Drug & supplement interaction

Greater Celandine + Pioglitazone

Pioglitazone brand name: Actos.

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

Greater Celandine has a moderate interaction with Pioglitazone. There is some concern that greater celandine can adversely affect the liver.

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

Greater Celandine and Pioglitazone

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Pioglitazone

Pioglitazone falls under HEPATOTOXIC DRUGS — the group Greater Celandine interacts with.

There is some concern that greater celandine can adversely affect the liver. Greater celandine has been linked to many cases of hepatotoxicity. Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage. Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (TriCor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo).
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 greater celandine and pioglitazone (Actos). This isn't about one changing how the other is broken down. Instead, it's about doubling up on stress to the same organ. Greater celandine has been tied to real cases of liver injury, and pioglitazone, on its own, can occasionally raise liver enzymes too. Taking both together could, in theory, add up and make liver problems more likely.

Honestly, the evidence here is anecdotal (case reports rather than strong studies), so I don't want to alarm you. Still, since greater celandine offers little proven benefit and carries a known liver risk, I'd run this by your pharmacist or doctor before combining them. Watch for yellowing skin or eyes, dark urine, or unusual fatigue.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Benninger J, Schneider HT, Schuppan D, et al. Acute hepatitis induced by greater celandine (Chelidonium majus). Gastroenterology 1999;117:1234-7. PubMed
  2. Stickel F, Poschl G, Seitz HK, et al. Acute hepatitis induced by Greater Celandine (Chelidonium majus). Scand J Gastroenterol 2003;38:565-8.
  3. Moro PA, Cassetti F, Giugliano G, et al. Hepatitis from greater celandine (Chelidonium majus L.): Review of literature and report of a new case. J Ethnopharmacol 2009;124:328-32. PubMed
  4. Stickel, F., Seitz, H. K., Hahn, E. G., and Schuppan, D. [Liver toxicity of drugs of plant origin]. Z.Gastroenterol. 2001;39(3):225-227.
  5. Hardeman, E., Van, Overbeke L., Ilegems, S., and Ferrante, M. Acute hepatitis induced by greater celandine (Chelidonium majus). Acta Gastroenterol.Belg. 2008;71(2):281-282.
  6. Gilca, M., Gaman, L., Panait, E., Stoian, I., and Atanasiu, V. Chelidonium majus--an integrative review: traditional knowledge versus modern findings. Forsch.Komplementmed. 2010;17(5):241-248. PubMed
  7. Teschke, R., Glass, X., and Schulze, J. Herbal hepatotoxicity by Greater Celandine (Chelidonium majus): causality assessment of 22 spontaneous reports. Regul.Toxicol.Pharmacol. 2011;61(3):282-291. PubMed
  8. Teschke, R., Glass, X., Schulze, J., and Eickhoff, A. Suspected Greater Celandine hepatotoxicity: liver-specific causality evaluation of published case reports from Europe. Eur.J Gastroenterol.Hepatol. 2012;24(3):270-280. PubMed
  9. Teschke, R., Frenzel, C., Glass, X., Schulze, J., and Eickhoff, A. Greater Celandine hepatotoxicity: a clinical review. Ann.Hepatol. 2012;11(6):838-848. DOI

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

Greater Celandine Also Interacts With Other Medications

Greater Celandine has 624 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 624 No known interaction 2,206 (incl. Pioglitazone)
Taking anything else?

Check Another of Your Medications Against Greater Celandine

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

Everything else you take

See Every Supplement That Interacts With Pioglitazone

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

We hold 11 real supplement products containing Greater Celandine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Greater Celandine. Your product may carry other ingredients that interact with Pioglitazone too, on top of Greater Celandine — 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 Greater Celandine 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 Greater Celandine
Steady interest

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

29 days ago today
Medication Pioglitazone
Steady interest

#2,083 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 Greater Celandine

What is Greater Celandine?

Greater Celandine
  • Digestive and gallbladder complaints
  • Stomach cramps and bloating
  • Topical use for warts and skin growths
  • Liver and gallbladder 'cleansing'
  • Mild pain relief

Greater celandine is a traditional herb most often promoted for digestive and gallbladder complaints, but solid human evidence for any use is lacking. More importantly, it has been linked to serious and sometimes severe liver injury, so most experts advise against taking it by mouth. If you are considering it, talk with your pharmacist or doctor first.

Read the full Greater Celandine 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 & Greater Celandine

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

0Major
624Moderate
0Minor
2,205No known interaction
624 Moderate 2,205 No interaction
Moderate

624 interactions

Showing 60 of 624 moderate interactions — see all 624 on the Greater Celandine page.

No interaction 2,205 drugs checked — show the list

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

Showing the 60 most looked-up of 2,205 medications checked with no known interaction — see the full Greater Celandine list.

See the full Greater Celandine 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
Greater Celandine 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 Greater Celandine and Pioglitazone Together: Common Questions

Can you take Greater Celandine 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 Greater Celandine 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 Greater Celandine?

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.