Drug & supplement interaction

Zizyphus + Macitentan

Macitentan brand name: Opsumit.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Oct 4, 2026
The bottom line No known interaction

We found no known interaction between Zizyphus and Macitentan 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.

Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Zizyphus and Macitentan

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 Macitentan 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 Macitentan and Zizyphus? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Macitentan

Interactions in our licensed database are recorded against drug classes, not just single drug names. Macitentan is filed under 4 classifications — including antihypertensive drugs, hepatotoxic drugs, cytochrome p450 3a4 (cyp3a4) substrates. 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 Macitentan’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 — Macitentan 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. Macitentan)
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 Macitentan May Share a Side Effect

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.

  • Headache reported in 12.1% of FDA reports for Macitentan 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

    Macitentan

    Listed in the ADVERSE REACTIONS section of the FDA label for Macitentan, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Zizyphus but not commonly for Macitentan: diarrhea and dry mouth.

Effects for Macitentan come from the ADVERSE REACTIONS section of its FDA label; effects for Zizyphus come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 68,860 voluntary FDA FAERS reports for Macitentan 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.

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

Overlapping uses

What Macitentan Is Prescribed For, and What Zizyphus Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Macitentan is a prescription medicine with approved uses on its FDA label. Zizyphus is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Macitentan is prescribed for: Macitentan tablets — sold under the brand name Opsumit — are used to treat pulmonary arterial hypertension (PAH, WHO Group I), a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to lower the chance of being hospitalized because of PAH. In the key clinical study, macitentan was used in adults with mainly moderate-to-severe PAH symptoms. Patients had PAH caused by unknown or inherited causes, connective tissue disorders, or congenital heart disease with repaired shunts.

Zizyphus has been studied for:

  • Hypertension studied, not established Zizyphus has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Zizyphus for hypertension

    Although there has been interest in using oral zizyphus for hypertension, there is insufficient reliable information about the clinical effects of zizyphus for this purpose.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Macitentan on your own; if you are taking Zizyphus for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Macitentan

This page covers Zizyphus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Macitentan page lists 253 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), Beer (major) and Grapefruit (major).

By severity: 9 major · 205 moderate · 39 minor.

From our pharmacist’s overview on the Macitentan page

“If you take macitentan (Opsumit) for pulmonary arterial hypertension, study this page rather than skim it. It lists 253 supplement and herbal ingredients, nine rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Macitentan interaction page

How much people look this up

Where Zizyphus and Macitentan 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
Top half

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

29 days ago today
Medication Macitentan
Top 25%

#507 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 October 4, 2026. The Zizyphus and Macitentan 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 Macitentan

What Is Macitentan Used For?

Brand name: Opsumit

Macitentan tablets — sold under the brand name Opsumit — are used to treat pulmonary arterial hypertension (PAH, WHO Group I), a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to lower the chance of being hospitalized because of PAH.

In the key clinical study, macitentan was used in adults with mainly moderate-to-severe PAH symptoms. Patients had PAH caused by unknown or inherited causes, connective tissue disorders, or congenital heart disease with repaired shunts.

Most-Reported Side Effects for Macitentan

From FAERS, the FDA’s public side-effect reporting system (68,860 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 11,958 reports
Headache 8,323 reports
Diarrhea 6,584 reports
Nausea 5,972 reports
Fatigue 5,041 reports
See full Macitentan 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 Macitentan, 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 Macitentan Together: Common Questions

Is it safe to take Zizyphus with Macitentan?
We do not list a known interaction between Zizyphus and Macitentan. 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 Macitentan have any of the same side effects?
Yes — our sources link each of them separately to one 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.
Are Zizyphus and Macitentan used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Zizyphus in each. That is a conversation for your prescriber, especially if Macitentan is being adjusted to a target.
How was the Zizyphus and Macitentan combination checked?
Interactions in our licensed database are recorded against drug classes. Macitentan is filed under 4 classifications, and Zizyphus has documented interactions with 3 drug classes — none of Macitentan'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 — Macitentan 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 Macitentan interact with any supplements?
Yes. Macitentan has documented interactions with 253 supplements in our database — Zizyphus is not one of them. The Macitentan 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 Macitentan drug information The full plain-English guide to this medication Macitentan supplement interactions Every supplement checked against Macitentan, 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 Macitentan and Zizyphus?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.