Drug & supplement interaction

Apple Cider Vinegar + Insulin Glargine

Insulin Glargine brand names: Basaglar, Lusduna, Semglee.

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

Insulin Glargine 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 Glargine

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 Glargine 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 gist when you pair apple cider vinegar with your insulin glargine (Basaglar, Semglee, and similar long-acting insulins). Insulin already nudges potassium out of your bloodstream and into your cells, which lowers blood potassium a little. There's a report of someone who used a lot of apple cider vinegar over time and ended up with low potassium, too. So in theory, regular heavy ACV use stacked on top of insulin could push potassium lower than ideal.

I'll be honest: this is based on a single case and reasoning, not strong studies, so I wouldn't lose sleep over a splash on your salad. The bigger picture is just being mindful of low blood sugar, which is the main thing insulin and ACV can both lean toward. Watch for shakiness, sweating, or muscle weakness or cramps, and check in with your pharmacist or doctor before using concentrated ACV daily.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Glargine

Insulin Glargine 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: insulin glargine (Basaglar, Semglee) is your long-acting, background insulin that gently lowers blood sugar all day. Apple cider vinegar may nudge blood sugar down a little too, partly by slowing how fast your stomach empties. So in theory, pairing the two could add up and push your sugar lower than expected, which means a slightly higher chance of a low blood sugar (hypoglycemia) episode. Think shakiness, sweating, dizziness, or feeling foggy.

That said, this is rated minor, and the evidence is mixed and mostly theoretical. A splash of ACV on a salad is unlikely to matter. If you take concentrated ACV regularly, just keep checking your sugars and chat with your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Glargine one above is among them. If you take anything else, check it against the full list below.

Moderate 88 Minor 73 No known interaction 2,669 (incl. Insulin Glargine)
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 Glargine

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 Glargine, 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 Glargine

This page covers Apple Cider Vinegar only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Insulin Glargine 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.

Open the Insulin Glargine 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 Glargine 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 Glargine 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%

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

29 days ago today
Medication Insulin Glargine
Top half

#1,137 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
Medication

About Insulin Glargine (rDNA origin) Injection

What Is Insulin Glargine (rDNA origin) Injection Used For?

Brand names: Basaglar, Lusduna, Semglee

Insulin glargine is used to improve glycemic control (blood sugar management) in adults and pediatric patients with type 1 diabetes mellitus, and in adults with type 2 diabetes mellitus. It is a long-acting basal insulin, meaning it works gradually over the course of the day to keep blood sugar steady.

Insulin glargine is not recommended for treating diabetic ketoacidosis (a serious complication where the blood becomes dangerously acidic).

See full Insulin Glargine (rDNA origin) Injection drug information
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
88 Moderate 73 Minor 2,668 No 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

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

Showing the 60 most looked-up of 2,668 medications checked with no known interaction — see the full Apple Cider Vinegar list.

See the full Apple Cider Vinegar interactions page
See every supplement checked against Insulin Glargine, 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
Apple Cider Vinegar monograph › Uses, safety, and every drug interaction in one place Insulin Glargine supplement interactions › Every supplement checked against Insulin Glargine, ranked by severity Insulin Glargine (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 Apple Cider Vinegar and Insulin Glargine Together: Common Questions

Can you take Apple Cider Vinegar with Insulin Glargine?
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 Glargine?
Insulin Glargine 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 Glargine 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 Glargine 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.