Drug & supplement interaction

Ilex Guayusa + Metformin, Sitagliptin

Metformin, Sitagliptin brand names: Janumet, Janumet XR.

Minor Interaction
The bottom line Minor

Metformin, Sitagliptin falls into 2 drug categories that Ilex Guayusa can interact with; the most serious is rated minor. Theoretically, taking Ilex guayusa with antidiabetes drugs might increase the risk of hypoglycemia.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ilex Guayusa and Metformin, Sitagliptin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Ilex Guayusa interacts with whole categories of medication. Metformin, Sitagliptin falls into 2 of those categories, so it can interact with Ilex Guayusa in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

ANTIDIABETES DRUGS

1 of 2

Why this applies to Metformin, Sitagliptin

Metformin, Sitagliptin falls under ANTIDIABETES DRUGS — the group Ilex Guayusa interacts with.

Theoretically, taking Ilex guayusa with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research in a model of hyperglycemia suggests that Ilex guayusa may have antihyperglycemic effects, although it does not appear to lower glucose levels when compared with baseline. This effect has not been evaluated in humans.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Janumet pairs two diabetes medicines, metformin and sitagliptin, and both work to lower your blood sugar. The thinking here is that guayusa, an Amazonian tea, might add a small extra blood-sugar-lowering nudge on top of your medication. If that happened, it could in theory raise your chances of going too low (hypoglycemia), which can feel like shakiness, sweating, dizziness, or confusion.

Honestly, I wouldn't lose sleep over this one. The only evidence comes from animal studies, and guayusa didn't even reliably lower glucose compared to baseline. It has never been tested in people. A cup of guayusa tea is very unlikely to cause trouble. Still, keep an eye on your sugar readings, and check with your pharmacist or doctor if you drink it often.

References
  1. Swanston-Flatt SK, Day C, Flatt PR, Gould BJ, Bailey CJ. Glycaemic effects of traditional European plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetes Res 1989;10(2):69-73.
  2. Mello TC, Dias DDS, Bernardes N, et al. Ilex Guayusa Tea Improves Glycaemia and Autonomic Modulation in Female Streptozotocin-Induced Diabetic Rats. Pharmaceuticals (Basel) 2025;18(3):316. PubMed
Minor

METFORMIN (Glucophage)

2 of 2
Theoretically, metformin might increase the levels and adverse effects of caffeine.
Ilex guayusa contains caffeine. Animal research suggests that metformin can reduce caffeine metabolism. Theoretically, concomitant use can increase caffeine serum concentrations and the risk of caffeine adverse effects.
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 interesting twist with Janumet (which combines metformin and sitagliptin): it's not your diabetes medicine that gets affected here, it's the caffeine in the guayusa tea. Animal studies hint that metformin may slow down how your body clears caffeine, so the caffeine could hang around a bit longer and feel a little stronger than usual.

In plain terms, you might notice more jitteriness, a faster heartbeat, trouble sleeping, or feeling on edge. Keep in mind this is based only on lab and animal research, so it's pretty theoretical, and a normal cup or two probably won't cause trouble. If you're drinking a lot of guayusa or taking concentrated caffeine supplements and feel wired, ease up and check in with your pharmacist or doctor.

References
  1. Mohiuddin, M., Azam, A. T., Amran, M. S., and Hossain, M. A. In vive effects of gliclazide and metformin on the plasma concentration of caffeine in healthy rats. Pak.J Biol Sci 5-1-2009;12(9):734-737.

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

Ilex Guayusa Also Interacts With Other Medications

Ilex Guayusa has 8 major, 470 moderate, 126 minor known drug interactions in our database — the Metformin, Sitagliptin one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ilex Guayusa

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

Everything else you take

See Every Supplement That Interacts With Metformin, Sitagliptin

This page covers Ilex Guayusa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metformin, Sitagliptin page lists 257 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 2 major · 217 moderate · 38 minor.

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

“Many people prescribed metformin with sitagliptin (Janumet, Janumet XR) for type 2 diabetes also try herbs sold as blood sugar support, fenugreek among the most popular, and that habit is exactly where the risk on this page concentrates. Of 257 documented supplement interactions, 239 can push glucose in the same direction the medicatio…”

Reviewed by 2 · Jul 18, 2026

Open the Metformin, Sitagliptin interaction page

How much people look this up

Where Ilex Guayusa and Metformin, 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 Ilex Guayusa
Steady interest

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

29 days ago today
Medication Metformin, Sitagliptin
Top half

#967 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 Ilex Guayusa

What is Ilex Guayusa?

  • Energy and alertness
  • Mental focus
  • Antioxidant support
  • Appetite control
  • Athletic and physical performance

Ilex guayusa is a caffeine-containing holly leaf from the Amazon, traditionally brewed as a tea for energy and alertness, much like yerba mate or green tea. There is limited human research confirming specific health benefits, and its main reliable effect comes from its caffeine content. Because it is a stimulant, use it cautiously and check with your pharmacist or doctor if you have heart concerns or are pregnant.

Read the full Ilex Guayusa monograph & all interactions
Keep checking

Other Drugs & Ilex Guayusa

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

8Major
470Moderate
126Minor
2,225No known interaction
Major

8 interactions

Moderate

470 interactions

Showing 60 of 470 moderate interactions — see all 470 on the Ilex Guayusa page.

Minor

126 interactions

Showing 60 of 126 minor interactions — see all 126 on the Ilex Guayusa page.

No interaction 2,225 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 Ilex Guayusa and Metformin, Sitagliptin Together: Common Questions

Can you take Ilex Guayusa with Metformin, Sitagliptin?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Ilex Guayusa and Metformin, Sitagliptin?
Metformin, Sitagliptin belongs to more than one drug category, and Ilex Guayusa 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 Ilex Guayusa and Metformin, Sitagliptin interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.