Drug & supplement interaction

Cassia Auriculata + Metformin Hydrochloride

Metformin Hydrochloride brand name: Riomet ER.

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

Cassia Auriculata has a moderate interaction with Metformin Hydrochloride. Theoretically, Cassia auriculata may reduce blood glucose levels and might have additive effects on glucose levels when used with antidiabetes drugs.

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

Cassia Auriculata and Metformin Hydrochloride

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Metformin Hydrochloride

Metformin Hydrochloride falls under ANTIDIABETES DRUGS — the group Cassia Auriculata interacts with.

Theoretically, Cassia auriculata may reduce blood glucose levels and might have additive effects on glucose levels when used with antidiabetes drugs. Monitor blood glucose levels closely. Medication dose adjustments may 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

Here's the simple version: both metformin and Cassia auriculata can lower your blood sugar. So when you take them together, the worry isn't that they fight each other, it's that their effects could stack up and push your sugar a little too low. With metformin on its own, low blood sugar is uncommon, but adding a second blood sugar lowering agent can tip the balance. Watch for shakiness, sweating, a racing heart, dizziness, or feeling unusually tired or foggy.

I want to be honest about the strength of this, though. This is mostly based on lab and animal studies, not solid human research, so it's a theoretical concern rather than a proven one. Still, if you're curious about this supplement, check in with your pharmacist or doctor first and keep an eye on your home glucose readings. Don't change your metformin dose on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Latha M, Pari L. Antihyperglycaemic effect of Cassia auriculata in experimental diabetes and its effects on key metabolic enzymes involved in carbohydrate metabolism. Clin Exp Pharmacol Physiol 2003;30:38-43.
  2. Pari L, Ramakrishnan R, Venkateswaran S. Antihyperglycaemic effect of Diamed, a herbal formulation, in experimental diabetes in rats. J Pharm Pharmacol 2001;53:1139-43. PubMed
  3. Nambirajan G, Karunanidhi K, Ganesan A, et al. Evaluation of antidiabetic activity of bud and flower of Avaram Senna (Cassia auriculata L.) In high fat diet and streptozotocin induced diabetic rats. Biomed Pharmacother. 2018;108:1495-1506. 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

Cassia Auriculata Also Interacts With Other Medications

Cassia Auriculata has 86 moderate known drug interactions in our database — the Metformin Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Metformin Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Cassia Auriculata

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

Everything else you take

See Every Supplement That Interacts With Metformin Hydrochloride

This page covers Cassia Auriculata only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metformin Hydrochloride page lists 257 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 · 217 moderate · 38 minor.

From our pharmacist’s overview on the Metformin Hydrochloride page

“Anyone taking metformin hydrochloride (Riomet ER) should treat this list with genuine care, because two of its 257 entries are rated major. Siberian cocklebur has caused severe hypoglycemia in people and should not be combined with metformin at all, and activated charcoal can adsorb the drug in the gut so less reaches your blood.”

Reviewed by 2 · Jul 18, 2026

Open the Metformin Hydrochloride interaction page

How much people look this up

Where Cassia Auriculata and Metformin Hydrochloride 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 Cassia Auriculata
Steady interest

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

29 days ago today
Medication Metformin Hydrochloride
Top 25%

#590 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 Cassia Auriculata

What is Cassia Auriculata?

  • Blood sugar support
  • Skin health
  • Urinary complaints
  • Digestive upset
  • General tonic and antioxidant

Cassia auriculata (often called Tanner's cassia or Avaram) is a flowering shrub used in traditional Indian medicine, especially for blood sugar and skin concerns. Most evidence comes from laboratory and animal studies, so its benefits in people are not well proven. Talk to your pharmacist or doctor before using it, particularly if you take diabetes medicine or are pregnant.

Read the full Cassia Auriculata monograph & all interactions
Keep checking

Other Drugs & Cassia Auriculata

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

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Cassia Auriculata page.

No interaction 2,743 drugs checked — show the list

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Cassia Auriculata list.

See the full Cassia Auriculata interactions page
See every supplement checked against Metformin Hydrochloride, 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
Cassia Auriculata monograph › Uses, safety, and every drug interaction in one place Metformin Hydrochloride supplement interactions › Every supplement checked against Metformin Hydrochloride, 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 Cassia Auriculata and Metformin Hydrochloride Together: Common Questions

Can you take Cassia Auriculata with Metformin Hydrochloride?
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 Cassia Auriculata and Metformin Hydrochloride 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 Metformin Hydrochloride and Cassia Auriculata?

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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.