Drug & supplement interaction

Macadamia Nut + Asfotase Alfa

Asfotase Alfa brand name: Strensiq.

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 Macadamia Nut and Asfotase Alfa 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

Macadamia Nut and Asfotase Alfa

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 Asfotase Alfa and Macadamia Nut 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Macadamia Nut at all — not against Asfotase Alfa, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

Macadamia Nut safety at a glance

Macadamia Nut overall Generally safe Macadamia nuts are widely eaten as a food and are generally safe for people without nut allergies.
Pregnancy Likely Safe When used as food. Read the full pregnancy detail
Breastfeeding Likely Safe When used as food. 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 Asfotase Alfa and Macadamia Nut? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Macadamia Nut and Asfotase Alfa 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. 2 of them are worth acting on rather than waiting out — marked below.

  • A severe allergic reaction / An allergic reaction Worth acting on Additional detail

    Macadamia Nut

    “Orally, macadamia nut is well tolerated.

    Serious Adverse Effects (Rare):

    All routes of administration: Allergic reactions, including anaphylaxis and contact dermatitis.”

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

    “Orally, eating macadamia nuts or macadamia nut oil can cause allergic reactions, including anaphylaxis. Processing methods may affect the allergenicity of macadamia nuts.

    Topically, occupational exposure to macadamia nut shells has resulted in allergic contact dermatitis.”

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

    6 sources cited
    1. 12600. Lerch M, Egger C, Bircher AJ. Allergic reactions to macadamia nut. Allergy 2005;60:130-1. PubMed
    2. 12601. Pallares DE. Allergy to macadamia nut. Ann Allergy Asthma Immunol 2000;85:385-6. PubMed
    3. 100019. De Knop KJ, Hagendorens MM, Bridts CH, Stevens WJ, Ebo DG. Macadamia nut allergy: 2 case reports and a review of the literature. Acta Clin Belg. 2010;65(2):129-32.
    4. 100031. Randhawa I, Morphew T, Marsteller NL. Correlation of negative skin-prick test results for tree nuts and successful tree nut challenges among children with peanut allergy. Allergy Asthma Proc. 2018;39(6):456-460. PubMed
    5. 100032. Polk BI, Dinakarpandian D, Nanda M, Barnes C, Dinakar C. Association of tree nut and coconut sensitizations. Ann Allergy Asthma Immunol. 2016;117(4):412-416. PubMed
    6. 100033. Ekbote A, Hayman G, Bansal A. Macadamia nut allergy: potentially misleading specific IgE results. Allergy. 2010;65(10):1345. PubMed

    Asfotase Alfa

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

  • A skin rash Additional detail

    Macadamia Nut

    Recorded for Macadamia Nut in the same Natural Medicines adverse-effect record shown under A severe allergic reaction / An allergic reaction above.

    Asfotase Alfa

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

Effects for Asfotase Alfa come from the ADVERSE REACTIONS section of its FDA label; effects for Macadamia Nut come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 9,959 voluntary FDA FAERS reports for Asfotase Alfa 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

Macadamia Nut in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When used as food.

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

How much people look this up

Where Macadamia Nut and Asfotase Alfa 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 Macadamia Nut
Steady interest

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

29 days ago today
Medication Asfotase Alfa
Top half

#1,363 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 Macadamia Nut reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Macadamia Nut and Asfotase Alfa 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 Macadamia Nut

What is Macadamia Nut?

  • Heart health
  • Healthy snacking
  • Weight management
  • Skin and hair care (oil)
  • Source of healthy fats

Macadamia nuts are a nutritious food rich in healthy monounsaturated fats, fiber, and minerals, and they can be a part of a heart-healthy diet. They are mainly eaten as a food rather than used as a medicine, and the strongest evidence supports them as a wholesome snack rather than a treatment for any disease. People with tree nut allergies should avoid them.

Macadamia integrifolia · Proteaceae · Nut (seed kernel) and nut oil · Whole nuts, nut butter, nut oil, milk, flour

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

Macadamia Nut: dosing

There is no official medicinal dose for macadamia nuts because they are a food, not a standardized supplement. A common snack portion is a small handful of nuts.If you use a macadamia product such as oil, butter, or a supplement, follow the directions on the product label.

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

Read the full Macadamia Nut monograph & all interactions
Medication

About Asfotase Alfa

What Is Asfotase Alfa Used For?

Brand name: Strensiq

Strensiq (asfotase alfa), given as a subcutaneous injection, is approved to treat perinatal/infantile-onset and juvenile-onset hypophosphatasia (HPP) — a rare genetic disorder in which the body lacks enough of an enzyme called TNSALP, leading to problems with bone mineralization, rickets, bone deformity, and muscle weakness.

HPP can present at birth or in childhood. Strensiq is the specific brand approved for these forms of the disease. Safety and effectiveness have been established in pediatric patients across both onset types.

Most-Reported Side Effects for Asfotase Alfa

From FAERS, the FDA’s public side-effect reporting system (9,959 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Injection site pain 1,327 reports
Fatigue 952 reports
Injection site erythema 869 reports
Injection site reaction 747 reports
Arthralgia 665 reports
See full Asfotase Alfa drug information
Keep checking

Other Drugs & Macadamia Nut

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Macadamia Nut list.

See the full Macadamia Nut interactions page
See every supplement checked against Asfotase Alfa, ranked by severity
Evidence & sources

Macadamia Nut References

The 11 references that drive our Macadamia Nut 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. Garg ML, Blake RJ, Wills RB. Macadamia nut consumption lowers plasma total and LDL cholesterol levels in hypercholesterolemic men. J Nutr 2003;133:1060-3. PubMed
  2. Curb JD, Wergowske G, Dobbs JC, et al. Serum lipid effects of a high-monounsaturated fat diet based on macadamia nuts. Arch Intern Med 2000;160:1154-8. PubMed
  3. Lerch M, Egger C, Bircher AJ. Allergic reactions to macadamia nut. Allergy 2005;60:130-1. PubMed
  4. Pallares DE. Allergy to macadamia nut. Ann Allergy Asthma Immunol 2000;85:385-6. PubMed
  5. Teuber SS, Brown RL, Haapanen LA. Allergenicity of gourmet nut oils processed by different methods. J Allergy Clin Immunol 1997;99:502-7. PubMed
  6. Knight TE, Hausen BM. Dermatitis in a nutshell: occupational exposure to Macadamia integrifolia. J Am Acad Dermatol 1996;35:482-4. PubMed
  7. De Knop KJ, Hagendorens MM, Bridts CH, Stevens WJ, Ebo DG. Macadamia nut allergy: 2 case reports and a review of the literature. Acta Clin Belg. 2010;65(2):129-32.
  8. Randhawa I, Morphew T, Marsteller NL. Correlation of negative skin-prick test results for tree nuts and successful tree nut challenges among children with peanut allergy. Allergy Asthma Proc. 2018;39(6):456-460. PubMed
  9. Polk BI, Dinakarpandian D, Nanda M, Barnes C, Dinakar C. Association of tree nut and coconut sensitizations. Ann Allergy Asthma Immunol. 2016;117(4):412-416. PubMed
  10. Ekbote A, Hayman G, Bansal A. Macadamia nut allergy: potentially misleading specific IgE results. Allergy. 2010;65(10):1345. PubMed
  11. Herbst RA, Wahl R, Frosch PJ. Specific IgE reactivity and identification of potential allergens in macadamia allergy. J Eur Acad Dermatol Venereol. 2010;24(11):1361-3. 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 Macadamia Nut and Asfotase Alfa Together: Common Questions

Is it safe to take Macadamia Nut with Asfotase Alfa?
We do not list a known interaction between Macadamia Nut and Asfotase Alfa. 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 Macadamia Nut and Asfotase Alfa have any of the same side effects?
Yes — our sources link each of them separately to 3 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.

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

Where next

Keep Exploring

Macadamia Nut monograph Uses, safety profile, and every drug interaction in one place Asfotase Alfa drug information The full plain-English guide to this medication Asfotase Alfa supplement interactions Every supplement checked against Asfotase Alfa, 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 11 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Asfotase Alfa and Macadamia Nut?

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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.