Drug & supplement interaction

Limonene + 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 Limonene 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

Limonene 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 Limonene 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.

Limonene safety at a glance

Limonene overall Use caution Generally well tolerated in food amounts, but human safety data for high-dose supplements is limited.
Pregnancy Avoid Not enough safety data exists for supplement doses, so it is best avoided.
Breastfeeding Likely Safe When consumed in amounts commonly found in foods. Limonene has Generally Recognized As Safe (GRAS) status in the US. There is insufficient reliable information... 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 Limonene? 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. Limonene has documented interactions with 5 drug classes — the most serious being cytochrome p450 2c19 (cyp2c19) inducers (moderate), cytochrome p450 2c19 (cyp2c19) inhibitors (moderate) and cytochrome p450 2c9 (cyp2c9) inducers (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

Limonene Does Interact With Other Medications

Limonene has 229 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 229 No known interaction 2,601 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Limonene

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

What to actually watch for

No Interaction Found — But Data Suggests Limonene 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.

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

    Limonene

    “Orally, limonene is generally well tolerated. It can cause nausea, vomiting, and diarrhea. Topically, limonene can cause contact dermatitis. Observational research has found that increased exposure to ambient air limonene from household cleaning products is associated with wheezing and asthma, particularly in children.”

    Limonene · Natural Medicines adverse-effect record, reported in asthma.

    6 sources cited
    1. 12709. Vigushin DM, Poon GK, Boddy A, et al. Phase I and pharmacokinetic study of D-limonene in patients with advanced cancer. Cancer Research Campaign Phase I/II Clinical Trials Committee. Cancer Chemother Pharmacol 1998;42:111-7. PubMed
    2. 12715. Matura M, Goossens A, Bordalo O, et al. Oxidized citrus oil (R-limonene): a frequent skin sensitizer in Europe. J Am Acad Dermatol 2002;47:709-14. PubMed
    3. 12716. Topham EJ, Wakelin SH. D-Limonene contact dermatitis from hand cleansers. Contact Dermatitis 2003;49:108-9.
    4. 99871. Dittmar D, Schuttelaar MLA. Contact sensitization to hydroperoxides of limonene and linalool: results of consecutive patch testing and clinical relevance. Contact Dermatitis 2019;80(2):101-9. PubMed
    5. 99872. Gatica-Ortega ME, Pastor-Nieto MA, Schoendorff-Ortega C, Mollejo-Villanueva M, Giménez-Arnau A. Lymphomatoid contact dermatitis caused by limonene hydroperoxides confirmed by an exposure provocation test with the involved personal hygiene products. Contac PubMed
    6. 99873. Nath NS, Liu B, Green C, Atwater AR. Contact allergy to hydroperoxides of linalool and D-limonene in a US population. Dermatitis 2017;28(5):313-6. PubMed

    “Orally, limonene can cause nausea, vomiting, and diarrhea.”

    Limonene · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 12709. Vigushin DM, Poon GK, Boddy A, et al. Phase I and pharmacokinetic study of D-limonene in patients with advanced cancer. Cancer Research Campaign Phase I/II Clinical Trials Committee. Cancer Chemother Pharmacol 1998;42:111-7. 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

    Limonene

    “Topically, limonene can cause contact dermatitis. Observational studies have found that 8% to 9.4% of patients with a suspected fragrance allergy have allergic skin reactions to limonene hydroperoxides.”

    Limonene · Natural Medicines adverse-effect record, reported in allergic rhinitis (hay fever).

    5 sources cited
    1. 12715. Matura M, Goossens A, Bordalo O, et al. Oxidized citrus oil (R-limonene): a frequent skin sensitizer in Europe. J Am Acad Dermatol 2002;47:709-14. PubMed
    2. 12716. Topham EJ, Wakelin SH. D-Limonene contact dermatitis from hand cleansers. Contact Dermatitis 2003;49:108-9.
    3. 99871. Dittmar D, Schuttelaar MLA. Contact sensitization to hydroperoxides of limonene and linalool: results of consecutive patch testing and clinical relevance. Contact Dermatitis 2019;80(2):101-9. PubMed
    4. 99872. Gatica-Ortega ME, Pastor-Nieto MA, Schoendorff-Ortega C, Mollejo-Villanueva M, Giménez-Arnau A. Lymphomatoid contact dermatitis caused by limonene hydroperoxides confirmed by an exposure provocation test with the involved personal hygiene products. Contac PubMed
    5. 99873. Nath NS, Liu B, Green C, Atwater AR. Contact allergy to hydroperoxides of linalool and D-limonene in a US population. Dermatitis 2017;28(5):313-6. PubMed

    Azithromycin

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

Reported for Limonene but not commonly for Azithromycin: wheezing.

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

Limonene in Pregnancy & Breastfeeding

Lactation Likely Safe

When consumed in amounts commonly found in foods. Limonene has Generally Recognized As Safe (GRAS) status in the US. There is insufficient reliable information available about using limonene in medicinal amounts during pregnancy or breast-feeding; avoid using.

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

We hold 89 real supplement products containing Limonene, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Limonene. Even though Limonene 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 Limonene 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 Limonene
Steady interest

#827 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 Limonene reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Limonene and Azithromycin records this page draws on were last updated July 11, 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 Limonene

What is Limonene?

  • Heartburn and acid reflux
  • Digestive upset
  • Stress and mood support
  • Antioxidant support
  • General wellness

Limonene is a natural compound found in the peel of citrus fruits like oranges and lemons, and it is used as a flavoring agent and dietary supplement. People take it for heartburn, digestion, and general wellness, but solid human evidence is limited. It is generally well tolerated in food amounts, but talk with your pharmacist or doctor before using concentrated supplements.

Essential oil from citrus peel (the natural source of limonene) · Softgel capsules, oils, flavoring agent in foods, aromatherapy oils

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

Limonene: dosing

There is no official or well-established dose for limonene supplements. Studies have used a wide range of amounts, and products vary a lot in strength.The best advice is to follow the directions on the product label and not exceed them.

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

Read the full Limonene 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 & Limonene

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

0Major
229Moderate
0Minor
2,600No known interaction
229 Moderate 2,600 No interaction
Moderate

229 interactions

Showing 60 of 229 moderate interactions — see all 229 on the Limonene page.

No interaction 2,600 drugs checked — show the list

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

Showing the 60 most looked-up of 2,600 medications checked with no known interaction — see the full Limonene list.

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

Limonene References

The 10 references that drive our Limonene 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. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Vigushin DM, Poon GK, Boddy A, et al. Phase I and pharmacokinetic study of D-limonene in patients with advanced cancer. Cancer Research Campaign Phase I/II Clinical Trials Committee. Cancer Chemother Pharmacol 1998;42:111-7. PubMed
  3. Crowell PL. Prevention and therapy of cancer by dietary monoterpenes. J Nutr 1999;129:775S-778S. PubMed
  4. Matura M, Goossens A, Bordalo O, et al. Oxidized citrus oil (R-limonene): a frequent skin sensitizer in Europe. J Am Acad Dermatol 2002;47:709-14. PubMed
  5. Topham EJ, Wakelin SH. D-Limonene contact dermatitis from hand cleansers. Contact Dermatitis 2003;49:108-9.
  6. Miyazawa M, Shindo M, Shimada T. Metabolism of (+)- and (-)-limonenes to respective carveols and perillyl alcohols by CYP2C9 and CYP2C19 in human liver microsomes. Drug Metab Dispos 2002;30:602-7. PubMed
  7. Dales RE, Cakmak S. Is residential ambient air limonene associated with asthma? Findings from the Canadian Health Measures Survey. Environ Pollut 2019;244:966-70. PubMed
  8. Dittmar D, Schuttelaar MLA. Contact sensitization to hydroperoxides of limonene and linalool: results of consecutive patch testing and clinical relevance. Contact Dermatitis 2019;80(2):101-9. PubMed
  9. Gatica-Ortega ME, Pastor-Nieto MA, Schoendorff-Ortega C, Mollejo-Villanueva M, Giménez-Arnau A. Lymphomatoid contact dermatitis caused by limonene hydroperoxides confirmed by an exposure provocation test with the involved personal hygiene products. Contac PubMed
  10. Nath NS, Liu B, Green C, Atwater AR. Contact allergy to hydroperoxides of linalool and D-limonene in a US population. Dermatitis 2017;28(5):313-6. 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 Limonene and Azithromycin Together: Common Questions

Is it safe to take Limonene with Azithromycin?
We do not list a known interaction between Limonene 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 Limonene 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 Limonene and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Limonene has documented interactions with 5 drug classes — 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 Limonene interact with any other medications?
Yes. Limonene has 229 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 — Limonene 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

Limonene 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 10 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Limonene?

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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.