Drug & supplement interaction

English Ivy + Pioglitazone

Pioglitazone brand name: Actos.

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

English Ivy has a moderate interaction with Pioglitazone. Theoretically, English ivy might increase the levels of drugs metabolized by CYP2C8.

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

English Ivy and Pioglitazone

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

Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

Why this applies to Pioglitazone

Pioglitazone falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES — the group English Ivy interacts with.

Theoretically, English ivy might increase the levels of drugs metabolized by CYP2C8.
In vitro research shows that English ivy inhibits CYP2C8 enzymes. So far, 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 gist: your body relies on a liver enzyme called CYP2C8 to break down pioglitazone (Actos). English ivy, in laboratory tests only, appears to slow that enzyme down. If that held true in people, pioglitazone could clear a little more slowly and build up, which might nudge its blood-sugar-lowering effect a bit stronger. With pioglitazone, that could mean things like low blood sugar (shakiness, sweating, dizziness), extra fluid retention, swelling in the ankles, or weight gain.

The reassuring part: this is theoretical and based on test-tube research, with no actual cases reported in humans. So I wouldn't lose sleep over an occasional ivy cough syrup, but it's worth a quick heads-up to your pharmacist or doctor, especially if you notice more frequent low blood sugars.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Rehman SU, Kim IS, Choi MS, Kim SH, Zhang Y, Yoo HH. Time-dependent Inhibition of CYP2C8 and CYP2C19 by Hedera helix Extracts, A Traditional Respiratory Herbal Medicine. Molecules. 2017;22(7). 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

English Ivy Also Interacts With Other Medications

English Ivy has 279 moderate known drug interactions in our database — the Pioglitazone one above is one of them. If you take anything else, check it against the full list below.

Moderate 279 No known interaction 2,551 (incl. Pioglitazone)
Taking anything else?

Check Another of Your Medications Against English Ivy

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

Everything else you take

See Every Supplement That Interacts With Pioglitazone

This page covers English Ivy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pioglitazone 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 · 309 moderate · 41 minor.

From our pharmacist’s overview on the Pioglitazone page

“Most of what appears on this pioglitazone (Actos) list shares one trait: the ingredients lower blood sugar on their own, which sounds helpful until you remember pioglitazone already does that job for people with type 2 diabetes. Stacked together, they can push glucose too low, and I would read this list with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Pioglitazone interaction page

One more smart check

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

We hold 118 real supplement products containing English Ivy, each one broken down to its full ingredient list — and combination products often carry several ingredients besides English Ivy. Your product may carry other ingredients that interact with Pioglitazone too, on top of English Ivy — 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 English Ivy and Pioglitazone 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 English Ivy
Steady interest

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

29 days ago today
Medication Pioglitazone
Steady interest

#1,988 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 English Ivy

What is English Ivy?

English Ivy
  • Cough and chest congestion
  • Bronchitis
  • Asthma symptoms
  • Sore throat
  • Skin irritation

English ivy leaf extract is most commonly used in cough and cold syrups to help loosen mucus and ease coughing, and it is a popular ingredient in many European herbal products. Some research suggests it may help with certain coughs, but the evidence is still limited and mixed. The raw plant is poisonous if eaten and can irritate skin, so only use properly prepared commercial products and check with your pharmacist first.

Read the full English Ivy monograph & all interactions
Medication

About Pioglitazone

What Is Pioglitazone Used For?

Brand name: Actos

Pioglitazone tablets — sold as Actos and under the generic names Pioglitazone and Pioglitazone Hydrochloride — are used to improve blood sugar (glucose) control in adults with type 2 diabetes. They are taken along with diet and exercise, either alone or combined with other diabetes medicines such as a sulfonylurea, metformin, or insulin.

Pioglitazone is not for type 1 diabetes or diabetic ketoacidosis (a serious complication where the blood becomes too acidic). It only works when the body is still producing some of its own insulin.

See full Pioglitazone drug information
Keep checking

Other Drugs & English Ivy

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

0Major
279Moderate
0Minor
2,550No known interaction
279 Moderate 2,550 No interaction
Moderate

279 interactions

Showing 60 of 279 moderate interactions — see all 279 on the English Ivy page.

No interaction 2,550 drugs checked — show the list

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

Showing the 60 most looked-up of 2,550 medications checked with no known interaction — see the full English Ivy list.

See the full English Ivy interactions page
See every supplement checked against Pioglitazone, 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
English Ivy monograph › Uses, safety, and every drug interaction in one place Pioglitazone supplement interactions › Every supplement checked against Pioglitazone, ranked by severity Pioglitazone drug information › The full plain-English guide to this medication 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 English Ivy and Pioglitazone Together: Common Questions

Can you take English Ivy with Pioglitazone?
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 English Ivy and Pioglitazone 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 and English Ivy?

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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.