Drug & supplement interaction

Guava + Simvastatin, Sitagliptin

Simvastatin, Sitagliptin brand name: Juvisync.

Moderate Interaction
The bottom line Moderate

Guava has a moderate interaction with Simvastatin, Sitagliptin. Theoretically, concomitant use with antidiabetes drugs might have additive effects and increase the risk of hypoglycemia.

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

Guava and Simvastatin, Sitagliptin

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Simvastatin, Sitagliptin

Simvastatin, Sitagliptin falls under ANTIDIABETES DRUGS — the group Guava interacts with.

Theoretically, concomitant use with antidiabetes drugs might have additive effects and increase the risk of hypoglycemia. Animal research shows that guava leaf extract or guava fruit can have hypoglycemic effects. Monitor blood glucose levels closely. Medication dose adjustments may be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (Diabeta, Glynase PresTab, Micronase), insulin, metformin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
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

Juvisync is a combination pill that pairs sitagliptin (a blood sugar medicine) with simvastatin (a cholesterol medicine). The interaction on file applies to the diabetes half, the sitagliptin. The idea is that guava leaf, in animal and lab studies, seems to lower blood sugar on its own. So pairing it with sitagliptin could add up and push your sugar a little too low.

If that happens, you might feel shaky, sweaty, dizzy, irritable, or unusually tired. Keep in mind this is theoretical, based on early animal research, and eating guava fruit as food is far less concentrated than a guava leaf supplement. If you do want to try guava leaf products, check in with your pharmacist or doctor first and keep an eye on your home glucose readings.

References
  1. Gutiérrez RM, Mitchell S, Solis RV. Psidium guajava: a review of its traditional uses, phytochemistry and pharmacology. J Ethnopharmacol. 2008;117(1):1-27. 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

Guava Also Interacts With Other Medications

Guava has 85 moderate known drug interactions in our database — the Simvastatin, Sitagliptin 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 Guava

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

Everything else you take

See Every Supplement That Interacts With Simvastatin, Sitagliptin

This page covers Guava only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Simvastatin, Sitagliptin page lists 362 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 8 major · 304 moderate · 50 minor.

From our pharmacist’s overview on the Simvastatin, Sitagliptin page

“Juvisync pairs simvastatin for cholesterol with sitagliptin for type 2 diabetes, and that combination carries 362 supplement interactions on file, eight rated major, so read this page with real care rather than a quick skim. Grapefruit stands out as the everyday hazard; it blocks the enzyme that clears simvastatin, raising statin level…”

Reviewed by 2 · Jul 18, 2026

Open the Simvastatin, Sitagliptin interaction page

One more smart check

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

We hold 484 real supplement products containing Guava, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guava. Your product may carry other ingredients that interact with Simvastatin, Sitagliptin too, on top of Guava — 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 Guava and Simvastatin, Sitagliptin 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 Guava
Top half

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

29 days ago today
Medication Simvastatin, Sitagliptin
Top half

#1,219 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 Guava

What is Guava?

  • Diarrhea and digestive upset
  • Blood sugar support
  • Cholesterol support
  • Wound and skin care
  • Cough and sore throat

Guava is a tropical fruit tree whose leaves and fruit have a long history of folk use for diarrhea, blood sugar, and general wellness. The fruit is a nutritious food rich in vitamin C, but evidence for guava leaf supplements treating specific health conditions is limited and mostly early. If you want to try guava leaf products, talk with your pharmacist or doctor first, especially if you take medicines or have a health condition.

Read the full Guava monograph & all interactions
Keep checking

Other Drugs & Guava

Browse every other medication we’ve checked against Guava — 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
Moderate

85 interactions

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

No interaction 2,744 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 Guava and Simvastatin, Sitagliptin Together: Common Questions

Can you take Guava with Simvastatin, Sitagliptin?
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 Guava and Simvastatin, Sitagliptin 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 Simvastatin, Sitagliptin and Guava?

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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.