Drug & supplement interaction

Artichoke + pioglitazone, metformin

pioglitazone, metformin brand name: ActoPlus Met.

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

Artichoke has a moderate interaction with pioglitazone, metformin. Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.

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

Artichoke and pioglitazone, metformin

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

Moderate

ANTIDIABETES DRUGS

Why this applies to pioglitazone, metformin

pioglitazone, metformin falls under ANTIDIABETES DRUGS — the group Artichoke interacts with.

Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
A meta-analysis of small clinical studies shows that taking artichoke leaf extract for 8-12 weeks can modestly reduce fasting plasma glucose when compared with placebo.
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 simple version: ActoPlus Met combines two diabetes medicines (pioglitazone and metformin) that already work to bring your blood sugar down. Artichoke leaf extract may also nudge your blood sugar a little lower on its own. So if you take both together, the worry is that they could stack up and push your sugar too low.

Low blood sugar can show up as shakiness, sweating, dizziness, a fast heartbeat, or feeling confused. I want to be honest, though: this is a theoretical concern based on how these things work, not something proven to happen often. Food amounts of artichoke aren't the issue here, it's the concentrated extract. If you'd like to add it, just check with your pharmacist or doctor first and keep an eye on your readings.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jalili C, Moradi S, Babaei A, et al. Effects of Cynara scolymus L. on glycemic indices: a systematic review and meta-analysis of randomized clinical trials. Complement Ther Med 2020;52:102496. PubMed

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

Artichoke Also Interacts With Other Medications

Artichoke has 362 moderate known drug interactions in our database — the pioglitazone, metformin one above is one of them. If you take anything else, check it against the full list below.

Moderate 362 No known interaction 2,468 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Artichoke

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

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Artichoke only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the pioglitazone, metformin page lists 357 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 311 moderate · 40 minor.

From our pharmacist’s overview on the pioglitazone, metformin page

“ActoPlus Met pairs pioglitazone with metformin for type 2 diabetes, and the size of this list, 357 supplements in all, reflects how many herbs lower blood sugar on their own. Stacked with the drug, they can push glucose too low; most of the 311 moderate entries work exactly that way.”

Reviewed by 2 · Jul 18, 2026

Open the pioglitazone, metformin interaction page

One more smart check

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

We hold 1,715 real supplement products containing Artichoke, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Artichoke. Your product may carry other ingredients that interact with pioglitazone, metformin too, on top of Artichoke — 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 Artichoke and pioglitazone, metformin 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 Artichoke
Top 10%

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

29 days ago today
Medication pioglitazone, metformin
Steady interest

#2,251 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 Artichoke

What is Artichoke?

Artichoke
  • High cholesterol
  • Indigestion and heartburn
  • Constipation and bloating
  • Liver and gallbladder support
  • General digestive health

Artichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, though the evidence is modest. It is not a replacement for proven treatments, so talk with your pharmacist or doctor before using it, especially if you have a medical condition.

Read the full Artichoke monograph & all interactions
Keep checking

Other Drugs & Artichoke

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

0Major
362Moderate
0Minor
2,467No known interaction
362 Moderate 2,467 No interaction
Moderate

362 interactions

Showing 60 of 362 moderate interactions — see all 362 on the Artichoke page.

No interaction 2,467 drugs checked — show the list

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

Showing the 60 most looked-up of 2,467 medications checked with no known interaction — see the full Artichoke list.

See the full Artichoke interactions page
See every supplement checked against pioglitazone, metformin, 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
Artichoke monograph › Uses, safety, and every drug interaction in one place pioglitazone, metformin supplement interactions › Every supplement checked against pioglitazone, metformin, ranked by severity 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 Artichoke and pioglitazone, metformin Together: Common Questions

Can you take Artichoke with pioglitazone, metformin?
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 Artichoke and pioglitazone, metformin 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 pioglitazone, metformin and Artichoke?

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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.