Drug & supplement interaction

Bael + Alogliptin, Pioglitazone

Alogliptin, Pioglitazone brand name: Oseni.

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

Alogliptin, Pioglitazone falls into 2 drug categories that Bael can interact with; the most serious is rated moderate. Evidence from animal research suggests that extracts of bael seed and leaf can reduce blood glucose levels.

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

Bael and Alogliptin, Pioglitazone

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

Why Are There 2 Interactions?

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

Moderate

ANTIDIABETES DRUGS

1 of 2

Why this applies to Alogliptin, Pioglitazone

Alogliptin, Pioglitazone falls under ANTIDIABETES DRUGS — the group Bael interacts with.

Evidence from animal research suggests that extracts of bael seed and leaf can reduce blood glucose levels. Theoretically, bael might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
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

Oseni combines two diabetes medicines, alogliptin and pioglitazone, that both work to bring your blood sugar down. Bael, the traditional Ayurvedic fruit, has shown a blood-sugar-lowering effect in animal studies. The thinking here is simple: if you add something that also nudges sugar lower on top of medicine already doing that job, the two together could push your blood sugar a little too far down.

If that happened, you might feel shaky, sweaty, dizzy, lightheaded, or unusually hungry. I'll be honest with you, though: this is based only on lab and animal work, not human studies, so it's more of a theoretical caution than a proven problem. Eating bael as a food is unlikely to matter much, but concentrated supplements are a different story. If you do try it, check your blood sugar more often and loop in your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sabu, M. C. and Kuttan, R. Antidiabetic activity of Aegle marmelos and its relationship with its antioxidant properties. Indian J Physiol Pharmacol 2004;48(1):81-88.
  2. Kesari, A. N., Gupta, R. K., Singh, S. K., Diwakar, S., and Watal, G. Hypoglycemic and antihyperglycemic activity of Aegle marmelos seed extract in normal and diabetic rats. J Ethnopharmacol 10-11-2006;107(3):374-379. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Alogliptin, Pioglitazone also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Bael and its constituents marmelosin and marmesinin inhibited cytochrome P450 3A4 (CYP3A4) activity in vitro. So far, this interaction has not been reported in humans. Theoretically, bael might increase levels of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others. Use bael cautiously or avoid in patients taking these drugs.
Severity Minor 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 for your Oseni, which combines alogliptin and pioglitazone. In lab dishes (not in people), compounds in bael slowed down an enzyme called CYP3A4. Pioglitazone leans partly on that enzyme to be broken down, so in theory bael could let a bit more of it linger in your body. Alogliptin barely uses this pathway, so it isn't really the concern here.

If pioglitazone levels nudged up, you might notice more of its usual effects, like fluid retention, mild swelling in the ankles, or weight gain. Honestly, this is a theoretical, lab-only signal rated minor, and food amounts of bael are unlikely to matter. Still, if you plan to take concentrated bael supplements, run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Manda VK, Avula B, Chittiboyina AG, Khan IA, Walker LA, Khan SI. Inhibition of CYP3A4 and CYP1A2 by Aegle marmelos and its constituents. Xenobiotica. 2016;46(2):117-25.

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

Bael Also Interacts With Other Medications

Bael has 110 moderate, 708 minor known drug interactions in our database — the Alogliptin, Pioglitazone one above is among them. If you take anything else, check it against the full list below.

Moderate 110 Minor 708 No known interaction 2,012 (incl. Alogliptin, Pioglitazone)
Taking anything else?

Check Another of Your Medications Against Bael

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

Everything else you take

See Every Supplement That Interacts With Alogliptin, Pioglitazone

This page covers Bael only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alogliptin, Pioglitazone page lists 356 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 · 309 moderate · 41 minor.

From our pharmacist’s overview on the Alogliptin, Pioglitazone page

“Someone taking Oseni (alogliptin and pioglitazone) for type 2 diabetes often shops the very shelf this list comes from, and the pairing deserves genuine caution. Of the 356 ingredients on file, 239 also lower blood sugar, so stacking them on top of the pill can drop glucose too far.”

Reviewed by 2 · Jul 18, 2026

Open the Alogliptin, Pioglitazone interaction page

One more smart check

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

We hold 94 real supplement products containing Bael, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bael. Your product may carry other ingredients that interact with Alogliptin, Pioglitazone too, on top of Bael — 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 Bael and Alogliptin, Pioglitazone 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 Bael
Top half

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

29 days ago today
Medication Alogliptin, Pioglitazone
Steady interest

#1,449 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 Bael

What is Bael?

Bael
  • Diarrhea and dysentery
  • Indigestion and other digestive complaints
  • Constipation
  • Blood sugar support
  • General wellness in traditional medicine

Bael is a fruit-bearing tree long used in traditional Indian (Ayurvedic) medicine, mostly for digestive problems like diarrhea and indigestion. Modern human evidence for its medicinal benefits is very limited, so it should be viewed mainly as a food and traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using bael as a supplement, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Bael monograph & all interactions
Keep checking

Other Drugs & Bael

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

0Major
110Moderate
708Minor
2,011No known interaction
110 Moderate 708 Minor 2,011 No interaction
Moderate

110 interactions

Showing 60 of 110 moderate interactions — see all 110 on the Bael page.

Minor

708 interactions

Showing 60 of 708 minor interactions — see all 708 on the Bael page.

No interaction 2,011 drugs checked — show the list

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

Showing the 60 most looked-up of 2,011 medications checked with no known interaction — see the full Bael list.

See the full Bael interactions page
See every supplement checked against Alogliptin, Pioglitazone, 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
Bael monograph › Uses, safety, and every drug interaction in one place Alogliptin, Pioglitazone supplement interactions › Every supplement checked against Alogliptin, Pioglitazone, 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 Bael and Alogliptin, Pioglitazone Together: Common Questions

Can you take Bael with Alogliptin, Pioglitazone?
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 Bael and Alogliptin, Pioglitazone?
Alogliptin, Pioglitazone belongs to more than one drug category, and Bael 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 Bael and Alogliptin, Pioglitazone 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 Alogliptin, Pioglitazone and Bael?

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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.