Drug & supplement interaction

Prickly Pear Cactus + Dulaglutide

Dulaglutide brand name: Trulicity.

Moderate Interaction
The bottom line Moderate

Prickly Pear Cactus has a moderate interaction with Dulaglutide. Combining prickly pear cactus with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Prickly Pear Cactus and Dulaglutide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIDIABETES DRUGS

Why this applies to Dulaglutide

Dulaglutide falls under ANTIDIABETES DRUGS — the group Prickly Pear Cactus interacts with.

Combining prickly pear cactus with antidiabetes drugs might increase the risk of hypoglycemia.
Case reports show that combining prickly pear cactus with antidiabetes drugs such as chlorpropamide, glyburide, glipizide, and metformin can increase the risk of hypoglycemia in patients with type 2 diabetes. Advise patients to monitor glucose levels closely. Dose adjustments may be necessary.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: prickly pear cactus may gently lower your blood sugar on its own, mostly through its soluble fiber slowing how fast sugar gets absorbed after meals. Your Trulicity (dulaglutide) is already working to bring those numbers down too. Stack the two together and the combined effect could push your blood sugar lower than you want.

If that happens, you might feel shaky, sweaty, dizzy, lightheaded, or unusually hungry or tired. I want to be honest about the evidence, though: this is based mostly on scattered case reports with older diabetes pills, not solid studies on dulaglutide, so the real-world risk is likely modest. Food amounts are less of a concern than concentrated supplements. If you'd like to try it, check your glucose more closely at first and talk with your pharmacist or doctor before changing anything.

References
  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. 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.
  3. 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
  4. 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.
  5. 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

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Prickly Pear Cactus Also Interacts With Other Medications

Prickly Pear Cactus has 85 moderate known drug interactions in our database — the Dulaglutide one above is one of them. If you take anything else, check it against the full list below.

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.

Everything else you take

See Every Supplement That Interacts With Dulaglutide

This page covers Prickly Pear Cactus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dulaglutide page lists 239 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Siberian Cocklebur (major), Acai (moderate), African Wild Potato (moderate), Agaricus Mushroom (moderate) and Agmatine (moderate).

By severity: 1 major · 208 moderate · 30 minor.

From our pharmacist’s overview on the Dulaglutide page

“Because dulaglutide (Trulicity) already lowers blood sugar in people with type 2 diabetes, nearly every entry on this page deserves genuine respect, and one demands it outright. Almost all of these supplements pull glucose in one direction or the other, so the danger that matters most is hypoglycemia, blood sugar dropping too low.”

Reviewed by 2 · Jul 18, 2026

Open the Dulaglutide 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. Your product may carry other ingredients that interact with Dulaglutide too, on top of Prickly Pear Cactus — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Prickly Pear Cactus and Dulaglutide 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 Dulaglutide
Steady interest

#1,786 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.

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.

Read the full Prickly Pear Cactus monograph & all interactions
Medication

About Dulaglutide Injection

What Is Dulaglutide Injection Used For?

Brand name: Trulicity

Trulicity (dulaglutide) injection is used alongside diet and exercise to improve blood sugar control in adults and children 10 years and older with type 2 diabetes mellitus. It is not for type 1 diabetes.

Trulicity is also used in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors to lower the risk of major heart events — specifically cardiovascular death, non-fatal heart attack, or non-fatal stroke.

See full Dulaglutide Injection 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
85Moderate
0Minor
2,744No known interaction
Moderate

85 interactions

Showing 60 of 85 moderate interactions — see all 85 on the Prickly Pear Cactus page.

No interaction 2,744 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Prickly Pear Cactus and Dulaglutide Together: Common Questions

Can you take Prickly Pear Cactus with Dulaglutide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Prickly Pear Cactus and Dulaglutide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Dulaglutide 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.