Drug & supplement interaction

Annatto + Insulin Degludec

Insulin Degludec brand name: Tresiba.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Annatto has a moderate interaction with Insulin Degludec. Animal studies suggest that certain annatto extracts may have hypoglycemic or hyperglycemic effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Annatto and Insulin Degludec

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIDIABETES DRUGS

Why this applies to Insulin Degludec

Insulin Degludec falls under ANTIDIABETES DRUGS — the group Annatto interacts with.

Animal studies suggest that certain annatto extracts may have hypoglycemic or hyperglycemic effects. Theoretically, taking annatto with antidiabetes drugs could reduce the therapeutic effects of these drugs or increase the risk for additive hypoglycemia. Monitor blood glucose levels closely.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the honest picture with annatto and your Tresiba (insulin degludec). Tresiba is your long-acting background insulin, and annatto is mostly a food coloring made from achiote seeds. The concern on file is purely theoretical, drawn from animal studies, not real human data. In those studies, annatto extracts pulled blood sugar in either direction, so the worry is that it could either nudge your sugar lower (adding to insulin's effect and raising the chance of a low, with shakiness, sweating, or confusion) or work against your insulin and let sugar creep up.

The small amount of annatto in food (cheese, snacks, butter) is very unlikely to matter. A concentrated supplement is the bigger unknown. If you decide to use it, keep checking your glucose and loop in your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Fernandes, A. C., Almeida, C. A., Albano, F., Laranja, G. A., Felzenszwalb, I., Lage, C. L., de Sa, C. C., Moura, A. S., and Kovary, K. Norbixin ingestion did not induce any detectable DNA breakage in liver and kidney but caused a considerable impairment
  3. Russell, K. R., Morrison, E. Y., and Ragoobirsingh, D. The effect of annatto on insulin binding properties in the dog. Phytother Res 2005;19(5):433-436. PubMed
  4. Morrison, E. Y., Thompson, H., Pascoe, K., West, M., and Fletcher, C. Extraction of an hyperglycaemic principle from the annatto (Bixa orellana), a medicinal plant in the West Indies. Trop.Geogr.Med 1991;43(1-2):184-188.
  5. Russell, K. R., Omoruyi, F. O., Pascoe, K. O., and Morrison, E. Y. Hypoglycaemic activity of Bixa orellana extract in the dog. Methods Find.Exp.Clin.Pharmacol. 2008;30(4):301-305.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Annatto Also Interacts With Other Medications

Annatto has 85 moderate known drug interactions in our database — the Insulin Degludec one above is one of them. If you take anything else, check it against the full list below.

Moderate 85 No known interaction 2,745 (incl. Insulin Degludec)
Taking anything else?

Check Another of Your Medications Against Annatto

Covers the 2,830 medications we’ve checked against Annatto. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Insulin Degludec

This page covers Annatto only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Insulin Degludec page lists 239 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Siberian Cocklebur (major), Acai (moderate), African Wild Potato (moderate), Agaricus Mushroom (moderate) and Agmatine (moderate).

By severity: 1 major · 208 moderate · 30 minor.

From our pharmacist’s overview on the Insulin Degludec page

“Insulin degludec (Tresiba) is a long-acting insulin meant to hold blood sugar steady around the clock, which means anything else that pushes glucose down can push it too far. That is the story for nearly all 239 ingredients on this page, and the list warrants genuine caution.”

Reviewed by 2 · Jul 18, 2026

Open the Insulin Degludec interaction page

One more smart check

Taking Annatto as Part of a Dietary Supplement Product? Check It for Interactions

We hold 304 real supplement products containing Annatto, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Annatto. Your product may carry other ingredients that interact with Insulin Degludec too, on top of Annatto — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Annatto and Insulin Degludec Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Annatto
Steady interest

#930 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Insulin Degludec
Steady interest

#1,858 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Annatto

What is Annatto?

Annatto
  • Natural food and cosmetic coloring
  • Source of antioxidants
  • Antimicrobial/anti-infective (traditional use)
  • Athletic performance and muscle soreness
  • Skin and bad-breath remedies (traditional use)

Annatto is a plant-based coloring made from the seeds of the achiote tree and is widely used as a safe food dye. While it has a long history in traditional medicine and contains antioxidant compounds, there is little high-quality human research supporting its use as a supplement. It can trigger allergic reactions in some people, so use caution and talk with your pharmacist or doctor.

Read the full Annatto monograph & all interactions
Medication

About Insulin Degludec (rDNA Origin) Injection

What Is Insulin Degludec (rDNA Origin) Injection Used For?

Brand name: Tresiba

Insulin degludec (brand name Tresiba) is used to improve blood sugar (glucose) control in adults and children 1 year of age and older who have diabetes mellitus — including both type 1 and type 2 diabetes.

It is not recommended for treating diabetic ketoacidosis (a dangerous complication of diabetes that requires a different type of treatment). In people with type 1 diabetes, insulin degludec must always be used together with a short-acting insulin.

See full Insulin Degludec (rDNA Origin) Injection drug information
Keep checking

Other Drugs & Annatto

Browse every other medication we’ve checked against Annatto — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
85Moderate
0Minor
2,744No known interaction
85 Moderate 2,744 No interaction
Moderate

85 interactions

Showing 60 of 85 moderate interactions — see all 85 on the Annatto page.

No interaction 2,744 drugs checked — show the list

We also checked Annatto against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,744 medications checked with no known interaction — see the full Annatto list.

See the full Annatto interactions page
See every supplement checked against Insulin Degludec, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Annatto monograph › Uses, safety, and every drug interaction in one place Insulin Degludec supplement interactions › Every supplement checked against Insulin Degludec, ranked by severity Insulin Degludec (rDNA Origin) Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Annatto and Insulin Degludec Together: Common Questions

Can you take Annatto with Insulin Degludec?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Annatto and Insulin Degludec interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Insulin Degludec and Annatto?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.