Drug & supplement interaction

Apple Cider Vinegar + Insulin (Bovine)

Insulin (Bovine) brand name: Hypurin Bovine Neutral.

Moderate Interaction
The bottom line Moderate

Insulin (Bovine) falls into 2 drug categories that Apple Cider Vinegar can interact with; the most serious is rated moderate. Theoretically, concomitant use of apple cider vinegar with insulin might increase the risk of hypokalemia.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Apple Cider Vinegar and Insulin (Bovine)

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Apple Cider Vinegar interacts with whole categories of medication. Insulin (Bovine) falls into 2 of those categories, so it can interact with Apple Cider Vinegar in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

INSULIN

1 of 2
Theoretically, concomitant use of apple cider vinegar with insulin might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. Theoretically, overuse of apple cider vinegar concomitantly with insulin might increase the risk of hypokalemia.
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 concern when you pair apple cider vinegar with your insulin (Hypurin Bovine Neutral). Insulin already pushes potassium out of your bloodstream and into your cells, which lowers blood potassium. There's a report of someone who used large amounts of apple cider vinegar over a long time also ending up with low potassium (called hypokalemia). So in theory, regularly overdoing ACV on top of insulin could add up and drop your potassium more than expected. Signs to watch for include muscle weakness, cramps, an irregular or pounding heartbeat, and feeling unusually tired.

I want to be honest: this is based on weak, anecdotal evidence, and a splash of vinegar in your food is very unlikely to cause trouble. The worry is large, daily, concentrated doses. If you take ACV regularly, mention it to your pharmacist or doctor so they can keep an eye on your potassium.

References
  1. Lhotta K, Hofle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia, and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80:242-3. PubMed
Minor

ANTIDIABETES DRUGS

2 of 2

Why this applies to Insulin (Bovine)

Insulin (Bovine) falls under ANTIDIABETES DRUGS — the group Apple Cider Vinegar interacts with.

Theoretically, taking apple cider vinegar with antidiabetes drugs might increase the risk of hypoglycemia.
Apple cider vinegar might reduce fasting and postprandial blood glucose levels and decrease gastric emptying in people with diabetes. However, not all research agrees. Theoretically, it might have additive effects on glucose levels when used with antidiabetes drugs.
Severity Minor Likelihood Possible Evidence B

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 simple version. Bovine insulin (Hypurin Bovine Neutral) already does one main job: it lowers your blood sugar. Apple cider vinegar may nudge blood sugar down a little too, partly by slowing how fast your stomach empties after a meal. Put the two together and, in theory, those effects could stack up and push your sugar lower than you intended.

If your blood sugar dips too low, you might feel shaky, sweaty, dizzy, confused, or unusually hungry. The good news is that this interaction is rated minor, the evidence is fairly weak, and a splash of vinegar on a salad is unlikely to matter. Daily concentrated vinegar doses are more worth a conversation. Don't change your insulin on your own, but do mention any ACV use to your doctor or pharmacist and keep checking your readings.

References
  1. Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol 2007;7:46. PubMed
  2. Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 2004;27:281-2. PubMed
  3. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complement Med Ther 2021;21(1):179. PubMed
  4. Feise NK, Johnston CS. Commercial vinegar tablets do not display the same physiological benefits for managing postprandial glucose concentrations as liquid vinegar. J Nutr Metab 2020;2020:9098739. PubMed
  5. Gheflati A, Bashiri R, Ghadiri-Anari A, Reza JZ, Kord MT, Nadjarzadeh A. The effect of apple vinegar consumption on glycemic indices, blood pressure, oxidative stress, and homocysteine in patients with type 2 diabetes and dyslipidemia: A randomized contro

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

Apple Cider Vinegar Also Interacts With Other Medications

Apple Cider Vinegar has 88 moderate, 73 minor known drug interactions in our database — the Insulin (Bovine) one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Apple Cider Vinegar

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

From our Q&A

Questions About Apple Cider Vinegar or Insulin (Bovine)

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Apple Cider Vinegar or Insulin (Bovine), not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Insulin (Bovine)

This page covers Apple Cider Vinegar only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Insulin (Bovine) page lists 242 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 2 major · 211 moderate · 29 minor.

From our pharmacist’s overview on the Insulin (Bovine) page

“Bovine insulin (Hypurin Bovine Neutral) lowers blood sugar, and the dose is calibrated to do exactly that, no more. That is why the 242 supplements on this page deserve real attention before adding one.”

Reviewed by 2 · Jul 18, 2026

Open the Insulin (Bovine) interaction page

One more smart check

Taking Apple Cider Vinegar as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,329 real supplement products containing Apple Cider Vinegar, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Apple Cider Vinegar. Your product may carry other ingredients that interact with Insulin (Bovine) too, on top of Apple Cider Vinegar — 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 Apple Cider Vinegar and Insulin (Bovine) 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 Apple Cider Vinegar
Top 10%

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

29 days ago today
Medication Insulin (Bovine)
Steady interest

#1,820 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 Apple Cider Vinegar

What is Apple Cider Vinegar?

Apple Cider Vinegar
  • Blood sugar support
  • Weight management
  • Digestive upset
  • Appetite control
  • Skin and hair care

Apple cider vinegar is a fermented apple product that many people use hoping to help with blood sugar, weight, or digestion. The evidence for most of these uses is limited and mixed, and the modest effects seen in small studies are not a substitute for proven treatments. When diluted and used in small amounts it is generally safe for most people, but undiluted vinegar can harm teeth and the throat.

Read the full Apple Cider Vinegar monograph & all interactions
Keep checking

Other Drugs & Apple Cider Vinegar

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

0Major
88Moderate
73Minor
2,668No known interaction
Moderate

88 interactions

Showing 60 of 88 moderate interactions — see all 88 on the Apple Cider Vinegar page.

Minor

73 interactions

Showing 60 of 73 minor interactions — see all 73 on the Apple Cider Vinegar page.

No interaction 2,668 drugs checked — show the list
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
Pharmacist Counseling Corner

Taking Apple Cider Vinegar and Insulin (Bovine) Together: Common Questions

Can you take Apple Cider Vinegar with Insulin (Bovine)?
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.
Why are there 2 interactions listed for Apple Cider Vinegar and Insulin (Bovine)?
Insulin (Bovine) belongs to more than one drug category, and Apple Cider Vinegar interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Apple Cider Vinegar and Insulin (Bovine) 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 (Bovine) and Apple Cider Vinegar?

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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.