Drug & supplement interaction

Hibiscus Sabdariffa + Alogliptin

Alogliptin brand name: Nesina.

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

Alogliptin falls into 3 drug categories that Hibiscus Sabdariffa can interact with; the most serious is rated moderate. Theoretically, taking Hibiscus sabdariffa with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hibiscus Sabdariffa and Alogliptin

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Hibiscus Sabdariffa interacts with whole categories of medication. Alogliptin falls into 3 of those categories, so it can interact with Hibiscus Sabdariffa in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIDIABETES DRUGS

1 of 3

Why this applies to Alogliptin

Alogliptin falls under ANTIDIABETES DRUGS — the group Hibiscus Sabdariffa interacts with.

Theoretically, taking Hibiscus sabdariffa with antidiabetes drugs might increase the risk of hypoglycemia.
Most clinical research shows that Hibiscus sabdariffa can reduce blood glucose levels.
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 for hibiscus and alogliptin (Nesina): this isn't about how your body breaks the drug down. Instead, both can nudge your blood sugar in the same direction. Alogliptin already works to lower blood sugar, and most research suggests hibiscus may lower it a little too. Stack the two and, in theory, your numbers could dip lower than expected.

I'll be honest, this concern is theoretical, based on how hibiscus behaves rather than strong studies in people on this exact drug. Alogliptin alone rarely causes true lows, so the risk is modest. Still, watch for shakiness, sweating, or feeling lightheaded, and check your sugars. If you enjoy hibiscus regularly or use concentrated supplements, mention it to your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Gurrola-Diaz, C. M., Garcia-Lopez, P. M., Sanchez-Enriquez, S., Troyo-Sanroman, R., Andrade-Gonzalez, I., and Gomez-Leyva, J. F. Effects of Hibiscus sabdariffa extract powder and preventive treatment (diet) on the lipid profiles of patients with metaboli
  2. Najafpour Boushehri S, Karimbeiki R, Ghasempour S, et al. The efficacy of sour tea (Hibiscus sabdariffa L.) on selected cardiovascular disease risk factors: A systematic review and meta-analysis of randomized clinical trials. Phytother Res. 2020;34(2):329
  3. Bule M, Albelbeisi AH, Nikfar S, Amini M, Abdollahi M. The antidiabetic and antilipidemic effects of Hibiscus sabdariffa: A systematic review and meta-analysis of randomized clinical trials. Food Res Int. 2020;130:108980. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Alogliptin also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP3A4. This interaction has not been reported in humans.
Severity Minor 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 for hibiscus and your alogliptin (Nesina). In lab dish studies, hibiscus extract can slow down a liver enzyme called CYP3A4, and alogliptin is partly handled by that pathway. In theory, blocking it could let a little more alogliptin hang around in your body. With a DPP-4 inhibitor like this, the main thing to watch would be slightly lower blood sugar than expected, especially if you also take other diabetes meds.

The good news: this is only a theoretical concern from test-tube research, and it hasn't actually been seen in people. A cup or two of hibiscus tea is very unlikely to cause trouble. Just give your pharmacist or doctor a heads-up before using concentrated hibiscus supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

3 of 3

Alogliptin also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, Hibiscus sabdariffa might reduce the metabolism of CYP2C8 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C8. This interaction has not been reported in humans.
Severity Minor 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 short version: your body uses an enzyme called CYP2C8 to help clear alogliptin (Nesina). In lab dish studies, hibiscus extract appears to slow that same enzyme down. In theory, that could let a little more alogliptin linger in your system, which might slightly nudge its blood-sugar-lowering effect upward. With a DPP-4 inhibitor like this one, that usually shows up as low blood sugar (shakiness, sweating, feeling lightheaded), though that's more of a concern if you also take insulin or a sulfonylurea.

I want to keep this in perspective. This is only a theoretical interaction seen in test tubes, never reported in real people, and it's rated minor. A cup of tart hibiscus tea is very unlikely to matter. Concentrated hibiscus capsules are a bit more of a question mark, so just give your pharmacist a heads-up before starting them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.

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

Hibiscus Sabdariffa Also Interacts With Other Medications

Hibiscus Sabdariffa has 2 major, 265 moderate, 819 minor known drug interactions in our database — the Alogliptin one above is among them. If you take anything else, check it against the full list below.

Major 2 Moderate 265 Minor 819 No known interaction 1,744 (incl. Alogliptin)
Taking anything else?

Check Another of Your Medications Against Hibiscus Sabdariffa

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

Everything else you take

See Every Supplement That Interacts With Alogliptin

This page covers Hibiscus Sabdariffa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alogliptin 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 · 299 moderate · 51 minor.

Open the Alogliptin interaction page

How much people look this up

Where Hibiscus Sabdariffa and Alogliptin 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 Hibiscus Sabdariffa
Top half

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

29 days ago today
Medication Alogliptin
Top half

#897 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 Hibiscus Sabdariffa

What is Hibiscus Sabdariffa?

Hibiscus Sabdariffa
  • High blood pressure
  • Heart and cholesterol health
  • Digestive upset
  • Antioxidant support
  • Fever and general wellness

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure. Evidence for other uses is limited, and while hibiscus tea is generally well tolerated in food amounts, concentrated supplements should be used cautiously and avoided in pregnancy. Talk to your pharmacist or doctor before using it for a medical condition.

Read the full Hibiscus Sabdariffa monograph & all interactions
Medication

About Alogliptin

What Is Alogliptin Used For?

Brand name: Nesina

Alogliptin tablets — sold under the brand names Alogliptin and Nesina — are used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Alogliptin is not used for type 1 diabetes or diabetic ketoacidosis, as it would not be effective in those situations.

See full Alogliptin drug information
Keep checking

Other Drugs & Hibiscus Sabdariffa

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

2Major
265Moderate
819Minor
1,743No known interaction
2 Major 265 Moderate 819 Minor 1,743 No interaction
Major

2 interactions

Moderate

265 interactions

Showing 60 of 265 moderate interactions — see all 265 on the Hibiscus Sabdariffa page.

Minor

819 interactions

Showing 60 of 819 minor interactions — see all 819 on the Hibiscus Sabdariffa page.

No interaction 1,743 drugs checked — show the list

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

Showing the 60 most looked-up of 1,743 medications checked with no known interaction — see the full Hibiscus Sabdariffa list.

See the full Hibiscus Sabdariffa interactions page
See every supplement checked against Alogliptin, 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
Hibiscus Sabdariffa monograph › Uses, safety, and every drug interaction in one place Alogliptin supplement interactions › Every supplement checked against Alogliptin, ranked by severity Alogliptin 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 Hibiscus Sabdariffa and Alogliptin Together: Common Questions

Can you take Hibiscus Sabdariffa with Alogliptin?
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 3 interactions listed for Hibiscus Sabdariffa and Alogliptin?
Alogliptin belongs to more than one drug category, and Hibiscus Sabdariffa 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 Hibiscus Sabdariffa and Alogliptin 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

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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.