Drug & supplement interaction

Prickly Pear Cactus + 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 Prickly Pear Cactus 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

Prickly Pear Cactus 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 Prickly Pear Cactus 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.

Prickly Pear Cactus safety at a glance

Prickly Pear Cactu... overall Use caution Generally well tolerated as food, but supplement safety is less studied.
Pregnancy Avoid Not enough safety data, so avoid supplement amounts during pregnancy.
Breastfeeding Avoid Not enough safety data, so avoid supplement amounts while breastfeeding.

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

Still wondering about combining Azithromycin and Prickly Pear Cactus? 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. Prickly Pear Cactus has documented interactions with 1 drug class — the most serious being antidiabetes 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

Prickly Pear Cactus Does Interact With Other Medications

Prickly Pear Cactus has 86 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 86 No known interaction 2,744 (incl. Azithromycin)
Taking anything else?

Check Another of Your Medications Against Prickly Pear Cactus

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

What to actually watch for

No Interaction Found — But Data Suggests Prickly Pear Cactus 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. One of them is worth acting on rather than waiting out — marked below.

  • Hives Worth acting on Additional detail

    Prickly Pear Cactus

    “Orally, prickly pear cactus has been linked to rare cases of urticaria and pruritus. In a clinical study of 41 patients taking prickly pear cactus pad ethanolic extract, three patients experienced pruritus and one patient experienced urticaria.”

    Prickly Pear Cactus · Natural Medicines adverse-effect record, reported in peripheral arterial disease (pad).

    1 source cited
    1. 105903. Han EH, Lim MK, Lee S, et al. Efficacy of Ethanolic Extract of Opuntia ficus-indica var. saboten Stems for Improving Cognitive Function in Elderly Subjects 55-85 Years of Age: A Randomized, Double-Blind, Placebo-Controlled Study. J Med Food 2020;23(11):11

    Azithromycin

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

  • Trouble sleeping / Dizziness / Headache Additional detail

    Prickly Pear Cactus

    “Orally, prickly pear cactus has been linked to rare cases of headache, insomnia, and dizziness. In a clinical study of 41 patients taking prickly pear cactus pad ethanolic extract, two patients experienced headache, one patient experienced dizziness, and one patient experienced insomnia.”

    Prickly Pear Cactus · Natural Medicines adverse-effect record, reported in cluster headache.

    2 sources cited
    1. 65266. Steinberg, J. M. and Eitan, A. Prickly pear fruit bezoar presenting as rectal perforation in an elderly patient. Int J Colorectal Dis. 2003;18(4):365-367. PubMed
    2. 105903. Han EH, Lim MK, Lee S, et al. Efficacy of Ethanolic Extract of Opuntia ficus-indica var. saboten Stems for Improving Cognitive Function in Elderly Subjects 55-85 Years of Age: A Randomized, Double-Blind, Placebo-Controlled Study. J Med Food 2020;23(11):11

    Azithromycin

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

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

    Prickly Pear Cactus

    “Orally, prickly pear cactus may cause mild diarrhea, dyspepsia, nausea, increased stool volume and frequency, and abdominal fullness. Cases of low colonic obstruction and rectal phytobezoars resulting in rectal perforation have been reported for patients who ingested prickly pear cactus fruit seeds. However, these events are extremely rare and attributed to the ingestion of a large number of fruits.”

    Prickly Pear Cactus · Natural Medicines adverse-effect record, reported in diarrhea.

    4 sources cited
    1. 7028. Rayburn K, Martinez R, Escobedo M, et al. Glycemic effects of various species of nopal (Opuntia sp.) in type 2 diabetes mellitus. Texas J Rural Health 1998;26:68-76.
    2. 65266. Steinberg, J. M. and Eitan, A. Prickly pear fruit bezoar presenting as rectal perforation in an elderly patient. Int J Colorectal Dis. 2003;18(4):365-367. PubMed
    3. 105903. Han EH, Lim MK, Lee S, et al. Efficacy of Ethanolic Extract of Opuntia ficus-indica var. saboten Stems for Improving Cognitive Function in Elderly Subjects 55-85 Years of Age: A Randomized, Double-Blind, Placebo-Controlled Study. J Med Food 2020;23(11):11
    4. 65260. Kleiner, O., Cohen, Z., and Mares, A. J. Low colonic obstruction due to Opuntia ficus indica seeds: the aftermath of enjoying delicious cactus fruits. Acta Paediatr. 2002;91(5):606-607.

    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 ›

  • Itching Additional detail

    Prickly Pear Cactus

    Recorded for Prickly Pear Cactus in the same Natural Medicines adverse-effect record shown under Hives above.

    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 Prickly Pear Cactus 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 Prickly Pear Cactus 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 Prickly Pear Cactus 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 Prickly Pear Cactus 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 Prickly Pear Cactus as Part of a Dietary Supplement Product? Check It for Interactions

We hold 432 real supplement products containing Prickly Pear Cactus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Prickly Pear Cactus. Even though Prickly Pear Cactus 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 Prickly Pear Cactus 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 Prickly Pear Cactus
Top half

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

What is Prickly Pear Cactus?

  • Blood sugar control
  • High cholesterol
  • Hangover symptoms
  • Digestive health
  • Antioxidant support

Prickly pear cactus is a desert plant whose pads and fruit are eaten as food and taken as a supplement, mainly for blood sugar, cholesterol, and hangover symptoms. Some small studies suggest modest benefits, but the evidence is limited and not strong enough to rely on it as a treatment. Talk with your pharmacist or doctor before using it, especially if you take medication for diabetes.

Opuntia ficus-indica · Cactaceae · Pads (cladodes), fruit, and flowers · Capsules, powder, juice, dried fruit, fresh pads, and extracts

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

Prickly Pear Cactus: dosing

There is no standardized, official dose for prickly pear cactus supplements. The right amount depends on the product, the form (capsule, powder, juice, or extract), and how it is being used.Because doses are not well established, follow the directions on the product label and do not exceed them. A pharmacist can help you review a specific product and decide whether it is appropriate for you, especially if you have diabetes or take other medicines.

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

Read the full Prickly Pear Cactus 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 & Prickly Pear Cactus

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

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Prickly Pear Cactus page.

No interaction 2,743 drugs checked — show the list

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Prickly Pear Cactus list.

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

Prickly Pear Cactus References

The 9 references that drive our Prickly Pear Cactus 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. Meckes-Lozyoa M, Roman-Ramos R. Opuntia streptacantha; a coadjutor in the treatment of diabetes mellitus. Am J Chin Med 1986;14:116-8.
  2. Rayburn K, Martinez R, Escobedo M, et al. Glycemic effects of various species of nopal (Opuntia sp.) in type 2 diabetes mellitus. Texas J Rural Health 1998;26:68-76.
  3. Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
  4. Sobieraj DM, Freyer CW. Probable hypoglycemic adverse drug reaction associated with prickly pear cactus, glipizide, and metformin in a patient with type 2 diabetes mellitus. Ann Pharmacother 2010;44:1334-7. PubMed
  5. Kleiner, O., Cohen, Z., and Mares, A. J. Low colonic obstruction due to Opuntia ficus indica seeds: the aftermath of enjoying delicious cactus fruits. Acta Paediatr. 2002;91(5):606-607.
  6. Steinberg, J. M. and Eitan, A. Prickly pear fruit bezoar presenting as rectal perforation in an elderly patient. Int J Colorectal Dis. 2003;18(4):365-367. PubMed
  7. Meckes-Lozyoa, M. and Roman-Ramos, R. Opuntia streptacantha: a coadjutor in the treatment of diabetes mellitus. Am J Chin Med 1986;14(3-4):116-118.
  8. Onakpoya IJ, O'Sullivan J, Heneghan CJ. The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition. 2015;31(5):640-6. PubMed
  9. Han EH, Lim MK, Lee S, et al. Efficacy of Ethanolic Extract of Opuntia ficus-indica var. saboten Stems for Improving Cognitive Function in Elderly Subjects 55-85 Years of Age: A Randomized, Double-Blind, Placebo-Controlled Study. J Med Food 2020;23(11):11

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 Prickly Pear Cactus and Azithromycin Together: Common Questions

Is it safe to take Prickly Pear Cactus with Azithromycin?
We do not list a known interaction between Prickly Pear Cactus 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 Prickly Pear Cactus and Azithromycin have any of the same side effects?
Yes — our sources link each of them separately to 8 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 Prickly Pear Cactus and Azithromycin combination checked?
Interactions in our licensed database are recorded against drug classes. Azithromycin is filed under 7 classifications, and Prickly Pear Cactus 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 Prickly Pear Cactus interact with any other medications?
Yes. Prickly Pear Cactus has 86 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 — Prickly Pear Cactus 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

Prickly Pear Cactus 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 9 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Azithromycin and Prickly Pear Cactus?

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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.