Drug & supplement interaction

Cashew + Tolbutamide

Tolbutamide brand name: Orinase.

Moderate Interaction
The bottom line Moderate

Cashew has a moderate interaction with Tolbutamide. Eating a diet that consists of high amounts of cashew might increase fasting blood glucose levels.

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

Cashew and Tolbutamide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Tolbutamide

Tolbutamide falls under ANTIDIABETES DRUGS — the group Cashew interacts with.

Eating a diet that consists of high amounts of cashew might increase fasting blood glucose levels. However, other evidence shows that eating 30 grams of cashew daily does not significantly affect glycemic measures. Until more is known, use with caution in combination with antidiabetes drugs. Theoretically, concomitant use might reduce the effects of antidiabetes drugs. Dosing adjustments for insulin or oral hypoglycemic agents may be necessary.
Oral hypoglycemic drugs include glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Diabeta, Micronase), tolazamide (Tolinase), 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 with tolbutamide (Orinase) and cashews. Tolbutamide works by nudging your pancreas to release more insulin, which brings your blood sugar down. The theoretical worry on file is that eating large amounts of cashew could push fasting blood sugar slightly upward, which might blunt how well tolbutamide does its job. In plain terms, this concern points toward a weaker sugar-lowering effect, not a stronger one.

Honestly, this is shaky evidence. Other research found that about 30 grams of cashews a day (a small handful) didn't meaningfully change blood sugar. So a normal snack-sized portion is unlikely to cause trouble. If you start eating cashews heavily every day, just keep an eye on your glucose readings and chat with your pharmacist or doctor before changing anything.

References
  1. Schutte, A. E., Van Rooyen, J. M., Huisman, H. W., Mukuddem-Petersen, J., Oosthuizen, W., Hanekom, S. M., and Jerling, J. C. Modulation of baroreflex sensitivity by walnuts versus cashew nuts in subjects with metabolic syndrome. Am.J Hypertens. 2006;19(6 PubMed
  2. Mohan V, Gayathri R, Jaacks LM, et al. Cashew nut consumption increases HDL cholesterol and reduces systolic blood pressure in Asian Indians with Type 2 diabetes: A 12-week randomized controlled trial. J Nutr. 2018;148(1):63-69. 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

Cashew Also Interacts With Other Medications

Cashew has 85 moderate known drug interactions in our database — the Tolbutamide 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 Cashew

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

Everything else you take

See Every Supplement That Interacts With Tolbutamide

This page covers Cashew only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tolbutamide page lists 305 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), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 2 major · 255 moderate · 48 minor.

From our pharmacist’s overview on the Tolbutamide page

“People take tolbutamide (Orinase) to lower blood sugar in type 2 diabetes, and diabetes is exactly the condition supplement shelves target, which is why this list runs to 305 ingredients and deserves real caution. Of those, 239 also push glucose around, most often downward, so combining them can drive sugar lower than intended.”

Reviewed by 2 · Jul 18, 2026

Open the Tolbutamide interaction page

One more smart check

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

We hold 10 real supplement products containing Cashew, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cashew. Your product may carry other ingredients that interact with Tolbutamide too, on top of Cashew — 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 Cashew and Tolbutamide 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 Cashew
Steady interest

#1,196 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tolbutamide
Steady interest

#1,655 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 Cashew

What is Cashew?

Cashew
  • Heart health support
  • Source of protein and minerals
  • Blood sugar support
  • Traditional digestive remedy
  • Skin and oral care (traditional)

Cashews are a nutritious tree nut that provides protein, healthy fats, fiber, and minerals like magnesium and copper. Eaten as part of a balanced diet, they may support heart health, but evidence for cashew supplements treating any specific disease is limited. People with tree nut allergies must avoid them entirely.

Read the full Cashew monograph & all interactions
Medication

About Tolbutamide

What Is Tolbutamide Used For?

Brand name: Orinase

  • Tolbutamide 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). Tolbutamide is in a class of medications called sulfonylureas. Tolbutamide 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. Tolbutamide 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 Tolbutamide drug information
Keep checking

Other Drugs & Cashew

Browse every other medication we’ve checked against Cashew — 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 Cashew 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 Cashew and Tolbutamide Together: Common Questions

Can you take Cashew with Tolbutamide?
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 Cashew and Tolbutamide 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

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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.