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Bitter melon generally causes few adverse reactions. GI effects (eg, abdominal pain, diarrhea) and headache have been reported in clinical trials. Case reports exist of hypoglycemic coma and atrial fibrillation associated with bitter melon intake. Increases in Liver enzymes have been observed experimentally, but without histological changes. Bitter melon should be used with caution in patients with impaired hepatic function.