Drug & supplement interaction

Zizyphus + Ketoconazole

Ketoconazole brand name: Nizoral.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Zizyphus and Ketoconazole 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

Zizyphus and Ketoconazole

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 Ketoconazole and Zizyphus 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.

Zizyphus safety at a glance

Zizyphus overall Use caution The fruit is widely eaten as food, but concentrated supplements have not been well studied for safety.
Pregnancy Likely Safe When zizyphus fruit is consumed in the amounts typically found in foods. There is insufficient reliable information available about the safety of zizyphus fruit... Read the full pregnancy detail
Breastfeeding Likely Safe When zizyphus fruit is consumed in the amounts typically found in foods. There is insufficient reliable information available about the safety of zizyphus fruit... 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 Ketoconazole and Zizyphus? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ketoconazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ketoconazole is filed under 8 classifications — including antifungals, cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 2c9 (cyp2c9) inhibitors. Zizyphus has documented interactions with 3 drug classes — the most serious being antidiabetes drugs (moderate), cns depressants (moderate) and cytochrome p450 1a2 (cyp1a2) substrates (moderate) — and none of Ketoconazole’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

Zizyphus Does Interact With Other Medications

Zizyphus has 469 moderate known drug interactions in our database — Ketoconazole isn’t one of them. If you take anything else, check it against the full list below.

Moderate 469 No known interaction 2,361 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against Zizyphus

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

What to actually watch for

No Interaction Found — But Data Suggests Zizyphus and Ketoconazole 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.

  • Dry mouth / Diarrhea Additional detail

    Zizyphus

    “Orally, zizyphus fruit extract was associated with three cases of mild diarrhea in newborn infants. Zizyphus seed extract was associated with one case of dry mouth and one case of increased bowel movements in a small clinical study.”

    Zizyphus · Natural Medicines adverse-effect record, reported in diarrhea.

    2 sources cited
    1. 93306. Ebrahimimd S, Ashkani-Esfahani S, Poormahmudibs A. Investigating the efficacy of zizyphus jujuba on neonatal jaundice. Iran J Pediatr. 2011 Sep;21(3):320-4.
    2. 107921. Shergis JL, Hyde A, Meaklim H, Varma P, Da Costa C, Jackson ML. Medicinal seeds Ziziphus spinosa for insomnia: a randomized, placebo-controlled, cross-over, feasibility clinical trial. Complement Ther Med 2021;57:102657. PubMed

    Ketoconazole

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

  • Headache Additional detail

    Zizyphus

    “Orally, zizyphus seed extract was associated with two cases of headache in a small clinical study.”

    Zizyphus · Natural Medicines adverse-effect record, reported in cluster headache.

    1 source cited
    1. 107921. Shergis JL, Hyde A, Meaklim H, Varma P, Da Costa C, Jackson ML. Medicinal seeds Ziziphus spinosa for insomnia: a randomized, placebo-controlled, cross-over, feasibility clinical trial. Complement Ther Med 2021;57:102657. PubMed

    Ketoconazole

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

Effects for Ketoconazole come from the ADVERSE REACTIONS section of its FDA label; effects for Zizyphus 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

Zizyphus in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When zizyphus fruit is consumed in the amounts typically found in foods. There is insufficient reliable information available about the safety of zizyphus fruit in amounts greater than those found in foods; 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 Zizyphus or Ketoconazole

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

This page covers Zizyphus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ketoconazole page lists 182 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 135 moderate · 41 minor.

From our pharmacist’s overview on the Ketoconazole page

“Ketoconazole (Nizoral) is already hard on the liver, so treat its 182 interacting supplements with genuine care, starting with the six rated major. Most of the list runs through CYP3A4, the liver enzyme ketoconazole strongly blocks, so it can raise levels of over a hundred herbal ingredients, while grapefruit pushes ketoconazole itself…”

Reviewed by 2 · Jul 18, 2026

Open the Ketoconazole interaction page

How much people look this up

Where Zizyphus and Ketoconazole 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 Zizyphus
Steady interest

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

29 days ago today
Medication Ketoconazole
Steady interest

#2,081 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 Zizyphus reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Zizyphus and Ketoconazole 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 Zizyphus

What is Zizyphus?

Zizyphus
  • Sleep problems and insomnia
  • Anxiety and stress
  • Digestive support
  • General nutrition (vitamin C and fiber)
  • Constipation

Zizyphus (jujube) is an edible fruit and traditional remedy used mainly for sleep, anxiety, and digestion. The fruit is a nutritious food, but human evidence for its medicinal benefits is limited and mostly preliminary. If you want to try a supplement form, talk with your pharmacist or doctor first, especially if you are pregnant, breastfeeding, or taking other medicines.

Ziziphus jujuba · Rhamnaceae · Fruit, seeds, leaves, and bark · Dried fruit, tea, capsules, extracts, powders, and traditional formulas (often the seed, known as suan zao ren)

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

Zizyphus: dosing

There is no official or well-established standardized dose for Zizyphus supplements. Doses vary widely depending on the form, whether it is the fruit, seed, or an extract, and the product.If you choose to use a supplement, follow the directions on the product label and do not exceed the recommended amount. Eating the fruit as a normal food does not require special dosing.

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

Read the full Zizyphus monograph & all interactions
Medication

About Ketoconazole

What Is Ketoconazole Used For?

Brand name: Nizoral

Ketoconazole 2% shampoo and foam are used to treat tinea versicolor (also called pityriasis versicolor) — a fungal infection caused by Pityrosporum orbiculare (also known as Malassezia furfur), a yeast that naturally lives on the skin.

This infection creates light or dark patches, most often on the trunk, neck, arms, and upper thighs. Even after the fungus is cleared, those skin patches may take months to return to their normal color — that's normal, and depends on your skin type and sun exposure. Tinea versicolor can also come back, since the fungus lives on healthy skin even when there's no active infection.

Most-Reported Side Effects for Ketoconazole

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Pruritus 984 reports
Fatigue 975 reports
Nausea 873 reports
Rash 858 reports
Diarrhea 814 reports
See full Ketoconazole drug information
Keep checking

Other Drugs & Zizyphus

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

0Major
469Moderate
0Minor
2,360No known interaction
469 Moderate 2,360 No interaction
Moderate

469 interactions

Showing 60 of 469 moderate interactions — see all 469 on the Zizyphus page.

No interaction 2,360 drugs checked — show the list

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

Showing the 60 most looked-up of 2,360 medications checked with no known interaction — see the full Zizyphus list.

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

Zizyphus References

The 15 references that drive our Zizyphus 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. Adzu, B., Amos, S., Dzarma, S., Wambebe, C., and Gamaniel, K. Effect of Zizyphus spina-christi Willd aqueous extract on the central nervous system in mice. J Ethnopharmacol. 2002;79(1):13-16.
  2. Cisse, A., Ndiaye, A., Lopez-Sall, P., Seck, F., Faye, B., and Faye, B. [Antidiabetic activity of Zizyphus mauritiana Lam (Rhamnaceae)]. Dakar Med 2000;45(2):105-107.
  3. Abdel-Zaher, A. O., Salim, S. Y., Assaf, M. H., and Abdel-Hady, R. H. Antidiabetic activity and toxicity of Zizyphus spina-christi leaves. J Ethnopharmacol. 10-3-2005;101(1-3):129-138. PubMed
  4. Nesseem, D. I., Michel, C. G., Sleem, A. A., and El-Alfy, T. S. Formulation and evaluation of antihyperglycemic leaf extracts of Zizyphus spina-christi (L.) Willd. Pharmazie 2009;64(2):104-109. DOI
  5. Anand, K. K., Singh, B., Chand, D., Chandan, B. K., and Gupta, V. N. Effect of Zizyphus sativa leaves on blood glucose levels in normal and alloxan-diabetic rats. J Ethnopharmacol. 1989;27(1-2):121-127. PubMed
  6. Morishita, S., Mishima, Y., Hirai, Y., Saito, T., and Shoji, M. Pharmacological studies of water extract of the Zizyphus seed and the Zizyphus seed containing drug. Gen Pharmacol 1987;18(6):637-641. PubMed
  7. Watanabe, I., Saito, H., and Takagi, K. Pharmacological studies of Zizyphus seeds. Jpn J Pharmacol 1973;23(4):563-571. DOI
  8. Wu, S. X., Zhang, J. X., Xu, T., Li, L. F., Zhao, S. Y., and Lan, M. Y. [Effects of seeds, leaves and fruits of Ziziphus spinosa and jujuboside A on central nervous system function]. Zhongguo Zhong Yao Za Zhi 1993;18(11):685-4.
  9. Glombitza, K. W., Mahran, G. H., Mirhom, Y. W., Michel, K. G., and Motawi, T. K. Hypoglycemic and antihyperglycemic effects of Zizyphus spina-christi in rats. Planta Med 1994;60(3):244-247.
  10. Jarald, E. E., Joshi, S. B., and Jain, D. C. Antidiabetic activity of extracts and fraction of <it>Zizyphus mauritiana. Pharmaceutical Biology 2009;47:328-334.
  11. Ebrahimimd S, Ashkani-Esfahani S, Poormahmudibs A. Investigating the efficacy of zizyphus jujuba on neonatal jaundice. Iran J Pediatr. 2011 Sep;21(3):320-4.
  12. Hajhashemi V, Safaei A. Hypnotic effect of Coriandrum sativum, Ziziphus jujuba, Lavandula angustifolia and Melissa officinalis extracts in mice. Res Pharm Sci. 2015 Nov-Dec;10(6):477-84.
  13. Jing XY, Peng YR, Wang XM, Duan JA. Effects of Ziziphus jujuba fruit extracts on cytochrome P450 (CYP1A2) activity in rats. Chin J Nat Med. 2015 Aug;13(8):588-94. PubMed
  14. Irannejad Niri Z, Shidfar F, Jabbari M, et al. The effect of dried Ziziphus vulgaris on glycemic control, lipid profile, apo-proteins and hs-CRP in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. J Food Biochem 2020; Mar 30
  15. Shergis JL, Hyde A, Meaklim H, Varma P, Da Costa C, Jackson ML. Medicinal seeds Ziziphus spinosa for insomnia: a randomized, placebo-controlled, cross-over, feasibility clinical trial. Complement Ther Med 2021;57:102657. 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 Zizyphus and Ketoconazole Together: Common Questions

Is it safe to take Zizyphus with Ketoconazole?
We do not list a known interaction between Zizyphus and Ketoconazole. 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 Zizyphus and Ketoconazole 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.
How was the Zizyphus and Ketoconazole combination checked?
Interactions in our licensed database are recorded against drug classes. Ketoconazole is filed under 8 classifications, and Zizyphus has documented interactions with 3 drug classes — none of Ketoconazole'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 Zizyphus interact with any other medications?
Yes. Zizyphus has 469 documented drug interactions in our database — Ketoconazole 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 Ketoconazole interact with any supplements?
Yes. Ketoconazole has documented interactions with 182 supplements in our database — Zizyphus is not one of them. The Ketoconazole 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

Zizyphus monograph Uses, safety profile, and every drug interaction in one place Ketoconazole drug information The full plain-English guide to this medication Ketoconazole supplement interactions Every supplement checked against Ketoconazole, 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 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Ketoconazole and Zizyphus?

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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.