Drug & supplement interaction

Cassia Cinnamon + Alogliptin

Alogliptin brand name: Nesina.

Moderate Interaction
The bottom line Moderate

Alogliptin falls into 2 drug categories that Cassia Cinnamon can interact with; the most serious is rated moderate. Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cassia Cinnamon and Alogliptin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Cassia Cinnamon interacts with whole categories of medication. Alogliptin falls into 2 of those categories, so it can interact with Cassia Cinnamon in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Alogliptin

Alogliptin falls under HEPATOTOXIC DRUGS — the group Cassia Cinnamon interacts with.

Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.
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 thing to understand about this pairing: cassia cinnamon isn't changing how alogliptin works or how strongly it lowers your blood sugar. Instead, the concern is about your liver. Cassia cinnamon naturally contains a compound called coumarin, and in very large or long-term supplement doses it can put stress on the liver. Alogliptin, in rare cases, has also been linked to liver issues, so the worry is simply that two things leaning on the same organ could add up.

This is a theoretical concern based on how these substances behave, not something proven to happen often. Sprinkling cinnamon on your oatmeal is no problem. If you're taking concentrated, daily cinnamon capsules, mention it to your pharmacist or doctor so they can keep an eye on your liver.

References
  1. Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
  2. Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75. PubMed
  3. Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
  4. Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep 2015;16:250-4. PubMed
Moderate

ANTIDIABETES DRUGS

2 of 2

Alogliptin also falls under ANTIDIABETES DRUGS.

Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Cassia cinnamon may lower blood glucose levels, and have additive effects in patients treated with antidiabetic agents. Dose adjustments to diabetes medications might be necessary.
Severity Moderate Likelihood Possible Evidence B

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: cassia cinnamon may nudge your blood sugar down a little on its own, and Alogliptin (Nesina) is already working to lower it. Stack the two together and the effects can add up, so your numbers could drop more than expected. The good news is that Alogliptin by itself rarely causes true low blood sugar, so this combo is usually mild.

Still, watch for signs of low blood sugar like shakiness, sweating, dizziness, or feeling foggy, especially if you also take other diabetes medicines. Honestly, the research here is mixed and not strong. A sprinkle of cinnamon on your oatmeal is no worry, but regular high-dose supplements are worth a quick chat with your pharmacist or doctor before starting.

References
  1. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215-8. PubMed
  2. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009;22:507-12. PubMed
  3. Akilen, R., Tsiami, A., Devendra, D., and Robinson, N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet.Med. 2010; PubMed
  4. Lu T, Sheng H Wu J Cheng Y Zhu J Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res. 2012;32(6):408-412. PubMed
  5. Stoecker BR, Zhan Z, Luo R, et al. Cinnamon extract lowers blood glucose in hyperglycemic subjects. FASEB J. 2010;22:722.1 (Abstract only). 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

Cassia Cinnamon Also Interacts With Other Medications

Cassia Cinnamon has 441 moderate known drug interactions in our database — the Alogliptin one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cassia Cinnamon

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

Everything else you take

See Every Supplement That Interacts With Alogliptin

This page covers Cassia Cinnamon only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alogliptin page lists 356 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 299 moderate · 51 minor.

Open the Alogliptin interaction page

One more smart check

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

We hold 3,249 real supplement products containing Cassia Cinnamon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cassia Cinnamon. Your product may carry other ingredients that interact with Alogliptin too, on top of Cassia Cinnamon — 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 Cassia Cinnamon and Alogliptin 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 Cinnamon
Top 10%

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

29 days ago today
Medication Alogliptin
Top half

#852 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 Cinnamon

What is Cassia Cinnamon?

Cassia Cinnamon
  • Blood sugar support
  • Digestive upset
  • Antioxidant support
  • Flavoring and culinary use
  • Antimicrobial

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed and far from proven, and because cassia is naturally high in coumarin, taking large amounts regularly may stress the liver. Use food amounts freely, but talk with a pharmacist or doctor before using high-dose supplements.

Read the full Cassia Cinnamon monograph & all interactions
Medication

About Alogliptin

What Is Alogliptin Used For?

Brand name: Nesina

Alogliptin tablets — sold under the brand names Alogliptin and Nesina — are used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Alogliptin is not used for type 1 diabetes or diabetic ketoacidosis, as it would not be effective in those situations.

See full Alogliptin drug information
Keep checking

Other Drugs & Cassia Cinnamon

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

0Major
441Moderate
0Minor
2,388No known interaction
Moderate

441 interactions

Showing 60 of 441 moderate interactions — see all 441 on the Cassia Cinnamon page.

No interaction 2,388 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 Cassia Cinnamon and Alogliptin Together: Common Questions

Can you take Cassia Cinnamon with Alogliptin?
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.
Why are there 2 interactions listed for Cassia Cinnamon and Alogliptin?
Alogliptin belongs to more than one drug category, and Cassia Cinnamon 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 Cassia Cinnamon and Alogliptin 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.