - Guidelines for Using Bitter Orange - Uses and Benefits
Taxonomic Class
Rutaceae
Common Trade Names
Aurantii Amarai Cortex (USP)
Common Forms
Available in liquid extracts, teas, and tinctures.
Source
Bitter orange is the fruit of the flowering evergreen Citrus aurantium. The tree is native to parts of Asia and cultivated to some extent in the Mediterranean region.
Chemical Components
Bitter orange contains large amounts of the furanocoumarin oxypeucedanin as well as hesperidin and neohesperidin.
Actions
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One study tested the fruit of bitter orange for an inhibitory effect against rotavirus and found that the component hesperidin had a 50% inhibitory concentration of 25 micromol/ml and that neohesperidin had a 50% inhibitory concentration of 10 micromol/ml.
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Susceptibility testing has indicated that the peel oil extract of bitter orange may be effective as a mosquito larvae insecticide .
Reported Uses
Bitter orange has been used in Puerto Rico and other parts of the world as a sedative and to treat GI disorders.
One study evaluated the efficacy of oil of bitter orange in treating superficial dermatophyte infections. Sixty patients with tinea corporis, tinea cruis, or tinea pedis were randomly divided into three equivalent groups. One group was treated with a 25% emulsion of oil of bitter orange three times daily, another group was treated with 20% oil in alcohol three times daily, and the third group received pure oil of bitter orange once daily. The 25% emulsion group showed cure rates of 80% in 1 to 2 weeks and 20% in 2 to 3 weeks. The 20% oil group showed cure rates of 50% in 1 to 2 weeks, 30% in 2 to 3 weeks, and 20% in 3 to 4 weeks. Twenty-five percent of patients in the pure oil group did not finish the study, and cure rates for the remaining patients were 33.3% in 1 week, 60% in I to 2 weeks, and 6.7% in 2 to 3 weeks. Mild skin irritation was the only adverse reaction noted and was observed only with the pure oil treatment.
Dosage
No consensus exists.
Adverse reactions
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CNS: headache, insomnia, nervousness.
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EENT: sore throat.
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GI: appetite loss, indigestion.
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Musculoskeletal: gout.
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Skin: photosensitivity, skin irritation with redness and swelling.
Interactions
None reported.
Contraindications And Precautions
Avoid using bitter orange in pregnant or breast-feeding patients; effects are unknown.
Special Considerations
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Oxypeucedanin can cause phototoxicity . Caution the patient to minimize exposure to the sun.
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Although no known chemical interactions have been reported in clinical studies, consideration must be given to the herbal product's pharmacologic properties and the potential for interference with the intend ed therapeutic effect of conventional drugs.
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Caution the patient not to self-treat symptoms of skin infections before receiving appropriate medical evaluation because this may delay diagnosis of a serious medical condition.
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Advise the patient to consult a health care provider before using herbal preparations because a treatment that has been clinically researched and proved effective may be available.
Points of Interest
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Bitter orange is used as the flavoring for the liqueur curacao.
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Bitter orange is less expensive than other treatments for superficial dermatophyte infection.
Commentary
The results of one study indicate that there is some promise for bitter orange as a topical antifungal . Additional trials are needed to determine the most appropriate dose and to properly evaluate adverse effects associated with this use. Further study is also needed to determine the efficacy and proper clinical role of bitter orange as a treatment for or protection against rotavirus infection. Other claims of clinical applications for bitter orange are unproven.
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