Drug & supplement interaction

Chaparral + Azithromycin

Azithromycin brand names: Zithromax, Zmax, Azasite.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Chaparral and Azithromycin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Chaparral and Azithromycin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Azithromycin and Chaparral in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Chaparral safety at a glance

Chaparral overall Avoid Chaparral has been linked to serious liver and kidney toxicity and is not recommended.
Pregnancy Likely Unsafe When used orally. There are several reports of serious poisoning, acute hepatitis, and kidney and liver damage, including irreversible renal and hepatic failure... Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. There are several reports of serious poisoning, acute hepatitis, and kidney and liver damage, including irreversible renal and hepatic failure... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Azithromycin and Chaparral? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Azithromycin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Azithromycin is filed under 7 classifications — including macrolide antibiotics, qt interval-prolonging drugs, antibiotic drugs. Chaparral has documented interactions with 1 drug class — the most serious being hepatotoxic drugs (moderate) — and none of Azithromycin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Chaparral Does Interact With Other Medications

Chaparral has 370 moderate known drug interactions in our database — Azithromycin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 370 No known interaction 2,460 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Chaparral

Covers the 2,830 medications we’ve checked against Chaparral. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Chaparral and Azithromycin May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • Yellowing of the skin or eyes / Liver problems Worth acting on Additional detail

    Chaparral

    “Chaparral is generally regarded as unsafe for use. Any benefits of therapy may not outweigh the risk of toxicity. Orally, chaparral can cause hepatoxicity, resulting in jaundice, fatigue, right upper quadrant abdominal pain, dark urine, light stools, nausea, diarrhea, weight loss, fever, and anorexia.”

    Chaparral · Natural Medicines adverse-effect record, reported in anorexia.

    6 sources cited
    1. 568. Smith BC, Desmond PV. Acute hepatitis induced by ingestion of the herbal medication chaparral. Aust N Z J Med 1993;23:526.. PubMed
    2. 569. Gordon DW, Rosenthal G, Hart J, et al. Chaparral ingestion: the broadening spectrum of liver injury caused by herbal medications. JAMA 1995;273:489-90.
    3. 570. Batchelor WB, Heathcote J, Wanless IR. Chaparral-induced hepatic injury. Am J Gastroenterol 1995;90:831-3.
    4. 571. Katz M, Saibil F. Herbal hepatitis: subacute hepatic necrosis secondary to chaparral leaf. J Clin Gastroenterol 1990;12:203-6.
    5. 3497. Sheikh NM, Philen RM, Love LA. Chaparral-associated hepatotoxicity. Arch Intern Med 1997;157:913-9. DOI
    6. 11121. Chaparral-induced toxic hepatitis-California and Texas, 1992. MMWR Morb Mortal Wkly Rep 1992;41:812-4.. DOI

    “Orally, chaparral can cause hepatoxicity, resulting in jaundice, fatigue, right upper quadrant abdominal pain, dark urine, light stools, nausea, diarrhea, weight loss, fever, and anorexia. It can also cause cirrhosis, cholestasis, cholangitis, acute hepatitis, and liver failure Multiple cases of severe hepatotoxicity have been reported, including at least two cases requiring liver transplant.

    The nordihydroguaiaretic…”

    Chaparral · Natural Medicines adverse-effect record, reported in anorexia.

    6 sources cited
    1. 3497. Sheikh NM, Philen RM, Love LA. Chaparral-associated hepatotoxicity. Arch Intern Med 1997;157:913-9. DOI
    2. 568. Smith BC, Desmond PV. Acute hepatitis induced by ingestion of the herbal medication chaparral. Aust N Z J Med 1993;23:526.. PubMed
    3. 569. Gordon DW, Rosenthal G, Hart J, et al. Chaparral ingestion: the broadening spectrum of liver injury caused by herbal medications. JAMA 1995;273:489-90.
    4. 570. Batchelor WB, Heathcote J, Wanless IR. Chaparral-induced hepatic injury. Am J Gastroenterol 1995;90:831-3.
    5. 571. Katz M, Saibil F. Herbal hepatitis: subacute hepatic necrosis secondary to chaparral leaf. J Clin Gastroenterol 1990;12:203-6.
    6. 11121. Chaparral-induced toxic hepatitis-California and Texas, 1992. MMWR Morb Mortal Wkly Rep 1992;41:812-4.. DOI

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Kidney problems Worth acting on Additional detail

    Chaparral

    “Orally, chaparral can cause kidney failure. Consumption of chaparral tea has been associated with cystic renal disease and cystic adenocarcinoma of the kidney. In one case report, consumption of 3-4 cups of chaparral tea daily was associated with these symptoms.”

    Chaparral · Natural Medicines adverse-effect record, reported in kidney failure.

    2 sources cited
    1. 3497. Sheikh NM, Philen RM, Love LA. Chaparral-associated hepatotoxicity. Arch Intern Med 1997;157:913-9. DOI
    2. 11129. Smith AY, Feddersen RM, Gardner KD Jr, Davis CJ Jr. Cystic renal cell carcinoma and acquired renal cystic disease associated with consumption of chaparral tea: a case report. J Urol 1994;152:2089-91.. PubMed

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

  • Reduced appetite / Fever / Stomach pain / Diarrhea / Tiredness / Nausea reported in 5.8% of FDA reports for Azithromycin Additional detail

    Chaparral

    Recorded for Chaparral in the same Natural Medicines adverse-effect record shown under Yellowing of the skin or eyes / Liver problems above.

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • A skin rash Additional detail

    Chaparral

    “Topically, chaparral can cause contact dermatitis.”

    Chaparral · Natural Medicines adverse-effect record, reported in dermatitis.

    3 sources cited
    1. 10417. Heron S, Yarnell E. The safety of low-dose Larrea tridentata (DC) Coville (creosote bush or chaparral): a retrospective clinical study. J Altern Complement Med 2001;7:175-85..
    2. 11128. Shasky DR. Contact dermatitis from Larrea tridentata (creosote bush). J Am Acad Dermatol 1986;15:302.. PubMed
    3. 41434. Leonforte, J. F. Contact dermatitis from Larrea (creosote bush). J Am Acad.Dermatol. 1986;14(2 Pt 1):202-207. PubMed

    Azithromycin

    Listed in the ADVERSE REACTIONS section of the FDA label for Azithromycin. Read the label on DailyMed ›

Reported for Chaparral but not commonly for Azithromycin: weight loss.

Effects for Azithromycin come from the ADVERSE REACTIONS section of its FDA label; effects for Chaparral come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 59,712 voluntary FDA FAERS reports for Azithromycin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Chaparral in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally. There are several reports of serious poisoning, acute hepatitis, and kidney and liver damage, including irreversible renal and hepatic failure. Advise patients not to use products containing chaparral.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Chaparral or Azithromycin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Chaparral or Azithromycin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Azithromycin

This page covers Chaparral only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azithromycin page lists 92 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 71 moderate · 13 minor.

From our pharmacist’s overview on the Azithromycin page

“A five-day Z-Pak for a sinus or chest infection seems too brief to fuss over, but azithromycin (Zithromax, Zmax) deserves genuine caution around supplements, and the eight major-rated entries on this list are the ones to understand first. Most of those involve the heart.”

Reviewed by 2 · Jul 18, 2026

Open the Azithromycin interaction page

One more smart check

Taking Chaparral as Part of a Dietary Supplement Product? Check It for Interactions

We hold 83 real supplement products containing Chaparral, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chaparral. Even though Chaparral itself has no known interaction with Azithromycin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Chaparral and Azithromycin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Chaparral
Steady interest

#1,014 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Azithromycin
Top 5%

#60 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Chaparral reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Chaparral and Azithromycin records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Chaparral

What is Chaparral?

Chaparral
  • Pain and inflammation
  • Skin conditions
  • Antioxidant/general wellness
  • Infections
  • Traditional 'detox' remedies

Chaparral is a desert shrub long used in traditional medicine, but there is no reliable proof it treats any condition. It has been linked to serious and sometimes irreversible liver and kidney damage, and the FDA has warned against using it. Because of these safety concerns, we recommend avoiding chaparral.

Larrea tridentata · Zygophyllaceae · Leaves and twigs · Tea, capsules, tablets, tinctures, topical salves

An interaction check asks whether these two react with each other — it does not ask whether Chaparral is a good idea for someone in your situation. Here is what our Chaparral record says about it on its own.

Chaparral: dosing

There is no safe or established dose for chaparral. For chaparral specifically, the best advice is to avoid it.

From our Chaparral monograph — the full record covers uses, side effects and every documented interaction.

Read the full Chaparral monograph & all interactions
Medication

About Azithromycin

What Is Azithromycin Used For?

Brand names: Zithromax, Zmax, Azasite

  • Azithromycin is used to treat certain bacterial infections, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, sinuses, skin, throat, and reproductive organs. Azithromycin also is used to treat or prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. Azithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria.

  • Antibiotics such as azithromycin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Most-Reported Side Effects for Azithromycin

From FAERS, the FDA’s public side-effect reporting system (59,712 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 4,651 reports
Nausea 3,461 reports
Pneumonia 3,225 reports
Cough 3,120 reports
Drug hypersensitivity 2,991 reports
See full Azithromycin drug information
Keep checking

Other Drugs & Chaparral

Browse every other medication we’ve checked against Chaparral — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
370Moderate
0Minor
2,459No known interaction
370 Moderate 2,459 No interaction
Moderate

370 interactions

Showing 60 of 370 moderate interactions — see all 370 on the Chaparral page.

No interaction 2,459 drugs checked — show the list

We also checked Chaparral against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,459 medications checked with no known interaction — see the full Chaparral list.

See the full Chaparral interactions page
See every supplement checked against Azithromycin, ranked by severity
Evidence & sources

Chaparral References

The 16 references that drive our Chaparral monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Smith BC, Desmond PV. Acute hepatitis induced by ingestion of the herbal medication chaparral. Aust N Z J Med 1993;23:526.. PubMed
  2. Gordon DW, Rosenthal G, Hart J, et al. Chaparral ingestion: the broadening spectrum of liver injury caused by herbal medications. JAMA 1995;273:489-90.
  3. Batchelor WB, Heathcote J, Wanless IR. Chaparral-induced hepatic injury. Am J Gastroenterol 1995;90:831-3.
  4. Katz M, Saibil F. Herbal hepatitis: subacute hepatic necrosis secondary to chaparral leaf. J Clin Gastroenterol 1990;12:203-6.
  5. Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm 1999;56:125-38. PubMed
  6. Sheikh NM, Philen RM, Love LA. Chaparral-associated hepatotoxicity. Arch Intern Med 1997;157:913-9. DOI
  7. Heron S, Yarnell E. The safety of low-dose Larrea tridentata (DC) Coville (creosote bush or chaparral): a retrospective clinical study. J Altern Complement Med 2001;7:175-85..
  8. Chaparral-induced toxic hepatitis-California and Texas, 1992. MMWR Morb Mortal Wkly Rep 1992;41:812-4.. DOI
  9. Estes JD, Stolpman D, Olyaei A, et al. High prevalence of potentially hepatotoxic herbal supplement use in patients with fulminant hepatic failure. Arch Surg 2003;138:852-8.. PubMed
  10. Lambert JD, Zhao D, Meyers RO, et al. Nordihydroguaiaretic acid: hepatotoxicity and detoxification in the mouse. Toxicon 2002;40:1701-8.. PubMed
  11. Shasky DR. Contact dermatitis from Larrea tridentata (creosote bush). J Am Acad Dermatol 1986;15:302.. PubMed
  12. Smith AY, Feddersen RM, Gardner KD Jr, Davis CJ Jr. Cystic renal cell carcinoma and acquired renal cystic disease associated with consumption of chaparral tea: a case report. J Urol 1994;152:2089-91.. PubMed
  13. Kauma, H., Koskela, R., Makisalo, H., Autio-Harmainen, H., Lehtola, J., and Hockerstedt, K. Toxic acute hepatitis and hepatic fibrosis after consumption of chaparral tablets. Scand.J Gastroenterol. 2004;39(11):1168-1171. PubMed
  14. Leonforte, J. F. Contact dermatitis from Larrea (creosote bush). J Am Acad.Dermatol. 1986;14(2 Pt 1):202-207. PubMed
  15. Alderman, S., Kailas, S., Goldfarb, S., Singaram, C., and Malone, D. G. Cholestatic hepatitis after ingestion of chaparral leaf: confirmation by endoscopic retrograde cholangiopancreatography and liver biopsy. J Clin.Gastroenterol. 1994;19(3):242-247.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Chaparral and Azithromycin Together: Common Questions

Is it safe to take Chaparral with Azithromycin?
We do not list a known interaction between Chaparral and Azithromycin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Chaparral and Azithromycin have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Chaparral and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Chaparral has documented interactions with 1 drug class — none of Azithromycin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Chaparral interact with any other medications?
Yes. Chaparral has 370 documented drug interactions in our database — Azithromycin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Azithromycin interact with any supplements?
Yes. Azithromycin has documented interactions with 92 supplements in our database — Chaparral is not one of them. The Azithromycin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Chaparral monograph Uses, safety profile, and every drug interaction in one place Azithromycin drug information The full plain-English guide to this medication Azithromycin supplement interactions Every supplement checked against Azithromycin, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 16 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Chaparral?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.