Is Prickly Pear Cactus Effective for Hangover?

Gayle Nicholas Scott, PharmD

Disclosures

March 11, 2014

Treating Hangover

Like research into the pathologic mechanisms of hangover, research on treatment and prevention of hangover is extremely limited. A systematic review of hangover treatments identified only 15 publications, and only one half of these met standards for obtaining credible results.[17] No drug is approved by the US Food and Drug Administration for treatment of hangover.

Prickly pear cactus (Opuntia ficus indica, nopal) holds the distinction of being one of the few hangover remedies to undergo clinical testing. In a manufacturer-sponsored, double-blind, placebo-controlled, crossover trial, 64 healthy young adults received either prickly pear cactus extract 1600 IU (Tex-OE™) or placebo 5 hours before consumption of up to 1.75 g of alcohol per kg body weight in a party-like atmosphere. Prickly pear cactus extract did not reduce overall hangover symptoms (P = .07), but it did reduce the risk for severe hangover by 50%. The groups receiving the extract reported nausea, anorexia, and dry mouth less frequently, but symptoms of headache, soreness, weakness, shakiness, diarrhea, and dizziness were similar to the placebo group. In the subgroups who consumed alcoholic beverages with high congener content, the extract was more effective than in those who consumed alcoholic beverages with low congener content.[18]

The researchers also studied the effect of alcohol and prickly pear cactus extract on blood levels of CRP and cortisol. In the group receiving placebo, alcohol raised CRP levels by 50% and doubled cortisol levels. Prickly pear cactus extract reduced CRP levels to those seen before alcohol consumption, but cortisol levels further increased. CRP and cortisol levels correlated with hangover severity: High CRP levels and low cortisol levels correlated with more severe hangover.[18] These results further support the theory that hangover is caused at least in part by inflammatory responses. Unfortunately, no further research on prickly pear cactus has been published to corroborate these results.

Prickly pear cactus appears as an ingredient in hangover remedies (eg, PreToxx™, HPF Hangover Prevention Formula™) as well as in single-ingredient products. The study described above used a proprietary extract with a dosage in units; hence, the relationship between units and milligrams is unclear. HPF Hangover Prevention Formula contains 800 IU Tex-OE as well as B vitamins; two 800-IU capsules cost approximately $12.

Like the prickly pear cactus extract used in the study, prickly pear cactus hangover products recommend dosing before alcohol consumption. Prickly pear cactus may lower blood glucose and should be used with caution in patients with diabetes.[19]

Evidence supporting the efficacy of any product when hangover occurs is absent. Such approaches as using past experience to gauge the point at which alcohol consumption should stop and avoiding alcoholic beverages with high congener content are probably more effective, as well as less expensive, than products claiming to prevent or treat hangover.

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