Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
1-Heptanecanol, 3-O-methylisorhamnein, 4-ethoxyl-6-hydroxymethyl-alpha-pyrone, 4-hydroxybenzoic acid, 4-hydroxyproline, 4-hydroxyproline(II), (6S,9S)-3-oxo-alpha-ionol-beta-D-glucopyranoside, adelprim, alpha-pyrone glycoside, amino acids, arabinose, aromadendrin, ascorbic acid, ash, aspasuc chocolate, barbary fig, betacyanin, betalains, betanin, biomage, Blanca Cristalina, Cactaceae (family), Cacti-Nea™, Cactus ficus-indica L., cactus flowers, cactus pear, CactuSlim, calcium, capteur de graisses (French), capture graisse (French), cardón de México (Spanish), catechin, cellulose, chardon d'Inde (French), Cheaters Relief, ChitoRich, chlorophyll, chumbera (Spanish), chumbo (Spanish), chumbua (Spanish), Coach Minceur, complete, corchoionoside C, cutting force, daucosterol, diet bread, Dietabelt, (+)-dihydrokaempferol, (+)-dihydroquercetin, DuoLean, (E)-ferulic acid, epicatechin, eriodictyol, Esmeralda, fiber, fiber & herb, figo da India (Portuguese), figo de pitoira (Portuguese), figue de Barbarie (French), figueira da India (Portuguese), figuera de moro (Spanish), figuier à raquettes (French), figuier d'Inde (French), Feigenkaktus (German), flame diet, folate, Frucht des Feigenkaktus (German), fructose, galactose, galacturonic acid, gallic acid, glucose, Gracemere pear, Herbopuntia, higo chimbo (Spanish), higo chumbo (Spanish), higo de pala (Spanish), higo México (Spanish), higuera de pala (Spanish), hyaluronic acid, Indian fig, indianische Feige (German), indicaxanthin, innocent peanuts, iron, isorhamnetin, isorhamnetin-3-O-beta-D-rutinoside, kaempferol, kaempferol 3-methyl ether, kaempferol 7-O-beta-D-glucopyranosyl-(1-->4)-beta-D-glucopyranoside, kaktea minceur (French), kaktuline, L-ascorbic acid, light malban, light nougat, linoleic acid, lipo block, lipoblock, Lipopuntia, Lipostop, L-(-)-malic acid, lomo notte, luteolin, maltase, manganese, mescaline, myricetin, Naranjona, narcissin, neOchelate, neOline, Neomincil, NeOpuntia® (Opuntia ficus-indica fiber), NeOpuntia® 100, NeOpuntia® 500, NeOpuntia® 1500, NeOpuntia® fettbinder (German), NeOpuntia® herb complex, NeOpuntia® kapseln (German), NeOpuntia® y FOS (Spanish), nopa lo, nopal cactus, nopal de castilla (Spanish), nopal flour, Nopalea cochinellifera (Linn.) Salm-Dyck (Cactaceae), Nopalea dejecta, nopales (Spanish), nopalito (Spanish), nopol, o calorie, OB2, opunce (French), opuncja (Polish), OpunDia™, Opuntia, Opuntia basilaris (beavertail cactus), Opuntia chlorotica (pancake prickly pear), Opuntia compressa, Opuntia compressa var. humifusa (eastern prickly pear), Opuntia dillenii, Opuntia ectodermis, Opuntia elator, Opuntia engelmannii (calico cactus, Engelmann prickly pear, Engelmann's pear), Opuntia erinacea (grizzly bear Opuntia, hedgehog prickly pear, porcupine prickly pear), Opuntia ficus-indica (Indian fig Opuntia), Opuntia ficus-indica f. inermis, Opuntia ficus-indica Mill., Opuntia ficus-indica var. saboten, Opuntia ficus-indica var. saboten Makino, Opuntia ficus-indica var. villanueva L., Opuntia fragilis (brittle cactus, little prickly pear), Opuntia humifusa (eastern prickly pear, low prickly pear, smooth prickly pear), Opuntia hyptiacantha, Opuntia imbricata, Opuntia laevis, Opuntia lasciacantha, Opuntia leucotricha (arborescent prickly pear, Aaron's beard cactus, duraznillo blanco, nopal blanco, semaphore cactus), Opuntia lindheimeri (Texas prickly pear), Opuntia littoralis (sprawling prickly pear), Opuntia macrocentra (black spine prickly pear, purple prickly pear), Opuntia macrorhiza (plains prickly pear, tuberous prickly pear), Opuntia maxima, Opuntia megacantha, Opuntia microdasys (bunny ears), Opuntia opuntia, Opuntia phaeacantha (brown-spined prickly pear, New Mexico prickly pear, purple-fruited prickly pear), Opuntiapolyacantha (plains prickly pear), Opuntiapuberula, Opuntiapusilla (creeping cactus), Opuntiarobusta, Opuntia rufida (blind prickly pear), Opuntiasanta-rita (Santa Rita prickly pear), Opuntiaspinosbacca (spiny-fruited prickly pear), Opuntiastreptacantha, Opuntiastricta, Opuntiastricta (coastal prickly pear, spineless prickly pear), Opuntiastrigil (bearded prickly pear), Opuntiavelutina, Opuntiaviolacea (purple prickly pear, Santa Rita prickly pear), Opuntiavulgaris, Opuntiavulgaris P., Opuntiawentiana, opuntin B, opuntin B(I), opuntioid cacti, opuntiol, opuntioside, opuntioside-I, palmatoria sem espinhos (Portuguese), pectin, penca, phase 3, pheophorbide A, phosphorus, p-hydroxybenzoic acid, phytochemicals, pentadieta, polyphenols, polysaccharides, polyunsaturated fatty acids, potassium, prickle pear cactus, prickly pear, prickly pear cactus, prickly-pear, protocole brule-graisse (French), pyropheophorbide-a, quemalip, quercetin, quercetin 3-methyl ether, raquette (French), rhamnose, rutin, selenium, Sicilian cactus pear, Sicilian prickly pear, soupe au chou (French), spineless prickly pear cactus, Start 3 Minceur, tabaido (Portuguese), taurine, taxifolin, termocuts, thermophilic laccase, Tri Action Minceur, trim form, tuna, tuna cardona, tuna de España (Spanish), tuna española (Spanish), tuna mansa (Spanish), tuna real (Spanish), tyrosine, tyrosine(III), Ultra Fett-Blocker (German), vanillic acid, vanillin, vita si-in linea, Vitalslim, Westwood pear, xebec, xoconostle cv. Cuaresmeño (Opuntia matudae), xylose, Zhi Puntia, zinc.
Nopal (also known as prickly pear) has been used as both food and medicine. Nopals are common in North American deserts and are generally sold fresh, canned, or dried for use in the preparation of traditional Mexican dishes. Nopal juice is used in jellies and candies. The fruit is also eaten fresh or used in pies, deserts, shakes, or spreads.
Traditionally, nopal has been used as an anti-inflammatory or a laxative. Nopal may offer benefits to individuals with an alcohol-induced hangover, diabetes, or hyperlipidemia (high cholesterol). However, additional research is needed.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Some studies suggest that nopal may prevent hangover symptoms, including fatigue, headache, dizziness, and a general unpleasant feeling. More evidence is needed before a conclusion can be made.
Scientific studies suggest that nopal may reduce blood glucose levels in people with type 2 diabetes. More research is needed before conclusions can be made.
Some studies have found that nopal may help reduce cholesterol. However, more evidence is needed before conclusions can be made.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Acne, allergies, anti-inflammatory, antioxidant, antispasmodic (reduces spasms), antiviral, arthritis, asthma, astringent, bruises, burns, cancer, chest congestion, cholera, cognitive disorders, colitis, cuts, dental plaque/gingivitis (mouthwash), diarrhea, diuretic, enlarged prostate, earache, exercise recovery, eye problems, gallstones, hair tonic, heart damage (due to lack of oxygen), hemorrhoids, high blood pressure, immune suppression, insect bites, laxative, liver protection, memory enhancement, metabolic syndrome (coronary heart disease), platelet aggregation, rash, scrapes, skin irritation, skin toner, sunburn, ulcers, weight loss, wound healing.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
Nopal has been taken by mouth as capsules, flowers, dried flower liquid extract, pear pulp, stem extract, broiled and blended stems, broiled leaves, and as the products OpunDia™ and NeOpuntia®.
For hangover prevention, 1,600 international units of nopal have been taken by mouth five hours before drinking alcohol.
For diabetes, the following have been taken by mouth: 10.1 grams of nopal stem extract as a single load, following a glucose load; up to 500 grams of broiled and blended nopal stems as a single dose; a single dose of 30 nopal capsules; 10 nopal capsules three times daily for one week; 100 grams of broiled nopal leaves daily for 10 days; and 400 milligrams of OpunDia™ daily for 16 weeks.
For high cholesterol, the following have been taken by mouth: 1.6 grams of NeOpuntia® three times daily with meals for six weeks; 100 grams of broiled nopal leaves daily for 10 days; 250 grams of edible nopal pulp daily for 4 weeks and 8 weeks; and 10 capsules of nopal three times daily for one week.
Children (younger than 18 years)
There is no proven effective dose for nopal in children.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in individuals with a known allergy or hypersensitivity to nopal or any of its parts. Nasal inflammation or asthma has been reported due to allergy.
Side Effects and Warnings
Nopal is likely safe when used in food amounts and is common in Mexican and southwestern American cuisine.
Side effects associated with nopal may include abdominal fullness, asthma, pink eye, headache, increase in stool volume and frequency, itching, joint inflammation, liver adverse effects, mild diarrhea, nausea, rash, rectal perforation, rhinitis (runny or congested nose), shortness of breath, skin redness, spleen adverse effects, swelling of the face and lips, tiredness, voice disorders, and wheezes.
Nopal may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Nopal may cause low blood pressure. Caution is advised in people with low blood pressure or in those taking drugs or herbs and supplements that lower blood pressure.
Nopal may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Use cautiously in people who have thyroid dysfunction, impaired liver function, or immune disorders or in those who are taking agents that suppress the immune system or lower cholesterol.
Avoid in individuals with a known allergy or hypersensitivity to nopal or any of its parts.
The nopal plant should be handled carefully, as it is covered in long, sharp spines that may be painful and difficult to remove once embedded in the skin.
Pregnancy and Breastfeeding
There is currently a lack of scientific evidence on the use of nopal during pregnancy or breastfeeding.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Nopal may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Nopal may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Nopal may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.
Nopal may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Nopal may also interact with agents that may affect the brain or nervous system, agents that may affect cholesterol levels, agents that may affect the immune system, agents that may affect the liver, agents that may lower seizure threshold, agents that may prevent muscle spasms, agents that may affect the heart, antiallergy agents, antibiotics, anticancer agents, antihistamines, anti-inflammatory agents, antiulcer and gastric acid-reducing agents, antiviral agents, chlorpropamide, diuretics, glipizide, highly protein-bound agents, hormonal agents, metformin, ranitidine, thyroid hormones, and weight loss agents.
Interactions with Herbs and Dietary Supplements
Nopal may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Nopal may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Nopal may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
Nopal may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the cytochrome P450 system.
Nopal may also interact with antiallergy herbs and supplements, antibacterials, anticancer herbs and supplements, antihistamines, anti-inflammatory herbs and supplements, antioxidants, antiulcer and gastric acid-reducing agents, antivirals, diuretics, fat-soluble vitamins, herbs and supplements that may affect the liver, herbs and supplements that may affect cholesterol levels, herbs and supplements that may affect the immune system, herbs and supplements that may lower seizure threshold, herbs and supplements that may prevent muscle spasms, herbs and supplements that may affect the heart, herbs and supplements that may affect the brain or nervous system, thyroid agents, vitamin C, vitamin E, and weight loss herbs and supplements.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Alimi, H, Hfaiedh, N, Bouoni, Z, et al. Antioxidant and antiulcerogenic activities of Opuntia ficus indica f. inermis root extract in rats. Phytomedicine. 12-1-2010;17(14):1120-1126. View Abstract
Andrade-Cetto, A and Wiedenfeld, H. Anti-hyperglycemic effect of Opuntia streptacantha Lem. J.Ethnopharmacol. 1-27-2011;133(2):940-943. View Abstract
Banuelos, GS, Fakra, SC, Walse, SS, et al. Selenium accumulation, distribution, and speciation in spineless prickly pear cactus: a drought- and salt-tolerant, selenium-enriched nutraceutical fruit crop for biofortified foods. Plant Physiol 2011;155(1):315-327. View Abstract
Bensadon, S, Hervert-Hernandez, D, Sayago-Ayerdi, SG, et al. By-products of Opuntia ficus-indica as a source of antioxidant dietary fiber. Plant Foods Hum.Nutr. 2010;65(3):210-216. View Abstract
Bisson, JF, Daubie, S, Hidalgo, S, et al. Diuretic and antioxidant effects of Cacti-Nea, a dehydrated water extract from prickly pear fruit, in rats. Phytother.Res. 2010;24(4):587-594. View Abstract
Bouslama, L, Hayashi, K, Lee, JB, et al. Potent virucidal effect of pheophorbide a and pyropheophorbide a on enveloped viruses. J.Nat.Med. 2011;65(1):229-233. View Abstract
Fernandez-Lopez, JA, Almela, L, Obon, JM, et al. Determination of antioxidant constituents in cactus pear fruits. Plant Foods Hum.Nutr. 2010;65(3):253-259. View Abstract
Ginestra G, Parker ML, Bennett RN, et al. Anatomical, chemical, and biochemical characterization of cladodes from prickly pear [Opuntia ficus-indica (L.) Mill.]. J Agric Food Chem. 11-11-2009;57(21):10323-10330.
Godard, MP, Ewing, BA, Pischel, I, et al. Acute blood glucose lowering effects and long-term safety of OpunDia supplementation in pre-diabetic males and females. J.Ethnopharmacol. 8-9-2010;130(3):631-634. View Abstract
Kumar, GN and Srikumar, K. Thermophilic laccase from xerophyte species Opuntia vulgaris. Biomed.Chromatogr. 2011;25(6):707-711. View Abstract
Lim, KT. Inhibitory effect of glycoprotein isolated from Opuntia ficus-indica var. saboten MAKINO on activities of allergy-mediators in compound 48/80-stimulated mast cells. Cell Immunol. 2010;264(1):78-85. View Abstract
Ortiz-Escobar, TB, Valverde-Gonzalez, ME, and Paredes-Lopez, O. Determination of the folate content in cladodes of nopal (Opuntia ficus indica) by microbiological assay utilizing Lactobacillus casei (ATCC 7469) and enzyme-linked immunosorbent assay. J.Agric.Food Chem. 5-26-2010;58(10):6472-6475. View Abstract
Sanchez, E, Garcia, S, and Heredia, N. Extracts of edible and medicinal plants damage membranes of Vibrio cholerae. Appl.Environ.Microbiol. 2010;76(20):6888-6894. View Abstract
Schmitt, L, Fouillot, JP, Nicolet, G, et al. Opuntia ficus indica's effect on heart-rate variability in high-level athletes. Int.J.Sport Nutr.Exerc.Metab 2008;18(2):169-178. View Abstract
Sobieraj, DM and Freyer, CW. Probable hypoglycemic adverse drug reaction associated with prickly pear cactus, glipizide, and metformin in a patient with type 2 diabetes mellitus. Ann.Pharmacother. 2010;44(7-8):1334-1337. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017