Drug & supplement interaction

Tribulus + Sirolimus

Sirolimus brand name: Rapamune.

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 Tribulus and Sirolimus 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

Tribulus and Sirolimus

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 Sirolimus and Tribulus 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.

Tribulus safety at a glance

Tribulus overall Use caution Often well tolerated short-term in healthy adults, but quality and long-term safety data are limited.
Pregnancy Possibly Unsafe When used orally. Animal research suggests that tribulus might adversely affect fetal development; avoid using. Read the full pregnancy detail
Breastfeeding Avoid Avoid while breastfeeding due to a lack of reliable safety information.

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 Sirolimus and Tribulus? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Sirolimus

Interactions in our licensed database are recorded against drug classes, not just single drug names. Sirolimus is filed under 5 classifications — including immunosuppressants, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Tribulus has documented interactions with 3 drug classes — the most serious being antidiabetes drugs (moderate), antihypertensive drugs (moderate) and lithium (moderate) — and none of Sirolimus’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

Tribulus Does Interact With Other Medications

Tribulus has 259 moderate known drug interactions in our database — Sirolimus isn’t one of them. If you take anything else, check it against the full list below.

Moderate 259 No known interaction 2,571 (incl. Sirolimus)
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.

What to actually watch for

No Interaction Found — But Data Suggests Tribulus and Sirolimus 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.

  • Kidney problems Worth acting on Additional detail

    Tribulus

    “Orally, tribulus seems to be well tolerated.

    Serious Adverse Effects (Rare):

    Orally: Cases of liver and kidney injury, seizures, and chronic painful erection with impaired sexual function have been reported. Pneumothorax and bronchial polyp after consuming the spine-covered tribulus fruit have been reported.”

    Tribulus · Natural Medicines adverse-effect record, reported in epilepsy.

    “In one case report, a patient drinking tribulus water 2 liters daily for two days presented with lower limb weakness, seizures, hepatitis, and acute kidney injury. The patient's condition improved after hemodialysis and discontinuation of tribulus water.”

    Tribulus · Natural Medicines adverse-effect record, reported in epilepsy.

    1 source cited
    1. 92069. Talasaz AH, Abbasi MR, Abkhiz S, Dashti-Khavidaki S. Tribulus terrestris-induced severe nephrotoxicity in a young healthy male. Nephrol Dial Tranplant 2010;25(11):3792-3. PubMed

    Sirolimus

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

  • Liver problems Worth acting on Additional detail

    Tribulus

    “In one case report, a patient drinking tribulus water 2 liters daily for two days presented with lower limb weakness, seizures, hepatitis, and acute kidney injury. The patient's condition improved after hemodialysis and discontinuation of the tribulus water.”

    Tribulus · Natural Medicines adverse-effect record, reported in epilepsy.

    2 sources cited
    1. 92069. Talasaz AH, Abbasi MR, Abkhiz S, Dashti-Khavidaki S. Tribulus terrestris-induced severe nephrotoxicity in a young healthy male. Nephrol Dial Tranplant 2010;25(11):3792-3. PubMed
    2. 92025. Ryan M, Lazar I, Nadasdy GM, et al. Acute kidney injury and hyperbilirubinemia in a young male after ingestion of Tribulus terrestris. Clin Nephrol 2015;83(3):177-83. PubMed

    Sirolimus

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

  • Constipation / Stomach pain / Diarrhea / Nausea Additional detail

    Tribulus

    “Orally, tribulus can cause abdominal pain, cramping, nausea, vomiting, diarrhea, and constipation. However, in one study, the rates of these gastrointestinal complaints were similar for patients taking tribulus and those receiving placebo.”

    Tribulus · Natural Medicines adverse-effect record, reported in constipation.

    2 sources cited
    1. 92022. Akhtari E, Raisi F, Keshavarz M, et al. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo-controlled study. Daru 2014;22:40. PubMed
    2. 92027. Postigo S, Lima SM, Yamada SS, et al. Assessment of the effects of Tribulus terrestris on sexual function of menopausal women. Rev Bras Ginecol Obstet 2016;38(3):140-6. PubMed

    Sirolimus

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

Reported for Tribulus but not commonly for Sirolimus: vomiting, trouble sleeping and seizures.

Effects for Sirolimus come from the ADVERSE REACTIONS section of its FDA label; effects for Tribulus come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Tribulus in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. Animal research suggests that tribulus might adversely affect fetal development; 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 Tribulus or Sirolimus

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Tribulus or Sirolimus, 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 Sirolimus

This page covers Tribulus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sirolimus page lists 188 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 149 moderate · 36 minor.

From our pharmacist’s overview on the Sirolimus page

“Sirolimus (Rapamune) is the anti-rejection medicine transplant patients depend on, and it is a narrow-therapeutic-index drug, meaning small shifts in its blood level can invite rejection on one side or toxicity on the other. That is why the 188 supplements on this page deserve genuine wariness, starting with the three rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Sirolimus 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. Even though Tribulus itself has no known interaction with Sirolimus, 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 Tribulus and Sirolimus 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 Sirolimus
Steady interest

#2,179 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 Tribulus reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Tribulus and Sirolimus 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 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.

Tribulus terrestris · Zygophyllaceae · Fruit, leaf, and root · Capsules, tablets, powders, tinctures, and standardized extracts

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

Tribulus: dosing

There is no well-established standard dose for Tribulus. Studies have used a range of doses and different extracts, often standardized to a percentage of saponins, which makes it hard to compare products or recommend one amount.The best approach is to follow the directions on the specific product label and not exceed them.

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

Read the full Tribulus monograph & all interactions
Medication

About Sirolimus

What Is Sirolimus Used For?

Brand name: Rapamune

Sirolimus oral solution and tablets are used to help prevent organ rejection in kidney (renal) transplant patients aged 13 and older. They are also used to treat lymphangioleiomyomatosis (LAM) — a rare lung disease in which abnormal muscle-like cells invade lung tissue.

Fyarro (sirolimus, intravenous injection) is used to treat adults with locally advanced, unresectable, or metastatic malignant PEComa — a rare tumor that grows in soft tissue or organs. Hyftor (sirolimus topical gel) is used to treat facial angiofibroma (small benign skin growths on the face) associated with tuberous sclerosis in adults and children aged 6 and older.

Most-Reported Side Effects for Sirolimus

From FAERS, the FDA’s public side-effect reporting system (13,394 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fever 525 reports
Diarrhea 515 reports
Pneumonia 487 reports
Acute kidney injury 435 reports
Thrombotic microangiopathy 376 reports
See full Sirolimus 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
259Moderate
0Minor
2,570No known interaction
259 Moderate 2,570 No interaction
Moderate

259 interactions

Showing 60 of 259 moderate interactions — see all 259 on the Tribulus page.

No interaction 2,570 drugs checked — show the list

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

Showing the 60 most looked-up of 2,570 medications checked with no known interaction — see the full Tribulus list.

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

Tribulus References

The 10 references that drive our Tribulus 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. 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. Walker D, Bird A, Flora T, O'Sullivan B. Some effects of feeding Tribulus terrestris, Ipomoea lonchophylla and the seed of Abelmoschus ficulneus on fetal development and the outcome of pregnancy in sheep. Reprod Fertil Dev 1992;4:135-44. PubMed
  3. Al-Ali M, Wahbi S, Twaij H, Al-Badr A. Tribulus terrestris: preliminary study of its diuretic and contractile effects and comparison with Zea mays. J Ethnopharmacol 2003;85:257-60. PubMed
  4. Tabakova, P., Dimitrov, M., Ognyanov, K., and et al. Clinical study of Tribestan in females with endocrine sterility. Documentation for Registration (unpublished) 1999.
  5. Akhtari E, Raisi F, Keshavarz M, et al. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo-controlled study. Daru 2014;22:40. PubMed
  6. Ryan M, Lazar I, Nadasdy GM, et al. Acute kidney injury and hyperbilirubinemia in a young male after ingestion of Tribulus terrestris. Clin Nephrol 2015;83(3):177-83. PubMed
  7. Postigo S, Lima SM, Yamada SS, et al. Assessment of the effects of Tribulus terrestris on sexual function of menopausal women. Rev Bras Ginecol Obstet 2016;38(3):140-6. PubMed
  8. Talasaz AH, Abbasi MR, Abkhiz S, Dashti-Khavidaki S. Tribulus terrestris-induced severe nephrotoxicity in a young healthy male. Nephrol Dial Tranplant 2010;25(11):3792-3. PubMed
  9. Samani NB, Jokar A, Soveid M, Heydari M, Mosavat SH. Efficacy of the hydroalcoholic extract of Tribulus terrestris on the serum glucose and lipid profile of women with diabetes mellitus: a double-blind randomized placebo-controlled clinical trial. J Evid
  10. 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.

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 Tribulus and Sirolimus Together: Common Questions

Is it safe to take Tribulus with Sirolimus?
We do not list a known interaction between Tribulus and Sirolimus. 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 Tribulus and Sirolimus have any of the same side effects?
Yes — our sources link each of them separately to 6 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 Tribulus and Sirolimus combination checked?
Interactions in our licensed database are recorded against drug classes. Sirolimus is filed under 5 classifications, and Tribulus has documented interactions with 3 drug classes — none of Sirolimus'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 Tribulus interact with any other medications?
Yes. Tribulus has 259 documented drug interactions in our database — Sirolimus 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 Sirolimus interact with any supplements?
Yes. Sirolimus has documented interactions with 188 supplements in our database — Tribulus is not one of them. The Sirolimus 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

Tribulus monograph Uses, safety profile, and every drug interaction in one place Sirolimus drug information The full plain-English guide to this medication Sirolimus supplement interactions Every supplement checked against Sirolimus, 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 Sirolimus 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.