Drug & supplement interaction

Kudzu + pioglitazone, metformin

pioglitazone, metformin brand name: ActoPlus Met.

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

pioglitazone, metformin falls into 2 drug categories that Kudzu can interact with; the most serious is rated moderate. Theoretically, concomitant use might have additive hepatotoxic effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Kudzu and pioglitazone, metformin

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

Why Are There 2 Interactions?

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

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to pioglitazone, metformin

pioglitazone, metformin falls under HEPATOTOXIC DRUGS — the group Kudzu interacts with.

Theoretically, concomitant use might have additive hepatotoxic effects.
There is some concern that kudzu can adversely affect the liver.
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 with ActoPlus Met (which combines pioglitazone and metformin) plus kudzu. This isn't about kudzu changing your blood sugar or how your body activates these drugs. The concern is purely about the liver. Pioglitazone is processed by your liver and, in rare cases, can stress it. Kudzu has also raised some questions about possible liver effects. So in theory, taking both together might add up to a bit more strain on the liver.

I want to be honest about how soft this evidence is. This is a theoretical worry based on how these things work, not real-world cases of harm. Still, watch for warning signs like yellowing skin or eyes, dark urine, belly pain, or unusual fatigue, and check with your pharmacist or doctor before adding kudzu.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kim HJ, Kim H, Ahn JH, Suk JH. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern Complement Med 2015;21(3):180-5. PubMed
  2. Santosh N, Mohan K, Royana S, Yamini TB. Hepatotoxicity of tubers of Indian Kudzu (Pueraria tuberosa) in rats. Food Chem Toxicol. 2010 Apr;48(4):1066-71. PubMed
  3. Teschke R, Zhang L, Long H, Schwarzenboeck A, Schmidt-Taenzer W, Genthner A, Wolff A, Frenzel C, Schulze J, Eickhoff A. Traditional Chinese Medicine and herbal hepatotoxicity: a tabular compilation of reported cases. Ann Hepatol. 2015 Jan-Feb;14(1):7-19. DOI
  4. Wang D, Qiu L, Wu X, Wei H, Xu F. Evaluation of kudzu root extract-induced hepatotoxicity. J Ethnopharmacol. 2015 Dec 24;176:321-6. PubMed
Minor

ANTIDIABETES DRUGS

2 of 2

pioglitazone, metformin also falls under ANTIDIABETES DRUGS.

Theoretically, taking kudzu with antidiabetes drugs might increase the risk of hypoglycemia.
Kudzu might lower blood glucose levels and have additive effects in patients treated with antidiabetic agents. The dose of diabetes medications might need to be adjusted.
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

Here's the simple version: kudzu may have a mild blood-sugar-lowering effect of its own. Since ActoPlus Met (the pioglitazone and metformin combo) is already working to bring your glucose down, stacking the two could, in theory, push your numbers a little lower than expected. That's what we call an additive effect.

Honestly though, this is a theoretical concern based only on lab and animal data, so it's unlikely to cause real trouble for most people. If you do try kudzu, just keep an eye out for signs your sugar dipped too low, like shakiness, sweating, dizziness, or feeling foggy. Don't change your dose on your own. Check your readings and loop in your pharmacist or doctor so they can guide you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lee KT, Sohn IC, Kim DH, et al. Hypoglycemic and hypolipidemic effects of tectorigenin and kaikasaponin III in the streptozotocin-lnduced diabetic rat and their antioxidant activity in vitro. Arch Pharm Res 2000;23:461-6.
  2. Hsu FL, Liu IM, Kuo DH, et al. Antihyperglycemic effect of puerarin in streptozotocin-induced diabetic rats. J Nat Prod 2003;66:788-92. PubMed
  3. Hsu, H. H., Chang, C. K., Su, H. C., Liu, I. M., and Cheng, J. T. Stimulatory effect of puerarin on alpha1A-adrenoceptor to increase glucose uptake into cultured C2C12 cells of mice. Planta Med 2002;68(11):999-1003.
  4. Hou, Q., Ao, X., Li, G., and Zhang, Y. [Puerarin combined with avandia for diabetic nephropathy]. Zhong.Nan.Da.Xue Xue Bao Yi Xue Ban. 2012;37(1):73-77.

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

Kudzu Also Interacts With Other Medications

Kudzu has 511 moderate, 72 minor known drug interactions in our database — the pioglitazone, metformin one above is among them. If you take anything else, check it against the full list below.

Moderate 511 Minor 72 No known interaction 2,247 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Kudzu

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

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Kudzu 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 Kudzu as Part of a Dietary Supplement Product? Check It for Interactions

We hold 536 real supplement products containing Kudzu, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Kudzu. Your product may carry other ingredients that interact with pioglitazone, metformin too, on top of Kudzu — 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 Kudzu 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 Kudzu
Top 25%

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

29 days ago today
Medication pioglitazone, metformin
Steady interest

#2,092 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 Kudzu

What is Kudzu?

Kudzu
  • Alcohol cravings and reduction
  • Menopausal symptoms
  • Heart and blood vessel health
  • Hangover relief
  • Traditional Chinese medicine (Ge Gen)

Kudzu is a fast-growing vine whose root has long been used in traditional Chinese medicine and is now studied mostly for reducing alcohol intake. Early research is promising for cutting back on drinking, but evidence for most other uses is weak. Talk with your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Kudzu monograph & all interactions
Keep checking

Other Drugs & Kudzu

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

0Major
511Moderate
72Minor
2,246No known interaction
511 Moderate 72 Minor 2,246 No interaction
Moderate

511 interactions

Showing 60 of 511 moderate interactions — see all 511 on the Kudzu page.

Minor

72 interactions

Showing 60 of 72 minor interactions — see all 72 on the Kudzu page.

No interaction 2,246 drugs checked — show the list

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

Showing the 60 most looked-up of 2,246 medications checked with no known interaction — see the full Kudzu list.

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

Can you take Kudzu 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.
Why are there 2 interactions listed for Kudzu and pioglitazone, metformin?
pioglitazone, metformin belongs to more than one drug category, and Kudzu 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 Kudzu 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 Kudzu?

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.