Drug & supplement interaction

Carnosine + Tolazamide

Tolazamide brand name: Tolinase.

Moderate Interaction
The bottom line Moderate

Carnosine has a moderate interaction with Tolazamide. Theoretically, taking carnosine with antidiabetes drugs might increase the risk of hypoglycemia.

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

Carnosine and Tolazamide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Tolazamide

Tolazamide falls under ANTIDIABETES DRUGS — the group Carnosine interacts with.

Theoretically, taking carnosine with antidiabetes drugs might increase the risk of hypoglycemia.
Some, but not all, preliminary clinical research shows that carnosine might reduce fasting blood glucose levels.
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: tolazamide already lowers your blood sugar by nudging your pancreas to release more insulin. Carnosine, in some early studies, also seems to bring fasting blood sugar down a little. Stack those two together and the worry is that your sugar could drop a bit too low (hypoglycemia), leaving you shaky, sweaty, lightheaded, or unusually hungry.

I want to be honest about how strong this is. The concern is theoretical, based on how things work and a few mixed early human studies, not on solid proof that carnosine causes real problems with tolazamide. It's not a reason to panic. If you'd like to add carnosine, just check with your pharmacist or doctor first, and keep an eye on your home glucose readings so any change gets caught early.

References
  1. Karkabounas S, Papadopoulos N, Anastasiadou C, et al. Effects of a-lipoic Acid, carnosine, and thiamine supplementation in obese patients with type 2 diabetes mellitus: A randomized, double-blind study. J Med Food. 2018;21(12):1197-1203.
  2. Peng W, Mao P, Liu L, et al. Effect of carnosine supplementation on lipid profile, fasting blood glucose, HbA1C and insulin resistance: a systematic review and meta-analysis of long-term randomized controlled trials. Complement Ther Med 2020;48:102241. PubMed
  3. Siriwattanasit N, Satirapoj B, Supasyndh O. Effect of oral carnosine supplementation on urinary TGF-ß in diabetic nephropathy: a randomized controlled trial. BMC Nephrol 2021;22(1):236. PubMed
  4. Sureshkumar K, Durairaj M, Srinivasan K, et al. Effect of L-Carnosine in Patients with Age-Related Diseases: A Systematic Review and Meta-Analysis. Front Biosci (Landmark Ed) 2023;28(1):18. 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

Carnosine Also Interacts With Other Medications

Carnosine has 85 moderate known drug interactions in our database — the Tolazamide one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Carnosine

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

Everything else you take

See Every Supplement That Interacts With Tolazamide

This page covers Carnosine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tolazamide page lists 272 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 2 major · 230 moderate · 40 minor.

From our pharmacist’s overview on the Tolazamide page

“Tolazamide (Tolinase) lowers blood sugar in type 2 diabetes, and I would handle its supplement list with care, because nearly everything listed can drag blood sugar lower still. Herbs and foods with glucose-lowering effects dominate the file, and stacked on a pill that already lowers glucose they raise the odds of hypoglycemia, blood s…”

Reviewed by 2 · Jul 18, 2026

Open the Tolazamide interaction page

One more smart check

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

We hold 407 real supplement products containing Carnosine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Carnosine. Your product may carry other ingredients that interact with Tolazamide too, on top of Carnosine — 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 Carnosine and Tolazamide 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 Carnosine
Top half

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

29 days ago today
Medication Tolazamide
Top half

#780 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 Carnosine

What is Carnosine?

  • Anti-aging and general wellness
  • Exercise performance and muscle support
  • Brain and cognitive health
  • Eye health (cataracts, with N-acetylcarnosine drops)
  • Antioxidant support

Carnosine is a naturally occurring dipeptide (made of beta-alanine and histidine) that acts as an antioxidant and buffer in muscle and brain. It is sold as an anti-aging and performance supplement, but human evidence for most uses is limited, and many studies actually use beta-alanine, its precursor. It appears generally well tolerated at common doses, but talk to your pharmacist or doctor before starting it.

Read the full Carnosine monograph & all interactions
Medication

About Tolazamide

What Is Tolazamide Used For?

Brand name: Tolinase

  • Tolazamide is used along with diet and exercise, and sometimes with other medications, 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). Tolazamide is in a class of medications called sulfonylureas. Tolazamide lowers blood sugar by causing the pancreas to produce insulin (a natural substance that is needed to break down sugar in the body) and helping the body use insulin efficiently. This medication will only help lower blood sugar in people whose bodies produce insulin naturally. Tolazamide 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) or diabetic ketoacidosis (a serious condition that may occur if high blood sugar is not treated).

  • 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. Taking 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.

See full Tolazamide drug information
Keep checking

Other Drugs & Carnosine

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

0Major
85Moderate
0Minor
2,744No known interaction
Moderate

85 interactions

Showing 60 of 85 moderate interactions — see all 85 on the Carnosine page.

No interaction 2,744 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Carnosine and Tolazamide Together: Common Questions

Can you take Carnosine with Tolazamide?
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 Carnosine and Tolazamide 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 Tolazamide and Carnosine?

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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.