Drug & supplement interaction

Codonopsis + Metformin, Rosiglitazone

Metformin, Rosiglitazone brand name: Avandamet.

Moderate Interaction
The bottom line Moderate

Codonopsis has a moderate interaction with Metformin, Rosiglitazone. Theoretically, codonopsis might increase the risk of hypoglycemia when taken with antidiabetes drugs.

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

Codonopsis and Metformin, Rosiglitazone

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Metformin, Rosiglitazone

Metformin, Rosiglitazone falls under ANTIDIABETES DRUGS — the group Codonopsis interacts with.

Theoretically, codonopsis might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Laboratory and animal research suggest that codonopsis has antidiabetic effects.
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

Avandamet combines two diabetes medicines, metformin and rosiglitazone, that both work to lower your blood sugar. The concern here is pretty simple: in lab and animal studies, codonopsis (dang shen) seems to have its own mild blood-sugar-lowering action. So if you add it on top of your medication, the worry is that your numbers could dip a little too low.

I want to be honest, this is a theoretical concern based on pharmacology, not real human studies, so I wouldn't lose sleep over it. Still, keep an eye out for signs of low blood sugar like shakiness, sweating, dizziness, or feeling foggy, especially if you also skip meals. Before starting codonopsis, just give your pharmacist or doctor a heads-up so they can help you watch your readings.

References
  1. Jia W, Bi Q, Jiang S, et al. Hypoglycemic activity of Codonopsis pilosula (Franch.) Nannf. in vitro and in vivo and its chemical composition identification by UPLC-Triple-TOF-MS/MS. Food Funct 2022;13(5):2456-2464.

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

Codonopsis Also Interacts With Other Medications

Codonopsis has 210 moderate known drug interactions in our database — the Metformin, Rosiglitazone 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 Codonopsis

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

Everything else you take

See Every Supplement That Interacts With Metformin, Rosiglitazone

This page covers Codonopsis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metformin, Rosiglitazone page lists 315 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Acai (moderate).

By severity: 4 major · 268 moderate · 43 minor.

From our pharmacist’s overview on the Metformin, Rosiglitazone page

“Avandamet pairs metformin with rosiglitazone to manage type 2 diabetes, and its supplement list calls for genuine care rather than a quick skim. Start with the four major-rated entries: alcohol and the herb Siberian cocklebur can each stress the liver, a serious concern with rosiglitazone on board, while activated charcoal can soak up…”

Reviewed by 2 · Jul 18, 2026

Open the Metformin, Rosiglitazone interaction page

One more smart check

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

We hold 493 real supplement products containing Codonopsis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Codonopsis. Your product may carry other ingredients that interact with Metformin, Rosiglitazone too, on top of Codonopsis — 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 Codonopsis and Metformin, Rosiglitazone 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 Codonopsis
Top half

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

29 days ago today
Medication Metformin, Rosiglitazone
Steady interest

#1,729 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 Codonopsis

What is Codonopsis?

  • Fatigue and low energy
  • Digestive support and poor appetite
  • Immune support
  • General tonic ('qi' tonic in Traditional Chinese Medicine)
  • Cough and weakness during recovery from illness

Codonopsis (often called 'dang shen') is a root long used in Traditional Chinese Medicine as a gentle energy and digestive tonic, frequently as a milder substitute for ginseng. Human research is very limited, so its benefits are not well proven. It appears reasonably well tolerated in food-like amounts, but you should talk with a pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Codonopsis monograph & all interactions
Keep checking

Other Drugs & Codonopsis

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

0Major
210Moderate
0Minor
2,619No known interaction
Moderate

210 interactions

Showing 60 of 210 moderate interactions — see all 210 on the Codonopsis page.

No interaction 2,619 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 Codonopsis and Metformin, Rosiglitazone Together: Common Questions

Can you take Codonopsis with Metformin, Rosiglitazone?
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 Codonopsis and Metformin, Rosiglitazone 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.