Chanca Piedra - Qternmet XR (Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride) Interaction
Herbal: Chanca Piedra
Also Known As: Phyllanthus niruri, Amli, Arranca-Pedras, Bhonya, Bhoomi Amalaki, Bhui-Amla, Bhuianvalah, Bhumi-Amla, Bhuimy Amali, Bhuin Amla, Bhumy Amalaki, Bhumyamalaki, Brise Pierre, Cane Peas Senna, Cane Senna, Carry-Me-Seed, Casse-Pierre, Chanca-Piedra Blanca, Chance Pierre
Drug: Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride
Brand names:
Qternmet XR
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 18, 2025
Interaction Details
Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride is classified as belonging to the following category: 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.
Interaction Rating
Likelihood of Occurrence
UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
References
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
Interaction Details
Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
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.
Interaction Rating
Likelihood of Occurrence
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
References
- 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.
Chanca Piedra Overview
Chanca piedra (Phyllanthus niruri) is a small herb native to the tropical regions of the Americas. It is commonly known by other names, such as "stone breaker" and "seed-on-the-leaf," due to its traditional use in breaking up kidney stones and gallstones.
Chanca piedra is used in traditional medicine to treat a variety of ailments, including kidney and gallbladder disorders, liver problems, and urinary tract infections. It is also believed to have antioxidant, anti-inflammatory, and antiviral properties.
Chanca Piedra - More Interactions
Chanca Piedra interacts with 994 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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