Licorice and Acarbose: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Acarbose
Licorice
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Acarbose (Precose) helps keep your blood sugar down after meals. Licorice (the real herb, found in some candies, teas, and supplements) can work against it. In theory, regular use of even moderate amounts of licorice can lower your body's potassium, and low potassium can push blood sugar up. That could make acarbose feel like it is not working as well.
The good news is this is only a theoretical concern, based mostly on one case report, and it is easy to keep an eye on. Please don't stop either one on your own. Just let your pharmacist or doctor know if you use licorice regularly, and they can help you manage it.
Effect: Theoretical reduction in antidiabetic effectiveness (possible hyperglycemia) when licorice is combined with acarbose.
Mechanism: Licorice (glycyrrhizin) has mineralocorticoid-like activity causing hypokalemia; hypokalemia can worsen glucose intolerance. Neither agent is metabolically activated, so this is a pharmacodynamic, not PK, interaction.
- Direction: May blunt glycemic control (reduces antidiabetic effect).
- Onset: Unspecified; associated with regular/chronic licorice intake.
- Evidence: Theoretical, single case report of hypokalemia-induced hyperglycemia and myopathy.
- Management: Reasonable glucose monitoring; consider checking serum potassium with regular licorice use. Dose may be individualized by the care team.
What happens
Reduced antidiabetic agent effectiveness
Interaction Deep Dive
In theory, licorice could diminish the action of antidiabetic drugs by inducing hyperglycemia. One case report described hypokalemia brought on by licorice that resulted in both hyperglycemia and myopathy1. Caution is advised.
Why it happens (mechanism)
Licorice-induced hypokalemia may aggravate glucose intolerance
How to manage this interaction
Keep taking your acarbose exactly as prescribed. This is a precaution based on limited evidence, and your care team can manage it easily.
- Tell your pharmacist or doctor if you regularly eat licorice candy, drink licorice tea, or take licorice supplements.
- They may monitor your blood glucose more closely, and could check your potassium level, since regular licorice can lower it.
- Your diabetes plan may be adjusted and individualized by your care team if needed.
- Occasional small amounts of licorice are less of a concern than regular, moderate-to-heavy use.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Licorice and Acarbose together?
Regular use of real licorice may lower your potassium and slightly raise blood sugar, which could work against acarbose. Keep taking your medication, mention any regular licorice use, and your care team can monitor and adjust as needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Licorice and Acarbose interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Licorice and Acarbose interaction managed?
Keep taking your acarbose exactly as prescribed. This is a precaution based on limited evidence, and your care team can manage it easily. Tell your pharmacist or doctor if you regularly eat licorice candy, drink licorice tea, or take licorice supplements. They may monitor your blood glucose more closely, and could check your potassium level, since regular licorice can lower it. Your diabetes plan… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Licorice or Acarbose need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Newall CA, Anderson LA, & Phillipson JDNewall CA, Anderson LA, & Phillipson JD: Herbal Medicines: A Guide for Healthcare Professionals, The Pharmaceutical Press, London, England, 1996.
Keep reading about Acarbose
Keep reading about Licorice
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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