Drug & supplement interaction

Codonopsis + Nateglinide

Nateglinide brand name: Starlix.

Moderate Interaction
The bottom line Moderate

Codonopsis has a moderate interaction with Nateglinide. 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 Nateglinide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Nateglinide

Nateglinide 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

Here's the simple version: nateglinide (Starlix) already lowers your blood sugar by nudging your pancreas to release insulin, especially around meals. In lab and animal studies, codonopsis (dang shen) has shown its own mild blood-sugar-lowering effects. Put the two together and, at least in theory, your sugar could dip a little lower than expected. That could mean shakiness, sweating, dizziness, or feeling foggy or hungry.

I want to be honest about the evidence here: this is a theoretical concern based on pharmacology, not proven in people, and food-sized amounts likely matter little. Concentrated supplement doses are where I'd be more cautious. Please don't change your nateglinide on your own. Just loop in your pharmacist or doctor and keep checking your blood sugar.

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 Nateglinide 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 Nateglinide

This page covers Codonopsis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nateglinide page lists 290 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), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 2 major · 241 moderate · 47 minor.

From our pharmacist’s overview on the Nateglinide page

“People who take nateglinide (Starlix) with meals for type 2 diabetes are often drawn to supplements marketed for blood sugar, and that overlap is why these 290 interactions warrant real caution. Some 239 of the ingredients affect blood sugar on their own, most pushing it lower, so stacking them on nateglinide raises the odds of hypogly…”

Reviewed by 2 · Jul 18, 2026

Open the Nateglinide 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 Nateglinide 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 Nateglinide 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

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

29 days ago today
Medication Nateglinide
Steady interest

#1,953 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
Medication

About Nateglinide

What Is Nateglinide Used For?

Brand name: Starlix

Nateglinide tablets are used to help improve blood sugar (glucose) control in adults with type 2 diabetes. It is always used together with diet and exercise — not as a replacement for them.

Nateglinide is not for type 1 diabetes, and it is not used to treat diabetic ketoacidosis (a serious complication where the blood becomes dangerously acidic).

See full Nateglinide drug information
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 Nateglinide Together: Common Questions

Can you take Codonopsis with Nateglinide?
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 Nateglinide 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 Nateglinide and Codonopsis?

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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.