Drug & supplement interaction

Chanca Piedra + Alogliptin

Alogliptin brand name: Nesina.

Moderate Interaction
The bottom line Moderate

Alogliptin falls into 2 drug categories that Chanca Piedra can interact with; the most serious is rated moderate. Theoretically, use of chanca piedra might increase the levels and clinical effects of CYP3A4 substrates.

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

Chanca Piedra and Alogliptin

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Alogliptin

Alogliptin falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Chanca Piedra interacts with.

Theoretically, use of chanca piedra might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that chanca piedra extract inhibits CYP3A4. Theoretically, chanca piedra might increase the levels of CYP3A4 substrates. This interaction has not been reported in humans.
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 good news on this pairing: the concern is mostly theoretical. In lab dishes, chanca piedra appears to slow down a liver enzyme called CYP3A4, which in turn could let drugs cleared by that enzyme build up a bit. The thinking is that your alogliptin (Nesina) levels might rise slightly if this happened in real life.

But honestly, alogliptin barely relies on CYP3A4. Most of it leaves your body unchanged through the kidneys, so this interaction is unlikely to matter much. Even if levels nudged up, you'd mainly want to watch for low blood sugar, especially if you also take insulin or a sulfonylurea. This hasn't been reported in people, so don't panic. Just give your pharmacist or doctor a heads-up before starting chanca piedra.

References
  1. Husain I, Abdulrahman B, Dale OR, et al. Interaction of Phyllanthus amarus extract and its lignans with human xenobiotic receptors, drug metabolizing enzymes and drug transporters. J Ethnopharmacol 2025;339:119142. PubMed
Minor

ANTIDIABETES DRUGS

2 of 2

Alogliptin also falls under ANTIDIABETES DRUGS.

Theoretically, concomitant use with antidiabetes drugs might affect glucose control and increase the risk of hypoglycemia.
Animal research suggests that chanca piedra can have hypoglycemic effects. However, a small clinical study in adults with diabetes shows that chanca piedra extract 25 grams orally daily for 1 week does not lower fasting or postprandial blood glucose levels.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with Nesina (alogliptin) and chanca piedra: the worry is mostly theoretical. Alogliptin already lowers your blood sugar by boosting your body's own insulin response, and some animal studies hint that chanca piedra might nudge blood sugar down too. Stack those together and, in theory, your sugar could dip a little lower than expected. That could show up as shakiness, sweating, feeling lightheaded, or unusual hunger.

The reassuring part: a small human study found that chanca piedra extract didn't actually lower blood sugar over a week. So this is weak, anecdotal evidence, not a strong red flag. Still, if you're starting the herb, it's smart to keep an eye on your glucose readings and check in with your pharmacist or doctor before changing anything.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Moshi, M. J., Lutale, J. J., Rimoy, G. H., Abbas, Z. G., Josiah, R. M., and Swai, A. B. The effect of Phyllanthus amarus aqueous extract on blood glucose in non-insulin dependent diabetic patients. Phytother.Res 2001;15(7):577-580.
  3. Adeneye, A. A., Amole, O. O., and Adeneye, A. K. Hypoglycemic and hypocholesterolemic activities of the aqueous leaf and seed extract of Phyllanthus amarus in mice. Fitoterapia 2006;77(7-8):511-514. PubMed
  4. Okoli, C. O., Obidike, I. C., Ezike, A. C., Akah, P. A., and Salawu, O. A. Studies on the possible mechanisms of antidiabetic activity of extract of aerial parts of Phyllanthus niruri. Pharm.Biol. 2011;49(3):248-255.
  5. Moshi MJ, Uiso FC Mahunnah RL et al. A study of the effect of Phyllanthus amarus extracts on blood glucose in rabbits. International Journal of Pharmacognosy 1997;35(3):167-173. DOI
  6. Kumar NG, Nair AN Raghunandanan VR et al. Hypoglycaemic effect of Phyllanthus niruri leaves in rabbits. Kerala Journal of Veterinary Science 1989;20(1):77-80.
  7. Navarro M, Coussio J Hnatyszyn O et al. Hypoglycemic Effect of an Aqueous Extract of Phyllanthus sellowianus ("sarandi blanco") in C57BL/Ks mice. Acta Farmaceutica Bonaerense 2004;23:520-523.

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

Chanca Piedra Also Interacts With Other Medications

Chanca Piedra has 870 moderate, 149 minor 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 Chanca Piedra

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

Everything else you take

See Every Supplement That Interacts With Alogliptin

This page covers Chanca Piedra 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 Chanca Piedra as Part of a Dietary Supplement Product? Check It for Interactions

We hold 355 real supplement products containing Chanca Piedra, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chanca Piedra. Your product may carry other ingredients that interact with Alogliptin too, on top of Chanca Piedra — 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 Chanca Piedra 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 Chanca Piedra
Top half

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

29 days ago today
Medication Alogliptin
Top half

#781 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 Chanca Piedra

What is Chanca Piedra?

Chanca Piedra
  • Kidney stones
  • Gallstones
  • Liver support
  • Urinary tract health
  • Digestive complaints

Chanca piedra is a tropical herb traditionally used as a 'stone breaker' for kidney and gallstones, and for liver and urinary health. Human evidence for these uses is limited and mostly small or preliminary, so it should not replace proven treatments. Talk with your pharmacist or doctor before using it, especially if you have a medical condition or take medications.

Read the full Chanca Piedra 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 & Chanca Piedra

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

0Major
870Moderate
149Minor
1,810No known interaction
Moderate

870 interactions

Showing 60 of 870 moderate interactions — see all 870 on the Chanca Piedra page.

Minor

149 interactions

Showing 60 of 149 minor interactions — see all 149 on the Chanca Piedra page.

No interaction 1,810 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 Chanca Piedra and Alogliptin Together: Common Questions

Can you take Chanca Piedra 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 Chanca Piedra and Alogliptin?
Alogliptin belongs to more than one drug category, and Chanca Piedra 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 Chanca Piedra 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.