Herb & supplement monograph

Northern Prickly Ash Drug Interactions, Uses, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Northern Prickly Ash interacts with medications. The heart of this page is the interaction list — every drug Northern Prickly Ash is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Northern Prickly Ash is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Northern Prickly Ash Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Northern Prickly Ash drug interaction appears low for most people. None of the listed interactions are rated major or even moderate, and every one is classed as minor with only limited, theoretical evidence behind it.

Interactions deserving the most attention

The only pattern that stands out involves stomach acid. There are reports that Northern Prickly Ash may increase stomach acid, so in theory it could work against acid-reducing medicines such as antacids, H2-blockers, and proton pump inhibitors (PPIs). If one of these medicines seems less effective while taking this supplement, that would be the most plausible explanation from the data. Even here, the concern is theoretical and has not been confirmed in human studies.

What the rest of the list means

Although a few dozen medications appear on the interaction list, they all fall into these same acid-related groups, and the concern for each is the same predicted effect rather than a proven problem. No interaction here has been shown to cause meaningful harm in people, which is why every entry carries the lowest severity rating.

Check your medications against Northern Prickly Ash

Based on HelloPharmacist’s Northern Prickly Ash interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Northern Prickly Ash

36 medications have a known interaction with Northern Prickly Ash, graded by severity. Select any drug for the full evidence-based detail.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Northern Prickly Ash using our pharmacist-reviewed interaction data.

AI summaries are generated from our Northern Prickly Ash interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Northern Prickly Ash combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Northern Prickly Ash affects

Every type of medication (drug category) Northern Prickly Ash is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 3 drug categories Northern Prickly Ash interacts with

AntacidsH2-blockersProton Pump Inhibitors (ppis)

Antacids

Theoretically, northern prickly ash might decrease the effectiveness of antacids.
There are reports that northern prickly ash increases stomach acid.

Likelihood Possible Evidence D

H2-Blockers

Theoretically, northern prickly ash might decrease the effectiveness of H2-blockers.
There are reports that northern prickly ash increases stomach acid.

Likelihood Possible Evidence D

Proton Pump Inhibitors (Ppis)

Theoretically, northern prickly ash might decrease the effectiveness of PPIs.
There are reports that northern prickly ash increases stomach acid.

Likelihood Possible Evidence D

Monograph

Northern Prickly Ash: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Northern Prickly Ash is a North American shrub whose bark and berries have a long history in folk medicine, especially for toothache, joint pain, and sluggish digestion. Modern scientific evidence for these uses is very limited, coming mostly from traditional reports and laboratory studies. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Scientific name: Zanthoxylum americanum
Family: Rutaceae
Part used: Bark and berries (fruit); sometimes leaves
Common forms: Dried bark, tincture, capsules, tea, fluid extract

People commonly use it for

Toothache and mouth pain
Joint pain and rheumatism
Digestive upset
Poor circulation
Cramping

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

Limited safety data exist, so use cautiously and only short-term.

PregnancyPossibly Unsafe

When the bark is used orally; avoid using. There is insufficient reliable information available about the safety of the berry or root during pregnancy...

Read the full pregnancy detail

BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Northern Prickly Ash (Zanthoxylum americanum) is a deciduous shrub or small tree native to North America. Its leaves and twigs give off a spicy, citrus-like smell when crushed, and the plant produces small greenish flowers followed by red berries.

It is often called the "toothache tree" because Native American and early American folk healers chewed its bark to numb tooth and gum pain. The bark and berries have also been used in traditional medicine for joint pain, poor circulation, and digestive complaints.

Today it is sold as a dried bark, tincture, tea, or capsule, usually marketed as a traditional herbal remedy rather than a proven treatment.

Uses & effectiveness

Northern Prickly Ash has a strong tradition of use, but high-quality human studies are lacking for nearly all of its purported benefits.

The most famous traditional use is for toothache and mouth pain, where chewing the bark can cause a tingling, numbing feeling. This effect is real for some people but has not been proven in modern clinical trials, and it is not a substitute for dental care.

People also use it for joint pain and rheumatism, digestive upset, cramping, and poor circulation. Evidence for these uses is mostly limited to traditional reports and a small number of laboratory or animal studies. There is not enough reliable evidence to say it works for any specific condition.

How it works

Northern Prickly Ash bark and berries contain a mix of plant compounds, including alkaloids, lignans, and aromatic oils. Some of these compounds have shown mild anti-inflammatory, antimicrobial, or circulation-related effects in laboratory and animal research.

The tingling, numbing sensation in the mouth is thought to come from certain compounds that stimulate the nerves and saliva flow, which may explain its traditional use for toothache.

It is important to remember that most of this information comes from test-tube and animal studies. These early findings do not prove that the herb produces the same effects in people.

Safety & precautions

There is not much modern safety data on Northern Prickly Ash, so it should be used cautiously and only for short periods. People with a known allergy to plants in the citrus (Rutaceae) family should be careful.

Pregnancy and breastfeeding: Because reliable safety information is missing, it is best to avoid Northern Prickly Ash if you are pregnant or breastfeeding.

People with stomach ulcers, inflammatory bowel conditions, bleeding disorders, or who are scheduled for surgery should talk to a healthcare provider before using it. Always check with your pharmacist or doctor first, especially if you take prescription medicines or have a chronic health condition.

Side effects

Reported side effects are not well documented, but the herb may cause mouth or throat irritation, a tingling or numbing sensation, and stomach upset such as nausea.

Larger amounts could cause more significant digestive upset. As with any plant product, allergic reactions are possible. Stop using it and seek medical care if you notice signs of an allergic reaction such as rash, swelling, or trouble breathing.

Dosing

There is no established standard dose for Northern Prickly Ash. Traditional preparations have varied widely, and product strengths differ between brands.

If you choose to use it, follow the directions on the product label and do not exceed the suggested amount. Because doses are not well studied, it is a good idea to check with your pharmacist or doctor before starting, and to use it only for a short time.

Pregnancy & Breastfeeding

Northern Prickly Ash & Pregnancy

Possibly Unsafe

When the bark is used orally; avoid using. There is insufficient reliable information available about the safety of the berry or root during pregnancy; avoid using.

McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

Northern Prickly Ash & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; 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

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 2 references that drive our Northern Prickly Ash 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.

McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

Keep reading

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.

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.

Brand directory

Brands that make products with Northern Prickly Ash

8 brands in our database make a supplement containing Northern Prickly Ash.

Biotics Research Corporation 250 products Energetix 283 products Flora 215 products Hawaii Pharm 4,726 products LYMPHORIA 1 product Nature's Answer 1,655 products Nature's Way 3,426 products Swanson Condition Specific Formulas 54 products

Product directory

Supplement products with Northern Prickly Ash

20 products in our database contain Northern Prickly Ash. Open any to see its full ingredient list and every drug interaction we check.

Pharmacist Counseling Corner

Northern Prickly Ash: Common Questions

Does Northern Prickly Ash interact with prescription medications?

Yes. We list 36 medications with a known interaction with Northern Prickly Ash. Use the checker above to see how Northern Prickly Ash interacts with a specific drug.

How are Northern Prickly Ash interactions rated?

Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.

Is it safe to take Northern Prickly Ash with my medications?

It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.

Where does this Northern Prickly Ash interaction information come from?

Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.

What is Northern Prickly Ash used for?

It is traditionally used for toothache and mouth pain, joint pain, digestive upset, and circulation problems. Strong scientific proof for these uses is lacking.

Why is it called the toothache tree?

Chewing its bark can create a tingling, numbing feeling in the mouth, which led folk healers to use it for tooth and gum pain. It is not a substitute for seeing a dentist.

Is Northern Prickly Ash safe to take?

There is limited safety data, so it should be used cautiously and only short-term. Check with your pharmacist or doctor before using it, especially if you have a health condition or take medicines.

Can I use it while pregnant or breastfeeding?

No. Because there is not enough safety information, it is best to avoid Northern Prickly Ash during pregnancy and breastfeeding.

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

Keep exploring

Products that contain Northern Prickly Ash

A rotating sample of real supplements in our database that list Northern Prickly Ash — open any to see its full ingredients and every drug interaction we check.

See all 20 products with Northern Prickly Ash →

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Northern Prickly Ash Drug Interactions, Uses, Safety & More

Your Choice:

Northern Prickly Ash Drug Interactions: The Bottom Line

Drugs that interact with Northern Prickly Ash

Don’t want to scroll the list? Just ask.

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Likelihood — How Well It’s Documented

Where This Data Comes From

The kinds of drugs Northern Prickly Ash affects

Northern Prickly Ash: Uses, Safety & Side Effects

Overview

Uses & effectiveness

How it works

Safety & precautions

Side effects

Dosing

Northern Prickly Ash & Pregnancy

Northern Prickly Ash & Breastfeeding

References & further reading

Brands that make products with Northern Prickly Ash

Supplement products with Northern Prickly Ash

Northern Prickly Ash: Common Questions

Related supplements & herbs

Products that contain Northern Prickly Ash

Have a question about Northern Prickly Ash?