Drug & supplement interaction

Juniper + pioglitazone, metformin

pioglitazone, metformin brand name: ActoPlus Met.

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

Juniper has a moderate interaction with pioglitazone, metformin. Theoretically, taking juniper berry with antidiabetes medications might cause additive hypoglycemia.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Juniper 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 Juniper interacts with.

Theoretically, taking juniper berry with antidiabetes medications might cause additive hypoglycemia.
Animal research shows that juniper berry can lower blood glucose.
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 (pioglitazone plus metformin) already works to bring your blood sugar down. In animal studies, juniper berry also nudged blood sugar lower. So the concern is that pairing the two could stack up and push your sugar too low.

I want to be honest about how strong this is. This is a theoretical worry based mostly on lab and animal research, not solid human data, and ordinary culinary amounts (like the juniper flavor in food) are unlikely to matter. Concentrated supplement doses are where I'd pay attention. If you do take juniper, watch for low-sugar signs (shakiness, sweating, dizziness, confusion) and check in with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Sanchez de Medina F, Gamez MJ, Jimenez I, et al. Hypoglycemic activity of juniper "berries." Planta Med 1994;60:197-200. PubMed
  3. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. 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

Juniper Also Interacts With Other Medications

Juniper has 85 moderate, 76 minor 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 Minor 76 No known interaction 2,669 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Juniper

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

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Juniper 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

One more smart check

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

We hold 1,100 real supplement products containing Juniper, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Juniper. Your product may carry other ingredients that interact with pioglitazone, metformin too, on top of Juniper — 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 Juniper 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 Juniper
Top 25%

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

29 days ago today
Medication pioglitazone, metformin
Steady interest

#2,360 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 Juniper

What is Juniper?

  • Water retention (diuretic)
  • Digestive upset and bloating
  • Urinary tract support
  • Joint and muscle discomfort
  • Flavoring (gin and food)

Juniper berry is a traditional herb best known for flavoring gin and for its folk use as a diuretic and digestive aid. Solid human evidence for its health benefits is limited, and it can irritate the kidneys with high doses or long-term use. Pregnant people and those with kidney problems should avoid it, and everyone should check with a pharmacist or doctor first.

Read the full Juniper monograph & all interactions
Keep checking

Other Drugs & Juniper

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

0Major
85Moderate
76Minor
2,668No known interaction
85 Moderate 76 Minor 2,668 No interaction
Moderate

85 interactions

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

Minor

76 interactions

Showing 60 of 76 minor interactions — see all 76 on the Juniper page.

No interaction 2,668 drugs checked — show the list

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

Showing the 60 most looked-up of 2,668 medications checked with no known interaction — see the full Juniper list.

See the full Juniper 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
Juniper 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 Juniper and pioglitazone, metformin Together: Common Questions

Can you take Juniper 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 Juniper 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

Still Have a Question About pioglitazone, metformin and Juniper?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.