Drug & supplement interaction

Blue Cohosh + Lixisenatide

Lixisenatide brand name: Adlyxin.

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

Blue Cohosh has a moderate interaction with Lixisenatide. There is some concern that blue cohosh might increase blood glucose levels.

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

Blue Cohosh and Lixisenatide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Lixisenatide

Lixisenatide falls under ANTIDIABETES DRUGS — the group Blue Cohosh interacts with.

There is some concern that blue cohosh might increase blood glucose levels. Theoretically, it might decrease the effectiveness of medicines used for diabetes. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), 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

Here's the gist for Lixisenatide (Adlyxin), which is a once-daily injection that helps your pancreas release insulin when your blood sugar runs high. The worry with blue cohosh is that it may push blood sugar up. If that happens, it could work against what your Lixisenatide is trying to do, and your numbers might not come down as well as expected.

I want to be honest about the strength of this: it's a theoretical concern based on how the herb behaves in lab and animal studies, not solid proof in people. Still, blue cohosh has real safety concerns of its own, so I'd avoid it unless your doctor or pharmacist says otherwise. If you do take both, watch your home glucose readings and loop in your care team before making any changes.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  2. Scott, C. C. and Chen, K. K. The pharmacological action of N-methylcytisine. The Journal of Pharmacology and Experimental Therapuetics 1943;79:334-339. DOI

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

Blue Cohosh Also Interacts With Other Medications

Blue Cohosh has 258 moderate known drug interactions in our database — the Lixisenatide one above is one of them. If you take anything else, check it against the full list below.

Moderate 258 No known interaction 2,572 (incl. Lixisenatide)
Taking anything else?

Check Another of Your Medications Against Blue Cohosh

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

Everything else you take

See Every Supplement That Interacts With Lixisenatide

This page covers Blue Cohosh only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lixisenatide page lists 239 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 1 major · 208 moderate · 30 minor.

From our pharmacist’s overview on the Lixisenatide page

“Lixisenatide (Adlyxin) is injected to lower blood sugar in type 2 diabetes, and nearly everything on this page acts on blood sugar too, which is why I would treat the list with genuine care rather than a shrug. Most of the entries, from bitter melon and fenugreek to both types of ginseng, can push glucose lower still and raise the odds…”

Reviewed by 2 · Jul 18, 2026

Open the Lixisenatide interaction page

One more smart check

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

We hold 126 real supplement products containing Blue Cohosh, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Blue Cohosh. Your product may carry other ingredients that interact with Lixisenatide too, on top of Blue Cohosh — 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 Blue Cohosh and Lixisenatide 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 Blue Cohosh
Steady interest

#1,073 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Lixisenatide
Steady interest

#1,949 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 Blue Cohosh

What is Blue Cohosh?

  • Inducing labor or starting menstruation
  • Menstrual cramps and irregular periods
  • Symptoms of menopause
  • Pelvic or uterine discomfort
  • Traditional Native American remedy

Blue cohosh is a traditional herb historically used by Native Americans and midwives to bring on labor or menstruation, but it carries serious safety concerns, especially for the heart and during pregnancy. There is very little reliable human evidence that it works, and reports of harm—including serious problems in newborns—make it an herb most people should avoid without close professional supervision.

Read the full Blue Cohosh monograph & all interactions
Medication

About Lixisenatide Injection

What Is Lixisenatide Injection Used For?

Brand name: Adlyxin

  • Lixisenatide injection is used along with diet and exercise to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood). Lixisenatide injection is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). Lixisenatide is not used instead of insulin to treat people with diabetes who need insulin. Lixisenatide injection is in a class of medications called incretin mimetics. It works by stimulating the pancreas to secrete insulin when blood sugar levels are high. Insulin helps move sugar from the blood into other body tissues where it is used for energy. Lixisenatide injection also slows the emptying of the stomach and causes a decrease in appetite.

  • Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

  • Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with lixisenatide injection and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.

See full Lixisenatide Injection drug information
Keep checking

Other Drugs & Blue Cohosh

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

0Major
258Moderate
0Minor
2,571No known interaction
258 Moderate 2,571 No interaction
Moderate

258 interactions

Showing 60 of 258 moderate interactions — see all 258 on the Blue Cohosh page.

No interaction 2,571 drugs checked — show the list

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

Showing the 60 most looked-up of 2,571 medications checked with no known interaction — see the full Blue Cohosh list.

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

Can you take Blue Cohosh with Lixisenatide?
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 Blue Cohosh and Lixisenatide 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 Lixisenatide and Blue Cohosh?

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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.