Drug & supplement interaction

Garcinia + Pioglitazone

Pioglitazone brand name: Actos.

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

Pioglitazone falls into 2 drug categories that Garcinia can interact with; the most serious is rated moderate. Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Garcinia and Pioglitazone

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Garcinia interacts with whole categories of medication. Pioglitazone falls into 2 of those categories, so it can interact with Garcinia in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Pioglitazone

Pioglitazone falls under HEPATOTOXIC DRUGS — the group Garcinia interacts with.

Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
There have been reports of acute hepatitis with elevated liver enzymes associated with garcinia, when taken alone or in combination with other ingredients. Case reports collected from the Drug Induced Liver Injury Network suggest this risk may be greater in people who carry the HLA B*35:01 allele.
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 concern with pairing Garcinia and pioglitazone (Actos): both can occasionally be tough on the liver. Pioglitazone itself is processed by the liver and, though rare, has been linked to liver enzyme changes. Garcinia has its own scattered reports of liver injury and even acute hepatitis. Stacking two things that each carry some liver risk could, in theory, add up.

To be clear, this is a theoretical caution based on how these work, not proof it will happen to you. Still, watch for warning signs like yellowing skin or eyes, dark urine, belly pain on the right side, or unusual tiredness, and call your doctor if they show up. Before starting Garcinia, please check with your pharmacist or doctor, especially if you already have any liver issues.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Stevens T, Qadri A, Zein NN. Two patients with acute liver injury associated with use of the herbal weight-loss supplement hydroxycut. Ann Intern Med 2005;142:477-8. PubMed
  2. Bunchorntavakul, C. and Reddy, K. R. Review article: herbal and dietary supplement hepatotoxicity. Aliment.Pharmacol.Ther 2013;37(1):3-17. PubMed
  3. Dara L, Hewett J, Lim JK. Hydroxycut hepatotoxicity: a case series and review of liver toxicity from herbal weight loss supplements. World J Gastroenterol. 2008 Dec 7;14(45):6999-7004. PubMed
  4. Sharma T, Wong L, Tsai N, Wong RD. Hydroxycut(®) (herbal weight loss supplement) induced hepatotoxicity: a case report and review of literature. Hawaii Med J. 2010 Aug;69(8):188-90.
  5. Rashid NN, Grant J. Hydroxycut hepatotoxicity. Med J Aust. 2010 Feb 1;192(3):173-4. PubMed
  6. Corey R, Werner KT, Singer A, Moss A, Smith M, Noelting J, Rakela J. Acute liver failure associated with Garcinia cambogia use. Ann Hepatol. 2016 Jan-Feb;15(1):123-6. PubMed
  7. Melendez-Rosado J, Snipelisky D, Matcha G, Stancampiano F. Acute hepatitis induced by pure Garcinia cambogia. J Clin Gastroenterol. 2015 May-Jun;49(5):449-50. PubMed
  8. García-Cortés M, Robles-Díaz M, Ortega-Alonso A, Medina-Caliz I, Andrade RJ. Hepatotoxicity by Dietary Supplements: A Tabular Listing and Clinical Characteristics. Int J Mol Sci. 2016 Apr 9;17(4):537. PubMed
  9. Yousaf MN, Chaudhary FS, Hodanazari SM, Sittambalam CD. Hepatotoxicity associated with Garcinia cambogia: a case report. World J Hepatol 2019;11(11):735-42.
  10. Mas Ordeig A, Bordón García N. Hepatotoxicity caused by Garcinia cambogia. Gastroenterol Hepatol 2020;43(3):134-5. DOI
  11. Vuppalanchi R, Bonkovsky HL, Ahmad J, et al. Garcinia cambogia, Either Alone or in Combination With Green Tea, Causes Moderate to Severe Liver Injury. Clin Gastroenterol Hepatol 2021. PubMed
Moderate

ANTIDIABETES DRUGS

2 of 2

Pioglitazone also falls under ANTIDIABETES DRUGS.

Theoretically, hydroxycitric acid (HCA), the main active ingredient in garcinia, might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
HCA reduces fasting and postprandial blood glucose levels in animal models, theoretically by delaying glucose absorption. This effect 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: Garcinia contains hydroxycitric acid (HCA), and in animal studies it seemed to nudge blood sugar a little lower. Pioglitazone (Actos) already works to lower your blood sugar by making your body more sensitive to insulin. So the theory is that stacking the two together could add up and push your sugar down further than expected, which might lead to low blood sugar (hypoglycemia): shakiness, sweating, dizziness, or feeling lightheaded.

I want to be honest, though: this is a theoretical concern. The blood sugar effect from HCA hasn't actually been shown in people, only in animals, and Garcinia's weight-loss benefits are weak at best. There's also a separate, more real worry about Garcinia and the liver. Before adding it, please check with your pharmacist or doctor so they can keep an eye on your numbers.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Asghar M, Monjok E, Kouamou G, et al. Super CitriMax (HCA-SX) attenuates increases in oxidative stress, inflammation, insulin resistance, and body weight in developing obese Zucker rats. Mol Cell Biochem 2007;304(1-2):93-99. PubMed
  2. Wielinga PY, Wachters-Hagedoorn RE, Bouter B, et al. Hydroxycitric acid delays intestinal glucose absorption in rats. Am J Physiol Gastrointest Liver Physiol 2005;288(6):G1144-G1149. PubMed
  3. Leonhardt M, Balkan B, Langhans W. Effect of hydroxycitrate on respiratory quotient, energy expenditure, and glucose tolerance in male rats after a period of restrictive feeding. Nutrition 2004;20(10):911-915. 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

Garcinia Also Interacts With Other Medications

Garcinia has 703 moderate known drug interactions in our database — the Pioglitazone one above is among them. If you take anything else, check it against the full list below.

Moderate 703 No known interaction 2,127 (incl. Pioglitazone)
Taking anything else?

Check Another of Your Medications Against Garcinia

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

Everything else you take

See Every Supplement That Interacts With Pioglitazone

This page covers Garcinia 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 Garcinia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,374 real supplement products containing Garcinia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Garcinia. Your product may carry other ingredients that interact with Pioglitazone too, on top of Garcinia — 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 Garcinia 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 Garcinia
Top 25%

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

29 days ago today
Medication Pioglitazone
Steady interest

#1,997 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 Garcinia

What is Garcinia?

Garcinia
  • Weight loss
  • Appetite suppression
  • Curbing sugar and carb cravings
  • Supporting metabolism
  • Traditional cooking and souring agent

Garcinia is a tropical fruit whose rind contains hydroxycitric acid (HCA), widely marketed for weight loss and appetite control. The scientific evidence is weak and mixed, with most studies showing only small or no meaningful weight effects, and rare reports of liver problems raise safety concerns. Talk to a pharmacist or doctor before trying it, especially if you have liver issues, are pregnant, or are breastfeeding.

Read the full Garcinia 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 & Garcinia

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

0Major
703Moderate
0Minor
2,126No known interaction
703 Moderate 2,126 No interaction
Moderate

703 interactions

Showing 60 of 703 moderate interactions — see all 703 on the Garcinia page.

No interaction 2,126 drugs checked — show the list

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

Showing the 60 most looked-up of 2,126 medications checked with no known interaction — see the full Garcinia list.

See the full Garcinia 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
Garcinia 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 Garcinia and Pioglitazone Together: Common Questions

Can you take Garcinia 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.
Why are there 2 interactions listed for Garcinia and Pioglitazone?
Pioglitazone belongs to more than one drug category, and Garcinia interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Garcinia 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 Garcinia?

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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.