Drug & supplement interaction

Kousso + Pramlintide

Pramlintide brand name: Symlin.

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

Kousso has a moderate interaction with Pramlintide. Theoretically, kousso might have an additive effect with antidiabetes drugs and cause hypoglycemia.

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

Kousso 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 Kousso interacts with.

Theoretically, kousso might have an additive effect with antidiabetes drugs and cause hypoglycemia. Animal research shows that kousso flower extract modestly decreases blood glucose levels in diabetic mice.
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 gist: Pramlintide (Symlin) already lowers your blood sugar, and it's always paired with mealtime insulin. The concern with kousso is that some animal studies suggest the flower extract can nudge blood sugar down a little on its own. Stack that on top of pramlintide and insulin, and in theory you could end up too low. That's hypoglycemia, and it can show up as shakiness, sweating, a racing heart, confusion, or feeling faint.

I want to be honest about the evidence though: this is based only on lab and animal research, not human studies, so it's more of a theoretical caution than a proven problem. Pramlintide itself isn't a prodrug and isn't activated by kousso. Still, since low blood sugar can get serious fast, please check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kifle ZD, Yesuf JS, Atnafie SA. Evaluation of in vitro and in vivo Anti-Diabetic, Anti-Hyperlipidemic and Anti-Oxidant Activity of Flower Crude Extract and Solvent Fractions of Hagenia Abyssinica (Rosaceae). J Exp Pharmacol. 2020 Jun 9;12:151-167.

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

Kousso Also Interacts With Other Medications

Kousso 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.

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

Check Another of Your Medications Against Kousso

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

Everything else you take

See Every Supplement That Interacts With Pramlintide

This page covers Kousso 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 Kousso 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 Kousso
Steady interest

#1,186 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pramlintide
Steady interest

#2,057 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 Kousso

What is Kousso?

  • Tapeworm infection (traditional anthelmintic)
  • Other intestinal worms
  • Traditional digestive remedies

Kousso is the dried flower of the African tree Hagenia abyssinica, used traditionally—especially in Ethiopia—to expel tapeworms. It was once listed in older pharmacopeias as a worm treatment, but it has largely been replaced by safer, more reliable modern medicines and can cause significant side effects. There is no good modern evidence supporting its use, so talk to a pharmacist or doctor before considering it.

Read the full Kousso 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 & Kousso

Browse every other medication we’ve checked against Kousso — 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 Kousso page.

No interaction 2,744 drugs checked — show the list

We also checked Kousso 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 Kousso list.

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

Can you take Kousso 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 Kousso 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

Still Have a Question About Pramlintide and Kousso?

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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.