F

Prickly Pear Opuntia ficus-indica (L.) Mill.,

O. streptacantha Lem.,
and related species

Family: Cactaceae
Other common names: Indian fig; nopal; paddle cactus; tuna
Botanical drug used: Cladode

Indications/uses: The ‘nopalitos’, the thick, chlorophyll-rich stems (cladodes),

are used widely in Mexico as a food and in the management of diabetes. In recent
years, its use has become popular in Europe, including the United Kingdom,
and in North America. In 2012, a ‘fibre complex’ containing O. ficus-indica was
registered as a ‘medical device’ for use in weight loss, and the extract is also
promoted in sports medicine to aid muscle recovery.
Evidence: The evidence is conflicting. Early studies in Mexico suggested good
clinical effects but more recent studies have given more variable results.
Safety: Despite the long use as a food, limited evidence is available. Concerns
have recently been raised due to a range of adverse reaction reports with the
product registered as a medical device in the United Kingdom.

Main chemical compounds: The genus is rich in fibre and also in polysaccha-
rides, especially the younger cladodes. A mucilage constituting up to 14% of the
cladode dry weight is produced, especially by younger cladodes and also by the
fruits, and consists of chains of (14)-linked β-D-galacturonic acid and R(1-2)-linked
L-rhamnose residues (Stinzing and Carle 2005).
Clinical evidence:
Overall, some - so far still limited - evidence points to the potential of a chemi-
cally well characterised extract in the management of pre-diabetic conditions and
in glucose management.
Antidiabetic effects: Initial studies in Mexico showed encouraging hypogly-
caemic effects in human diabetic and normal subjects (Frati-Munari et al. 1991;
Frati-Munari et al. 1988). More recently, a small (verum – n = 15, placebo – n = 14)
double-blind, placebo-controlled study used 200 mg of a chemically characterised

Phytopharmacy: An evidence-based guide to herbal medicinal products, First Edition.

Sarah E. Edwards, Inês da Costa Rocha, Elizabeth M. Williamson and Michael Heinrich.
© 2015 John Wiley & Sons, Ltd. Published 2015 by John Wiley & Sons, Ltd.
 Prickly Pear 303

extract over a 16-week period. An oral glucose tolerance test (OGTT) was also
included, with a 400 mg dose of an O. ficus-indica preparation given 30 min before
orally ingesting a 75 g glucose drink. The authors demonstrated acute blood-
glucose-lowering effects and the long-term safety of the proprietary product used
(Godard et al. 2010).
Stimulation of glycogen synthesis: An O. ficus-indica extract, together with
carbohydrates, stimulated post-exercise muscle glycogen resynthesis (Pischel et al.
2012).
Pre-clinical evidence and mechanisms of action:
Much of the earlier research was done with related species (often O. streptacantha
Lem.) or poorly defined material.
Antidiabetic effects: There is considerable evidence for its hypoglycaemic effects
(e.g. Andrade-Cetto and Heinrich 2005; Butterweck et al. 2011).
Anti-inflammatory and cytoprotective effects: Anti-inflammatory and chon-
droprotective effect (Panico et al. 2007), prevention of chemically induced liver
damage (Ncibi et al. 2008), cytoprotective effects on gastric mucosa (rat, Galati
et al. 2007) and antioxidant activity (Lee et al. 2002) have also been described.
Interactions: No relevant data are available.
Adverse effects: A number of adverse drug reactions have been reported for prod-
ucts sold in the United Kingdom (MHRA 2013) and since currently there is no clear
picture in terms of the pharmaceutical quality of the material used and of its com-
position, the use of O. ficus-indica products cannot be recommended. Food uses of
the fruit and cladodes seem generally to be considered safe (Lopez 1995).
Dosage: Based on the study by Godard et al. (2010) a daily dose 200 mg/day is
recommended, but further dose determining studies are urgently needed.
General plant information: This cactus is the source of the cactus pear fruit, which
is widely cultivated. It is rich in betalaines (Stintzing and Carle 2004) and has been
used for centuries in Mexico both medicinally and as a vegetable (Andrade-Cetto
and Heinrich 2005). This and other species have now become noxious weeds in
many drier, hot regions outside of its native habitat (e.g. Australia). The genus is
also the host plant for the cochineal beetle, used to produce the intense red colour
dye carmine (the aluminium salt of carminic acid).

References
Andrade-Cetto A, Heinrich M. (2005) Mexican plants with hypoglycaemic effect used in the
treatment of diabetes. Journal of Ethnopharmacology 99(3): 325–348.
Butterweck V, Semlin L, Feistel B, Pischel I, Bauer K, Verspohl EJ. (2011) Comparative eval-
uation of two different Opuntia ficus-indica extracts for blood sugar lowering effects in rats.
Phytotherapy Research 25(3): 370–5.
Frati-Munari AC, Gordillo BE, Altamirano P, Ariza CR. (1988) Hypoglycemic effect of Opun-
tia streptacantha Lemaire in NIDDM. Diabetes Care 11(1): 63–66.
Frati-Munari AC, Gordillo BE, Altamirano P, Ariza CR, Cortés-Franco R, Chávez-Negrete
A, Islas-Andrade S. (1991) Influence of nopal intake upon fasting glycemia in type II dia-
betics and healthy subjects. Archivo Investigaciones Medicas (Mex). 22(1): 51–56.
Galati EM, Monforte MT, Miceli N, Mondello MR, Taviano MF, Galluzzo M, Tripodo MM.
(2007) Opuntia ficus indica (L.) Mill. mucilages show cytoprotective effect on gastric mucosa
in rat. Phytotherapy Research 21(4): 344–346.
304 Phytopharmacy

Ginestra G, Parker ML, Bennett RN, Robertson J, Mandalari G, Narbad A, Lo Curto RB,
Bisignano G, Faulds CB, Waldron KW. (2009) Anatomical, chemical, and biochemical
characterization of cladodes from prickly pear [Opuntia ficus-indica (L.) Mill.]. Journal of
Agricultural and Food Chemistry 57(21): 10323–10330.
Godard MP, Ewing BA, Pischel I, Ziegler A, Benedek B, Feistel B. (2010) Acute blood glucose
lowering effects and long-term safety of OpunDia supplementation in pre-diabetic males
and females. Journal of Ethnopharmacology 130(3): 631–634.
Lee JC, Kim HR, Kim J, Jang YS. (2002) Antioxidant property of an ethanol extract of the
stem of Opuntia ficus-indica var. saboten. Journal of Agricultural and Food Chemistry 50(22):
6490–6496.
Lopez, AD. (1995) Review: Use of the fruits and stems of the prickly pear cactus (Opuntia
spp.) into human food. Food Science and Technology International 1(2–3): 65–74.
MHRA. (2013) Drug Analysis Print: Opuntia ficus-indica. http://www.mhra.gov.uk/home
/groups/public/documents/sentineldocuments/dap_4869624197041.pdf.
Ncibi S, Ben Othman M, Akacha A, Krifi MN, Zourgui L. (2008) Opuntia ficus indica extract
protects against chlorpyrifos-induced damage on mice liver. Food and Chemical Toxicology
46(2): 797–802.
Panico AM, Cardile V, Garufi F, Puglia C, Bonina F, Ronsisvalle S. (2007) Effect
of hyaluronic acid and polysaccharides from Opuntia ficus indica (L.) cladodes on
the metabolism of human chondrocyte cultures. Journal of Ethnopharmacology 111(2):
315–321.
Pischel I, van Proeyen, K, Hespel P. (2012) Dose finding of OpunDia™ (O. ficus-indica extract)
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