Drug & supplement interaction

Collard + pioglitazone, metformin

pioglitazone, metformin brand name: ActoPlus Met.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Collard has a moderate interaction with pioglitazone, metformin. In an animal study, an aqueous extract of collard leaves and stems has been shown to reduce glucose levels.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Collard and pioglitazone, metformin

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

Moderate

ANTIDIABETES DRUGS

Why this applies to pioglitazone, metformin

pioglitazone, metformin falls under ANTIDIABETES DRUGS — the group Collard interacts with.

In an animal study, an aqueous extract of collard leaves and stems has been shown to reduce glucose levels. Collard extract 60 mg/kg lowers blood glucose levels in a rat model of diabetes after both single- and multi-dose oral administration similarly to glibenclamide 5 mg/kg. Theoretically, collard extract might have additive effects when used concomitantly with antidiabetes drugs and may increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments may be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), and tolbutamide (Orinase).
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: collard greens may have a mild blood-sugar-lowering effect of their own. Your ActoPlus Met already does that job with two medicines (pioglitazone plus metformin), so in theory, stacking a concentrated collard supplement on top could nudge your sugar a little lower than expected. If that happens, you might feel shaky, sweaty, dizzy, or unusually tired, which are classic signs of low blood sugar (hypoglycemia).

Honestly, this concern comes from a single rat study, not from people, so the evidence is thin. Eating collards as a normal food is very unlikely to cause trouble. If you decide to take a strong collard supplement regularly, just check your sugars a bit more often at first and loop in your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Amssayef A, Eddouks M. Antihyperglycemic Effect of the Moroccan Collard Green (Brassica oleracea var. viridis) in Streptozotocin-Induced Diabetic Rats. Endocr Metab Immune Disord Drug Targets 2020. PubMed

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

Collard Also Interacts With Other Medications

Collard has 85 moderate known drug interactions in our database — the pioglitazone, metformin one above is one of them. If you take anything else, check it against the full list below.

Moderate 85 No known interaction 2,745 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Collard

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

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Collard only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the pioglitazone, metformin page lists 357 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 · 311 moderate · 40 minor.

From our pharmacist’s overview on the pioglitazone, metformin page

“ActoPlus Met pairs pioglitazone with metformin for type 2 diabetes, and the size of this list, 357 supplements in all, reflects how many herbs lower blood sugar on their own. Stacked with the drug, they can push glucose too low; most of the 311 moderate entries work exactly that way.”

Reviewed by 2 · Jul 18, 2026

Open the pioglitazone, metformin interaction page

One more smart check

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

We hold 379 real supplement products containing Collard, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Collard. Your product may carry other ingredients that interact with pioglitazone, metformin too, on top of Collard — 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 Collard and pioglitazone, metformin 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 Collard
Steady interest

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

29 days ago today
Medication pioglitazone, metformin
Steady interest

#2,086 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 Collard

What is Collard?

  • General nutrition and vitamin source
  • Bone health
  • Heart health support
  • Digestive fiber
  • Antioxidant intake

Collard is a leafy green vegetable in the cabbage family that is rich in vitamins, minerals, and fiber, and is best thought of as a nutritious food rather than a medicine. Eating it as part of a balanced diet is healthy for most people, but there is little high-quality research on collard as a concentrated supplement. If you take blood thinners or have kidney concerns, talk with your pharmacist or doctor because of its vitamin K and oxalate content.

Read the full Collard monograph & all interactions
Keep checking

Other Drugs & Collard

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

0Major
85Moderate
0Minor
2,744No known interaction
85 Moderate 2,744 No interaction
Moderate

85 interactions

Showing 60 of 85 moderate interactions — see all 85 on the Collard page.

No interaction 2,744 drugs checked — show the list

We also checked Collard against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,744 medications checked with no known interaction — see the full Collard list.

See the full Collard interactions page
See every supplement checked against pioglitazone, metformin, ranked by severity
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

Keep exploring
Collard monograph › Uses, safety, and every drug interaction in one place pioglitazone, metformin supplement interactions › Every supplement checked against pioglitazone, metformin, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Collard and pioglitazone, metformin Together: Common Questions

Can you take Collard with pioglitazone, metformin?
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 Collard and pioglitazone, metformin 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 pioglitazone, metformin and Collard?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.