Drug & supplement interaction

Gardenia + 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 Gardenia 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

Gardenia 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 Gardenia 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.

Gardenia safety at a glance

Gardenia overall Use caution Human safety data are limited, and large or long-term amounts have not been well studied.
Pregnancy Avoid Not enough safety information is available, so it is best to avoid it during pregnancy.
Breastfeeding Avoid There is not enough safety information, so avoid it while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Azithromycin and Gardenia? 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. Gardenia has documented interactions with 1 drug class — the most serious being stimulant laxatives (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

Gardenia Does Interact With Other Medications

Gardenia has 21 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 21 No known interaction 2,809 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Gardenia

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

What to actually watch for

No Interaction Found — But Data Suggests Gardenia 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.

  • Stomach pain / Nausea / Vomiting reported in 5.8% of FDA reports for Azithromycin Additional detail

    Gardenia

    “Orally, there are case reports of mesenteric phlebosclerosis, a thickening of the walls of the intestine and mesenteric veins, which can lead to obstruction and occlusion. Typical presenting symptoms are paroxysmal abdominal pain with nausea and vomiting, and imaging studies reveal thickening and stiffening of the walls of the ascending and transverse colon, with dark purple discoloration of the colonic and rectal mu…”

    Gardenia · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 112954. Tong T, Fu J, Kong Y. Recurrent Abdominal Pain in a 61-Year-Old Woman. Gastroenterology 2023;164(6):887-890. PubMed

    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

    Gardenia

    “Topically, exposure to gardenia fruit extract or the whole plant has been associated with allergic contact dermatitis.

    Orally, there is a case report of blue-gray skin pigmentation associated with taking a product containing the extracts of gardenia fruit, phellodendron bark, and licorice for 7 years in a 77-year-old female.”

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

    3 sources cited
    1. 26518. Kubo, Y., Nonaka, S., and Yoshida, H. Allergic contact dermatitis from gardenia fruit. Contact Dermatitis 1990;22(2):65-7. PubMed
    2. 49078. Paulsen, E., Skov, P. S., and Andersen, K. E. Immediate skin and mucosal symptoms from pot plants and vegetables in gardeners and greenhouse workers. Contact Dermatitis 1998;39(4):166-170. PubMed
    3. 102698. Mizawa M, Andoh T, Shimizu T. Gardenia fruit-related blue-gray skin pigmentation. JAMA Dermatol. 2020. PubMed

    Azithromycin

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

Effects for Azithromycin come from the ADVERSE REACTIONS section of its FDA label; effects for Gardenia 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.

From our Q&A

Questions About Gardenia 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 Gardenia 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 Gardenia 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 Gardenia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 240 real supplement products containing Gardenia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Gardenia. Even though Gardenia 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 Gardenia 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 Gardenia
Steady interest

#762 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 Gardenia reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Gardenia 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 Gardenia

What is Gardenia?

Gardenia
  • Liver and digestive complaints
  • Fever and inflammation
  • Anxiety, restlessness, and trouble sleeping
  • Blood pressure and blood sugar support (traditional)
  • Natural food and fabric coloring

Gardenia fruit has a long history in traditional Chinese medicine and is also used as a natural food coloring. While early lab and animal studies are interesting, strong human evidence for its health benefits is lacking, so talk with your pharmacist or doctor before using it as a supplement.

Gardenia jasminoides · Rubiaceae · Fruit (the dried ripe fruit, called zhi zi in Chinese medicine), and sometimes the flower · Dried fruit, powders, capsules, teas/decoctions, liquid extracts, and as a natural food coloring (gardenia yellow/blue)

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

Gardenia: dosing

There is no standardized, well-established dose for gardenia supplements. Traditional formulas use the dried fruit in decoctions, but products sold today vary widely in strength and form.If you choose to use a gardenia product, follow the directions on the label and do not exceed the recommended amount.

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

Read the full Gardenia 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 & Gardenia

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

0Major
21Moderate
0Minor
2,808No known interaction
21 Moderate 2,808 No interaction
Moderate

21 interactions

No interaction 2,808 drugs checked — show the list

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

Showing the 60 most looked-up of 2,808 medications checked with no known interaction — see the full Gardenia list.

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

Gardenia References

The 5 references that drive our Gardenia 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. Kubo, Y., Nonaka, S., and Yoshida, H. Allergic contact dermatitis from gardenia fruit. Contact Dermatitis 1990;22(2):65-7. PubMed
  2. Yamauchi, K., Fujimoto, N., Kuwano, S., Inouye, H., and Inoue, K. The mechanism of purgative action of geniposide, an iridoid glucoside of the fruit of Gardenia, in mice. Planta Med 1976;30(1):39-47.
  3. Paulsen, E., Skov, P. S., and Andersen, K. E. Immediate skin and mucosal symptoms from pot plants and vegetables in gardeners and greenhouse workers. Contact Dermatitis 1998;39(4):166-170. PubMed
  4. Mizawa M, Andoh T, Shimizu T. Gardenia fruit-related blue-gray skin pigmentation. JAMA Dermatol. 2020. PubMed
  5. Tong T, Fu J, Kong Y. Recurrent Abdominal Pain in a 61-Year-Old Woman. Gastroenterology 2023;164(6):887-890. PubMed

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 Gardenia and Azithromycin Together: Common Questions

Is it safe to take Gardenia with Azithromycin?
We do not list a known interaction between Gardenia 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 Gardenia and Azithromycin have any of the same side effects?
Yes — our sources link each of them separately to 4 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 Gardenia and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Gardenia 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 Gardenia interact with any other medications?
Yes. Gardenia has 21 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 — Gardenia 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

Gardenia 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 5 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Gardenia?

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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.