May 23 2022

Medicinal uses of nopal (Opuntia ficus indica)


Nopal(<em>Opuntia ficus indica</em>)

The nopal, or rather, nopals, includes several native species from American continent, where they grow spontaneously in all latitudes. From its places of origin, were spread by europeans who colonized the continent into the warm parts of the old continent, and then to everyone.

The most characteristic feature of Opuntia varieties is the cladode, a thorny segment with oval appearance, that is a very fleshy leaf, capable of reproducing the full structure of the cactus, producing new shoots, branches, flowers and fruits.

The second feature element of most varieties of Opuntia are the glochidia, where spines around the areolas are clustered.

Flowers of Opuntia ficus indica are large, very open, with variable colors, from yellow to purple that appear in spring, becoming during the warm season in prickly pear, with recognized gastronomic importance.

Both fruits and cladodes are harvested as a spice (xoconostles), base plate (nopalitos) and fresh or prepared dessert (ice cream).


Fruits of Opuntia are rich in minerals, fiber and vitamins. Sugars contained in the cladodes of Opuntia ficus indica are mainly glucose and galacturonic acid. By high performance liquid chromatography were detected kaempferol and isorhamnetin glycosides. It have been found oxalate crystal in large amount [1].

Analysis of ethanol extract of opuntia dillenii has identified two alpha-pyrones compounds, called opuntioside II and III[2]. These substances have antioxidant properties[3].

Two beta-sitosterols (opuntisterol and opuntisteroside) have also been identified, along with other elements already known (beta-sitosterol, taraxerol, friedelin, metyl linoleate, 7-oxositosterol, 6-beta-hidroxy-stigmast-4-ene-3-one, daucosterol, metyl eucomate and eucómic acid[4][5]. Opuntia ficus indica have considerable amounts of taurine[6].

In the edible part of the plant have been identified biothiols, flavonols compounds, tocopherols and carotenoids, while the edible pulp of the cactus is not formally considered a source of flavanols[7]. Overall, it seems to have been found eight flavonoids, kaempferol, quercetin, kaempferol-methyl-ether, quercetin-methyl-ether, narcisine aromadendrine, taxifolin, eriodictiol, two terpenoids, corchoionoside and betalaines (among others, the indicaxanthin and betanine pigments)[8][9][10]. Evidence shows that the ratio and concentration among different betalainic pigments are responsible for the different colors of the flowers and fruits of Opuntia[11].

The major components of the cladodes are hydrocarbon polymers, mainly mucilage and pectin[12][13].

Opuntia's juice has interesting antioxidant properties, attributable to phenolic derivatives[14]. In the skin, has been found arabinogalactan, galactose polysaccharide compounds and arabinose, with traces of glucose, rhamnose and xylose[15][16]. It have been also isolated alkaloid as opuntin B(I), 4-hydroxyproline(II) and tyrosine(III)[17].

Traditional uses     

Popular medicinal uses include the treatment of catarrhs, asthma and similar processes, migraine and headaches in general. It is also used in traditional medicine since immemorial time for diabetes and high cholesterol, according to a usage from the early inhabitants of the Americas, the Pima people[18][19][20][21].

Nopal is also used in folk medicine to treat burns, edema (swelling of limbs), dyspepsia and indigestion[2]. In Sicily, folk medicine uses the cladodes of Opuntia for the treatment of peptic ulcer[22][23]. In many countries, nopal is used in folk medicine as healing agent[12].

Clinical studies     

Despite the widespread traditional use of this plant for the treatment of diabetic patients, documentation currently available is insufficient to argue for to treat diabetes mellitus or other risk factors[24]. However, it have been recorded observations in medical literature about reduced levels of glucose by nopal based diets[29].

A preliminary trial randomized placebo-controlled, including ten volunteers athletes seems to improve cardiac performance in those who received supplements of the plant, although limitations of this study precludes obtaining generalizable conclusions[25].

The administration of a commercial preparation containing dried leaves of nopal (NeOpuntia) for six weeks to 68 women with metabolic syndrome, produces an increase in HDL cholesterol in the subgroup of age of 45 years and a nonsignificant trend to decreased triglycerides. At the end of the study, 39% of patients treated with NeOpuntia appeared to be free of metabolic syndrome, whereas this occurs only in 8% of patients treated with placebo[26]. This study is methodologically questionable.

There is no clinical evidence to consider effective the preventive treatment with nopal for hangover caused by alcohol consumption[27]. However, a small study with only 64 healthy volunteers, seems to contradict the data of this rigorous systematic review, showing a moderate decrease in symptoms of a hangover in the group of patients receiving nopal[28].

A study concluded that supplementing the diet with fruits of cactus seems to decrease oxidative stress in healthy individuals, in a similar way as carried out by vitamin C[30]. Other observations point in the same direction. So a study containing few patients on familial hypercholesterolemia concludes that nopal can to counteract oxidative tissue damage due to lipids, reporting an apparent cardiovascular benefit[21].

It has been published a paper on a small group of healthy volunteers (n = 8) and patients with familial hypercholesterolemia (n = 8). The study found that eating the fruit of prickly pear reduced platelet proteins such as factor 4 and beta-thromboglobulin, platelet aggregation induced by ADP and platelet sensitivity versus prostaglandins in the group of volunteers and in patients with hypercholesterolemia. Both WU-test as 11-DH-TXB2 showed significant differences in both groups. Researchers postulate that the cactus fruit could produce its beneficial effect on cardiovascular system by reducing platelet aggregation[19].

A pilot study on 24 non-obese males showed a reduction in total cholesterol, LDL cholesterol, apolipoprotein B, triglycerides, fibrinogen, glucose, insulin and uric acid in the blood, remaining unmodified other parameters. The authors consider that the hypolipidemic action could be explained, at least in part by the pectin content, although this would not be the reason for its effect on glucose and insulin[31].

Adverse reactions     

The most frequent adverse reactions caused by nopal are digestive complications by inadequate intake of fruit. Have been reported a variety of these, including impaction of feces, colonic obstruction, which in some cases have required a surgical intervention, and severe cases of rectal perforation secondary to obstruction[32][33][34].

There have also been published cases of contact dermatitis and general hypersensitivity reactions caused by the fruit of Opuntia[35][36].

Estudios experimentales     

The results of animal experiments or in vitro with Opuntia have revealed a variety of pharmacological activities, some of which may deserve further studies.

T cell activation with immunosuppressive effect[37]. Some polysaccharides from Opuntia would optimize the membrane of red blood cells, which may help improve the antitumor defense of the organism[38].

The juice of different varieties of Opuntia has shown a antitumor effect in vitro against malignant cell lines from prostate and colon[39].

In experimental animals, nopal has shown a neuroprotective effect against injury induced by ischemia and reperfusion brain[40][41]. Another study suggests that chronic administration of Opuntia ficus indica could stimulate long term memory[42]. Favorable results on the nervous system may be due to inhibition of NO by activated microglial cells[43]. Isoflavonoids quercetin dihydroquercetin and quercetin methyl ether show neuroprotective effects, the latter being the most potent[44].

A very recent study suggests that a glycoprotein isolated from the plant could block certain mediators of allergic reaction[45]. This glycoprotein also would produces a decreased level of blood lipids, including total cholesterol, triglycerides and LDL cholesterol[46].

Cladodes extract seems to have antigenotoxic activity against chromosomal aberrations produced by zearalenone (an estrogen-like substance) in laboratory mice[47].This same extract appears to protect against toxicity and oxidative damage induced by nickel[48][49]. It has been also reported an antitoxic effect against chlorpyrifos, an organophosphate pesticide[50].

Opuntia polycanta also has immunomodulatory effects attributed to polysaccharides containing[51]. These substances have a protective effect on growth cartilage[52].

Betanin, a betacyanin pigment present in the plant, induces apoptosis or cell death in of human chronic myelogenous leukemia line K562 cells[53].

Mucilage content in cladodes seems to have a protective effect on the gastric mucosa, according to experimental observations[13]. It would also have a restorative effect of injuries sustained chronically by ethanol[54]. Other studies also show the antiulcer effect of nopal[14][22]. The administration of Opuntia cladodes would result in a cytoprotective effect, stimulating gastric mucus production[12]. Other data suggest that the plant would have an inhibitory effect on the lesions without a direct antiulcer effect[55].

The methanol extract of cladodes showed a significant effect on wound healing[56]. In another experiment, topical application for 6 days of polysaccharides from Opuntia induced a beneficial effect on skin repair, accelerating reepithelialization of skin lesions[23].

The anti inflammatory effect of nopal has been shown in experimental models[57]. This action seems to depend from beta sitosterol content of the plant.

A dehydrated extract from prickly pear fruit has shown a diuretic effect in experimental models comparable to hydrochlorothiazide[58][59]. According to the authors, both infusion of fruits and cladodes increase the excretion of water, sodium and potassium. Unlike traditional diuretics, this plant decreases the blood uric acid.

This cactus also has a protective effect on the liver by protecting the lab rat of the effect produced by carbon tetrachloride. The researchers believe that the main hepatoprotective effect is related to flavonoid fraction of the plant[60].

Both the methanol extract of Opuntia dillenii as alpha-pyrone glycoside opuntioside-I show a marked antihypertensive effect in normotensive rats. However, administration of high doses of glucoside produces gross lesions in the liver and spleen[61].

Other observations seem to support the anti-inflammatory effect of alfa pyrones opuntiosides II and III of Opuntia dillenii[2].

It has been described an inhibitory effect on monoamine oxidase in vitro by varieties from methyl malate and methylcitrate[62]. Have been identified three substances that are involved in anti-inflammatory effect, as two derivatives of isorhamnetin and another from kaempferol[63].

Experimentally it has been verified that nopal reduces significantly (22%) glucose concentration in blood of experimental animals, with an elevation of liver glycogen. Also there has been observed a decrease in total cholesterol and LDL[64][65]. The effect on lipids would be more apparent in hyperlipemic rats[66].

Betalains give to the plant its antioxidant effect[67][68][69].

Administration of a diet based on nopal seed powder reduced the weight of laboratory animals, probably because of a decrease in free thyroxine. In animals treated with opuntia was also observed a decrease in blood glucose concentration, increased glycogen in liver and skeletal muscles, and a reduction in total cholesterol and LDL[70].


Clinical data available does not allow to establish beyond any doubt the potential benefits of using this plant. Medizzine recommends a prudent use of nopal by the risk of severe intestinal obstruction that may occur.


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66: Li CY, Cheng XS, Cui MZ, Yan YG. Regulative effect of Opuntia powder on blood lipids in rats and its mechanism. Zhongguo Zhong Yao Za Zhi. 2005 May;30(9):694-6.
67: Gentile C, Tesoriere L, Allegra M, Livrea MA, D'Alessio P. Antioxidant betalains from cactus pear (Opuntia ficus-indica) inhibit endothelial ICAM-1 expression. Ann N Y Acad Sci. 2004 Dec;1028:481-6.
68: Butera D, Tesoriere L, Di Gaudio F, Bongiorno A, Allegra M, Pintaudi AM, Kohen R, Livrea MA. Antioxidant activities of sicilian prickly pear (Opuntia ficus indica) fruit extracts and reducing properties of its betalains: betanin and indicaxanthin. J Agric Food Chem. 2002 Nov 6;50(23):6895-901.
69: Lee JC, Kim HR, Kim J, Jang YS. Antioxidant property of an ethanol extract of the stem of Opuntia ficus-indica var. saboten. J Agric Food Chem. 2002 Oct 23;50(22):6490-6.
70: Ennouri M, Fetoui H, Bourret E, Zeghal N, Guermazi F, Attia H. Evaluation of some biological parameters of Opuntia ficus indica. 2. Influence of seed supplemented diet on rats. Bioresour Technol. 2006 Nov;97(16):2136-40.

Date Update page: June 9, 2010.


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