Planta Med 2021; 87(10/11): 803-817
DOI: 10.1055/a-1497-6241
Biological and Pharmacological Activity
Reviews

Safety of Cranberry: Evaluation of Evidence of Kidney Stone Formation and Botanical Drug-Interactions[ # ]

Emily Madden
1  United States Pharmacopeial Convention, Rockville, MD
,
Caleb McLachlan
2  Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL
,
1  United States Pharmacopeial Convention, Rockville, MD
,
Angela I. Calderón
2  Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL
3  United States Pharmacopeia Botanical Dietary Supplements and Herbal Medicines Expert Committee, Rockville, MD
› Author Affiliations

Abstract

Cranberry is a popular ingredient in dietary supplements in the U. S. and is commonly used for preventing urinary tract infections. Because of its popularity in dietary supplements, the U. S. Pharmacopeial Convention has developed quality standards for cranberry ingredients. The purpose of this review was to determine if there are safety issues that should preclude the admission of cranberry ingredients from the development of U. S. Pharmacopeial Convention quality standards. Based on the totality of the data, the U. S. Pharmacopeial Convention concluded that cranberry ingredients are not known to be associated with serious risks to human health when consumed properly in dietary supplements and therefore were admitted for standard development. Although published clinical and animal data indicated that cranberry is not associated with serious adverse effects, interactions with warfarin and kidney stone formation were identified as potential risks. Studies have reported contradictory data regarding the role of cranberry in kidney stone formation, with some reports suggesting cranberry is associated with a reduced risk of kidney stones. Interactions with warfarin were not associated with moderate intakes of cranberry juice (240 – 480 mL). Some reports suggested that the potential for warfarin interactions requires excessive intakes of cranberry juice (1 – 2 L/day) or cranberry extracts (3000 mg/day). Cases of warfarin interactions with cranberry have mostly involved patients with serious illnesses and/or individuals taking concomitant medications. Based on these findings, the U. S. Pharmacopeial Convention concluded that the use of cautionary labeling statements regarding interactions with warfarin or kidney stone formation is not necessary in the development of quality standards for cranberry ingredients.

# Dedicated to Professor Arnold Vlietinck on the occasion of his 80th birthday.




Publication History

Received: 02 February 2021

Accepted after revision: 01 May 2021

Publication Date:
20 May 2021 (online)

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