Drug & supplement interaction

Tribulus + Methazolamide

Methazolamide brand name: Neptazane.

Moderate Interaction
The bottom line Moderate

Tribulus has a moderate interaction with Methazolamide. Theoretically, taking tribulus with antihypertensive drugs might increase the risk of hypotension.

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

Tribulus and Methazolamide

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

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Methazolamide

Methazolamide falls under ANTIHYPERTENSIVE DRUGS — the group Tribulus interacts with.

Theoretically, taking tribulus with antihypertensive drugs might increase the risk of hypotension.
Animal research shows that tribulus can lower blood pressure by inhibiting angiotensin-converting enzyme (ACE). Tribulus has also demonstrated hypotensive effects in pre-hypertensive adults.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the thing to keep in mind with this pairing. The interaction we have on file groups methazolamide with blood pressure lowering drugs, because tribulus has shown in animal studies (and a little human data in pre-hypertensive adults) that it can nudge blood pressure down. So the concern is that stacking the two could drop your blood pressure a bit more than expected.

Methazolamide isn't a prodrug, and it's really a glaucoma medicine, but as a carbonic anhydrase inhibitor it does act as a mild water pill and can lower blood pressure on its own. Combined with tribulus, you might feel lightheaded, dizzy, or wobbly when standing up. The evidence here is weak and mostly theoretical, so don't panic, but please run it by your pharmacist or doctor before adding tribulus.

References
  1. Sharifi AM, Darabi R, Akbarloo N. Study of antihypertensive mechanism of Tribulus terrestris in 2K1C hypertensive rats: role of tissue ACE activity. Life Sci 2003;73:2963-71. PubMed
  2. Siddiqui MA, Itrat M, Mobeen A, Khan MI. Efficacy of khar-i-khasak (Tribulus terrestris Linn.) in prehypertension: a randomized, double-blind, placebo-controlled trial. J Complement Integr Med. 2021.

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

Tribulus Also Interacts With Other Medications

Tribulus has 258 moderate known drug interactions in our database — the Methazolamide 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 Tribulus

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

Everything else you take

See Every Supplement That Interacts With Methazolamide

This page covers Tribulus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methazolamide page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 187 moderate · 24 minor.

From our pharmacist’s overview on the Methazolamide page

“Methazolamide (Neptazane) treats glaucoma by lowering pressure inside the eye, and because it also has mild water-pill effects it can nudge blood pressure and potassium on its own. That is exactly where most of the 218 supplements on this page press, and the list earns real caution.”

Reviewed by 2 · Jul 18, 2026

Open the Methazolamide interaction page

One more smart check

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

We hold 1,680 real supplement products containing Tribulus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tribulus. Your product may carry other ingredients that interact with Methazolamide too, on top of Tribulus — 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 Tribulus and Methazolamide 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 Tribulus
Top 10%

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

29 days ago today
Medication Methazolamide
Top 25%

#637 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 Tribulus

What is Tribulus?

Tribulus
  • Low libido and sexual function
  • Athletic performance and muscle building
  • Testosterone support
  • Male and female fertility
  • General 'vitality' or wellness

Tribulus is a plant supplement most often marketed to boost libido, testosterone, and athletic performance, but the human evidence behind these claims is weak and inconsistent. It is generally well tolerated by healthy adults in the short term, but it should be avoided during pregnancy and breastfeeding and discussed with your pharmacist or doctor before use.

Read the full Tribulus monograph & all interactions
Medication

About Methazolamide

What Is Methazolamide Used For?

Brand name: Neptazane

Methazolamide tablets are used to treat eye conditions where lowering intraocular pressure (pressure inside the eye) is expected to help. These include chronic open-angle glaucoma and secondary glaucoma.

Methazolamide tablets are also used before surgery in acute angle-closure glaucoma, when reducing eye pressure ahead of the procedure is needed. Note that long-term use in angle-closure glaucoma is not appropriate.

See full Methazolamide drug information
Keep checking

Other Drugs & Tribulus

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

0Major
258Moderate
0Minor
2,571No known interaction
Moderate

258 interactions

Showing 60 of 258 moderate interactions — see all 258 on the Tribulus page.

No interaction 2,571 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 Tribulus and Methazolamide Together: Common Questions

Can you take Tribulus with Methazolamide?
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 Tribulus and Methazolamide 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 Methazolamide and Tribulus?

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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.