Drug & supplement interaction

Hollyhock + pioglitazone, metformin

pioglitazone, metformin brand name: ActoPlus Met.

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

Hollyhock has a moderate interaction with pioglitazone, metformin. Animal and in vitro research shows that hollyhock flower extracts might lower blood glucose levels.

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

Hollyhock and pioglitazone, metformin

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

Moderate

ANTIDIABETES DRUGS

Why this applies to pioglitazone, metformin

pioglitazone, metformin falls under ANTIDIABETES DRUGS — the group Hollyhock interacts with.

Animal and in vitro research shows that hollyhock flower extracts might lower blood glucose levels. While the effect of hollyhock in patients with diabetes has not been studied, theoretically, hollyhock might decrease blood glucose and have additive effects in patients treated with antidiabetes drugs. Dose adjustments to diabetes medications may be necessarily. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), 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

Here's the simple version: your ActoPlus Met (the combo of pioglitazone and metformin) already works to bring your blood sugar down. In lab and animal studies, hollyhock flower extracts also seemed to lower blood sugar a little. So if you put the two together, the worry is that they could add up and push your numbers down too far.

If that happened, you might notice signs of low blood sugar (hypoglycemia) like shakiness, sweating, dizziness, hunger, or feeling foggy. I want to be honest, though: this is only a theoretical concern based on early research, not real studies in people, so the actual risk is likely small. Still, if you'd like to try hollyhock, check with your pharmacist or doctor first and keep an eye on your glucose readings.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Zhang Y, Jin L, Chen Q, et al. Hypoglycemic activity evaluation and chemical study on hollyhock flowers. Fitoterapia 2015;102:7-14. 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

Hollyhock Also Interacts With Other Medications

Hollyhock has 85 moderate known drug interactions in our database — the pioglitazone, metformin one above is one of them. If you take anything else, check it against the full list below.

Moderate 85 No known interaction 2,745 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Hollyhock

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

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Hollyhock only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the pioglitazone, metformin page lists 357 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 · 311 moderate · 40 minor.

From our pharmacist’s overview on the pioglitazone, metformin page

“ActoPlus Met pairs pioglitazone with metformin for type 2 diabetes, and the size of this list, 357 supplements in all, reflects how many herbs lower blood sugar on their own. Stacked with the drug, they can push glucose too low; most of the 311 moderate entries work exactly that way.”

Reviewed by 2 · Jul 18, 2026

Open the pioglitazone, metformin interaction page

How much people look this up

Where Hollyhock and pioglitazone, metformin 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 Hollyhock
Steady interest

#1,416 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication pioglitazone, metformin
Steady interest

#1,692 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 Hollyhock

What is Hollyhock?

  • Sore throat and cough
  • Digestive upset
  • Soothing irritated skin
  • Mild inflammation
  • Urinary discomfort

Hollyhock is a flowering plant in the mallow family that has been used in traditional medicine, mainly as a soothing (demulcent) remedy for the throat, gut, and skin. Solid human studies are very limited, so its benefits are not well proven. It is generally considered gentle, but you should still talk to a pharmacist or doctor before using it, especially if you are pregnant or breastfeeding.

Read the full Hollyhock monograph & all interactions
Keep checking

Other Drugs & Hollyhock

Browse every other medication we’ve checked against Hollyhock — 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
85 Moderate 2,744 No interaction
Moderate

85 interactions

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

No interaction 2,744 drugs checked — show the list

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

Showing the 60 most looked-up of 2,744 medications checked with no known interaction — see the full Hollyhock list.

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

Can you take Hollyhock with pioglitazone, metformin?
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 Hollyhock and pioglitazone, metformin 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.