Drug & supplement interaction

Maritime Pine + Canagliflozin

Canagliflozin brand name: Invokana.

Moderate Interaction
The bottom line Moderate

Maritime Pine has a moderate interaction with Canagliflozin. Theoretically, maritime pine bark extract might increase the risk of hypoglycemia when used with antidiabetes drugs.

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

Maritime Pine and Canagliflozin

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Canagliflozin

Canagliflozin falls under ANTIDIABETES DRUGS — the group Maritime Pine interacts with.

Theoretically, maritime pine bark extract might increase the risk of hypoglycemia when used with antidiabetes drugs.
One clinical study shows that maritime pine bark extract decreases blood sugar in patients with diabetes being treated with antidiabetes agents. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Severity Moderate Likelihood Possible Evidence B

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: maritime pine bark (Pycnogenol) may have a mild blood-sugar-lowering effect of its own. When you stack that on top of canagliflozin (Invokana), which is already working to bring your sugar down, the two together could push your levels a little lower than expected.

This isn't about how your body breaks down the drug, it's just two things nudging blood sugar in the same direction. With canagliflozin alone, low blood sugar is uncommon, but adding the supplement raises that possibility. Watch for shakiness, sweating, dizziness, or feeling foggy. The evidence here comes from one small study, so this is a possible concern, not a sure thing. Don't change anything on your own, just check your readings more often and talk with your pharmacist or doctor first.

References
  1. Liu X, Wei J, Tan F, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci 2004;75:2505-13. 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

Maritime Pine Also Interacts With Other Medications

Maritime Pine has 326 moderate known drug interactions in our database — the Canagliflozin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Maritime Pine

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

Everything else you take

See Every Supplement That Interacts With Canagliflozin

This page covers Maritime Pine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Canagliflozin page lists 256 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 · 215 moderate · 39 minor.

From our pharmacist’s overview on the Canagliflozin page

“Canagliflozin (Invokana) lowers blood sugar, and that is precisely why this list deserves genuine care. Nearly every ingredient on it works on glucose one way or another: most can push it too low when stacked with the drug, while a few, niacin among them, raise it and work against the medicine.”

Reviewed by 2 · Jul 18, 2026

Open the Canagliflozin interaction page

One more smart check

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

We hold 452 real supplement products containing Maritime Pine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Maritime Pine. Your product may carry other ingredients that interact with Canagliflozin too, on top of Maritime Pine — 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 Maritime Pine and Canagliflozin 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 Maritime Pine
Top 25%

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

29 days ago today
Medication Canagliflozin
Steady interest

#1,951 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 Maritime Pine

What is Maritime Pine?

Maritime Pine
  • Circulation and vein health
  • Antioxidant support
  • Skin health and aging
  • High blood pressure
  • Joint comfort

Maritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research is promising, but many studies are small or industry-funded, so benefits are not firmly proven. It is generally well tolerated, but talk to your pharmacist or doctor before starting it.

Read the full Maritime Pine monograph & all interactions
Medication

About Canagliflozin

What Is Canagliflozin Used For?

Brand name: Invokana

Invokana (canagliflozin) is used alongside diet and exercise to improve blood sugar control in adults and children aged 10 and older with type 2 diabetes. It is not for type 1 diabetes.

In adults with type 2 diabetes, Invokana is also used to lower the risk of heart attack, stroke, and cardiovascular death in those with established cardiovascular disease, and to reduce the risk of serious kidney complications — including end-stage kidney disease, cardiovascular death, and hospitalization for heart failure — in those with diabetic kidney disease and high levels of protein in the urine.

See full Canagliflozin drug information
Keep checking

Other Drugs & Maritime Pine

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

0Major
326Moderate
0Minor
2,503No known interaction
Moderate

326 interactions

Showing 60 of 326 moderate interactions — see all 326 on the Maritime Pine page.

No interaction 2,503 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 Maritime Pine and Canagliflozin Together: Common Questions

Can you take Maritime Pine with Canagliflozin?
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 Maritime Pine and Canagliflozin 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

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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.