Drug & supplement interaction

Beer + pioglitazone, metformin

pioglitazone, metformin brand name: ActoPlus Met.

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

pioglitazone, metformin falls into 3 drug categories that Beer can interact with; the most serious is rated major. Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions3
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Beer and pioglitazone, metformin

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Beer interacts with whole categories of medication. pioglitazone, metformin falls into 3 of those categories, so it can interact with Beer in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

HEPATOTOXIC DRUGS

1 of 3

Why this applies to pioglitazone, metformin

pioglitazone, metformin falls under HEPATOTOXIC DRUGS — the group Beer interacts with.

Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.
Concomitant use of excessive amounts of alcohol with potentially hepatotoxic drugs can increase the risk of liver damage.
Severity Major Likelihood Probable Evidence B

Interaction 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..

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

Here's the thing to know about pairing beer with ActoPlus Met (pioglitazone plus metformin): both of these medicines are processed by your liver, and alcohol puts stress on that same organ. Mixing the two, especially with heavy or regular drinking, can raise your risk of liver trouble. Watch for warning signs like yellowing of the skin or eyes, dark urine, belly pain on the upper right side, nausea, or unusual tiredness.

There's a second concern that's specific to metformin. Drinking, particularly in large amounts, can raise the chance of a rare but serious problem called lactic acidosis (think fast breathing, deep fatigue, muscle aches). An occasional light drink may be fine for many people, but please check with your doctor or pharmacist about what's safe for you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
  2. Thummel, K. E., Slattery, J. T., Ro, H., Chien, J. Y., Nelson, S. D., Lown, K. E., and Watkins, P. B. Ethanol and production of the hepatotoxic metabolite of acetaminophen in healthy adults. Clin Pharmacol Ther 2000;67(6):591-599. PubMed
Moderate

ANTIDIABETES DRUGS

2 of 3

pioglitazone, metformin also falls under ANTIDIABETES DRUGS.

Concomitant use may interfere with blood glucose control.
Alcohol can impair gluconeogenesis and may increase the risk of acute hypoglycemia when used concomitantly with antidiabetes drugs. However, the carbohydrates in beer may also worsen glycemic control in patients with diabetes.
Severity Moderate Likelihood Probable Evidence C

Interaction 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..

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

Mixing beer with your ActoPlus Met (pioglitazone plus metformin) can push your blood sugar in two different directions, which makes it tricky. Alcohol blocks your liver from making new sugar, so drinking, especially on an empty stomach or after skipping a meal, can drop your blood sugar too low. With low sugar you might feel shaky, sweaty, dizzy, confused, or get a fast heartbeat, and alcohol can mask or worsen those warning signs.

On the flip side, the carbs in beer can raise your sugar, so your control becomes unpredictable. There's also a small added concern: combining alcohol with metformin can rarely contribute to lactic acidosis. None of this means you must avoid the occasional drink, but please check with your pharmacist or doctor about what's safe for you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
Moderate

METFORMIN (Glucophage)

3 of 3
Concomitant use may increase the risk of lactic acidosis.
Concomitant consumption of large amounts of alcohol may increase the risk of lactic acidosis with metformin.
Severity Moderate Likelihood Possible Evidence C

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

Your medication, ActoPlus Met, combines two diabetes drugs. The piece that matters most with beer is the metformin. Metformin can cause a buildup of lactic acid in rare cases, and drinking a lot of alcohol pushes that risk higher. This isn't about a single beer with dinner for most people, it's heavy or binge drinking that's the real concern.

Lactic acidosis is uncommon but serious. Warning signs include deep tiredness, muscle aches, trouble breathing, stomach pain, and feeling cold or dizzy. Alcohol can also drop your blood sugar too low. I'd suggest checking with your doctor or pharmacist about what amount of beer, if any, is safe for you, since this depends on your kidneys and overall health.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Glucophage XR (metformin) prescribing information. Bristol-Myers Squibb Company. Princeton, NJ, May 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020357s034,021202s018lbl.pdf

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

Beer Also Interacts With Other Medications

Beer has 653 major, 272 moderate known drug interactions in our database — the pioglitazone, metformin one above is among them. If you take anything else, check it against the full list below.

Major 653 Moderate 272 No known interaction 1,905 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Beer

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

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Beer 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), Grapefruit (major), Siberian Cocklebur (major), St. John's Wort (major) and Wine (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

How much people look this up

Where Beer 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 Beer
Top 25%

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

29 days ago today
Medication pioglitazone, metformin
Steady interest

#2,247 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 Beer

What is Beer?

Beer
  • Social and recreational drinking
  • Relaxation
  • Heart health (popular belief)
  • Bone health (popular belief)
  • Source of antioxidants and B vitamins

Beer is an alcoholic beverage that contains some minerals, B vitamins, and plant compounds from hops and grain, but it is not a health supplement. Any possible benefits come only from light-to-moderate intake, and they are easily outweighed by the well-known harms of alcohol. The safest amount of alcohol for health is none, and beer should be avoided in pregnancy and breastfeeding.

Read the full Beer monograph & all interactions
Keep checking

Other Drugs & Beer

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

653Major
272Moderate
0Minor
1,904No known interaction
653 Major 272 Moderate 1,904 No interaction
Major

653 interactions

Showing 60 of 653 major interactions — see all 653 on the Beer page.

Moderate

272 interactions

Showing 60 of 272 moderate interactions — see all 272 on the Beer page.

No interaction 1,904 drugs checked — show the list

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

Showing the 60 most looked-up of 1,904 medications checked with no known interaction — see the full Beer list.

See the full Beer 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
Beer 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 Beer and pioglitazone, metformin Together: Common Questions

Can you take Beer with pioglitazone, metformin?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Beer and pioglitazone, metformin?
pioglitazone, metformin belongs to more than one drug category, and Beer 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 Beer and pioglitazone, metformin interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

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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.