Drug & supplement interaction

Madagascar Periwinkle + Metformin Hydrochloride

Metformin Hydrochloride brand name: Riomet ER.

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

Madagascar Periwinkle has a moderate interaction with Metformin Hydrochloride. Animal research shows that Madagascar periwinkle lowers blood glucose levels in diabetic rats.

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

Madagascar Periwinkle and Metformin Hydrochloride

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Metformin Hydrochloride

Metformin Hydrochloride falls under ANTIDIABETES DRUGS — the group Madagascar Periwinkle interacts with.

Animal research shows that Madagascar periwinkle lowers blood glucose levels in diabetic rats. Theoretically, using Madagascar periwinkle in combination with antidiabetes drugs might increase the risk of hypoglycemia; monitor blood glucose closely.
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: in studies done with diabetic rats, Madagascar periwinkle lowered blood sugar on its own. Metformin already works to bring your blood sugar down, so the worry is that stacking the two could push your levels lower than intended.

I'll be honest with you though, this is really a theoretical concern. The evidence comes only from animal and lab work, not from people, so we can't say how strong the effect would be in real life. If your sugar did drop too low, you might feel shaky, sweaty, dizzy, or get a pounding heart. The bigger issue is that the raw plant itself is genuinely toxic and shouldn't be used as a home remedy. Please loop in your pharmacist or doctor before mixing the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Oguntibeju OO, Aboua Y, Goboza M. Vindoline-A natural product from catharanthus roseus reduces hyperlipidemia and renal pathophysiology in experimental type 2 diabetes. Biomedicines. 2019 Aug 13;7(3):59. 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

Madagascar Periwinkle Also Interacts With Other Medications

Madagascar Periwinkle has 86 moderate known drug interactions in our database — the Metformin Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Metformin Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Madagascar Periwinkle

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

Everything else you take

See Every Supplement That Interacts With Metformin Hydrochloride

This page covers Madagascar Periwinkle only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metformin Hydrochloride 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 Hydrochloride page

“Anyone taking metformin hydrochloride (Riomet ER) should treat this list with genuine care, because two of its 257 entries are rated major. Siberian cocklebur has caused severe hypoglycemia in people and should not be combined with metformin at all, and activated charcoal can adsorb the drug in the gut so less reaches your blood.”

Reviewed by 2 · Jul 18, 2026

Open the Metformin Hydrochloride interaction page

One more smart check

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

We hold 8 real supplement products containing Madagascar Periwinkle, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Madagascar Periwinkle. Your product may carry other ingredients that interact with Metformin Hydrochloride too, on top of Madagascar Periwinkle — 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 Madagascar Periwinkle and Metformin Hydrochloride 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 Madagascar Periwinkle
Top half

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

29 days ago today
Medication Metformin Hydrochloride
Top 5%

#142 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 Madagascar Periwinkle

What is Madagascar Periwinkle?

  • Diabetes (folk use)
  • High blood pressure (traditional use)
  • Sore throat and mouth ailments
  • Wound healing (topical)
  • Source of cancer chemotherapy drugs

Madagascar periwinkle is a flowering plant famous as the natural source of important chemotherapy drugs (vincristine and vinblastine), but the raw plant itself is toxic and not safe to use as a home remedy. While it has a long history in traditional medicine, there is no reliable evidence that taking the whole herb is safe or effective, and it should not be self-administered.

Read the full Madagascar Periwinkle monograph & all interactions
Keep checking

Other Drugs & Madagascar Periwinkle

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

0Major
86Moderate
0Minor
2,743No known interaction
86 Moderate 2,743 No interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Madagascar Periwinkle page.

No interaction 2,743 drugs checked — show the list

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Madagascar Periwinkle list.

See the full Madagascar Periwinkle interactions page
See every supplement checked against Metformin Hydrochloride, 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
Madagascar Periwinkle monograph › Uses, safety, and every drug interaction in one place Metformin Hydrochloride supplement interactions › Every supplement checked against Metformin Hydrochloride, 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 Madagascar Periwinkle and Metformin Hydrochloride Together: Common Questions

Can you take Madagascar Periwinkle with Metformin Hydrochloride?
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 Madagascar Periwinkle and Metformin Hydrochloride 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 Metformin Hydrochloride and Madagascar Periwinkle?

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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.