Drug & supplement interaction

Hollyhock + Pramlintide

Pramlintide brand name: Symlin.

Moderate Interaction
The bottom line Moderate

Hollyhock has a moderate interaction with Pramlintide. 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 Pramlintide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Pramlintide

Pramlintide 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: pramlintide (Symlin) already works alongside your mealtime insulin to bring blood sugar down. Hollyhock, based only on lab and animal studies, might nudge blood sugar a little lower too. Put them together and the worry is an additive drop in blood sugar, which could mean shakiness, sweating, dizziness, a racing heart, or confusion. Because pramlintide is always paired with insulin, a low can come on fast.

I want to be honest that this is theoretical. We don't have human studies showing hollyhock actually lowers blood sugar in people, so it may turn out to be a non-issue. Still, since pramlintide is one of those medicines where blood sugar control really matters, check your levels closely and chat with your doctor or pharmacist before combining them.

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 Pramlintide 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 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 Pramlintide

This page covers Hollyhock only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pramlintide page lists 239 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Siberian Cocklebur (major), Acai (moderate), African Wild Potato (moderate), Agaricus Mushroom (moderate) and Agmatine (moderate).

By severity: 1 major · 208 moderate · 30 minor.

From our pharmacist’s overview on the Pramlintide page

“The single entry rated major on the pramlintide (Symlin) list is Siberian cocklebur, which has caused severe hypoglycemia in humans, not just in lab studies. That matters more than usual here because pramlintide is injected at mealtimes alongside insulin, and a dangerous low is already the main hazard of that pairing.”

Reviewed by 2 · Jul 18, 2026

Open the Pramlintide interaction page

How much people look this up

Where Hollyhock and Pramlintide 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

#1,448 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pramlintide
Steady interest

#2,063 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
Medication

About Pramlintide Injection

What Is Pramlintide Injection Used For?

Brand name: Symlin

SymlinPen (pramlintide) is used as an add-on treatment for adults with type 1 or type 2 diabetes who already use mealtime insulin but still haven't reached their target blood sugar levels — even with optimal insulin therapy.

It is not a replacement for insulin. It works alongside insulin, given right before major meals, to reduce the spike in blood sugar that happens after eating.

See full Pramlintide Injection drug information
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
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
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 Hollyhock and Pramlintide Together: Common Questions

Can you take Hollyhock with Pramlintide?
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 Pramlintide 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.