Drug & supplement interaction

Octacosanol + Pioglitazone

Pioglitazone brand name: Actos.

Moderate Interaction
The bottom line Moderate

Octacosanol has a moderate interaction with Pioglitazone. Theoretically, octacosanol might have additive effects when used in combination with antidiabetes drugs.

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

Octacosanol and Pioglitazone

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Pioglitazone

Pioglitazone falls under ANTIDIABETES DRUGS — the group Octacosanol interacts with.

Theoretically, octacosanol might have additive effects when used in combination with antidiabetes drugs.
Octacosanol is the main component of policosanol. In humans, policosanol can decrease blood glucose. It is not clear if these effects occur with the use of octacosanol.
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 gist with pioglitazone (Actos) and octacosanol. This isn't about your liver breaking the drug down faster or slower. Instead, it's about adding up effects. Pioglitazone already works to lower your blood sugar by making your body more sensitive to insulin. Octacosanol (the main piece of policosanol) has shown some blood-sugar-lowering activity in people, so stacking the two could push your numbers a little lower than expected.

To be fair, the evidence here is on the weak side, and we're not even sure octacosanol alone does this. But if you do combine them, just keep an eye out for signs of low blood sugar, like shakiness, sweating, dizziness, or feeling foggy. Check your readings and chat with your pharmacist or doctor before adding it.

References
  1. Wang HY, Jiao QP, Chen SY, et al. Efficacy and safety of policosanol plus fenofibrate combination therapy in elderly patients with mixed dyslipidemia: A randomized, controlled clinical study. Am J Med Sci. 2018;356(3):254-261. 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

Octacosanol Also Interacts With Other Medications

Octacosanol has 247 moderate known drug interactions in our database — the Pioglitazone 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 Octacosanol

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

Everything else you take

See Every Supplement That Interacts With Pioglitazone

This page covers Octacosanol only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pioglitazone page lists 356 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 · 309 moderate · 41 minor.

From our pharmacist’s overview on the Pioglitazone page

“Most of what appears on this pioglitazone (Actos) list shares one trait: the ingredients lower blood sugar on their own, which sounds helpful until you remember pioglitazone already does that job for people with type 2 diabetes. Stacked together, they can push glucose too low, and I would read this list with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Pioglitazone interaction page

One more smart check

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

We hold 435 real supplement products containing Octacosanol, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Octacosanol. Your product may carry other ingredients that interact with Pioglitazone too, on top of Octacosanol — 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 Octacosanol and Pioglitazone 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 Octacosanol
Steady interest

#1,008 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pioglitazone
Steady interest

#2,002 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 Octacosanol

What is Octacosanol?

Octacosanol
  • Physical performance and endurance
  • Cholesterol support
  • Parkinson's and movement concerns
  • Antioxidant support
  • General energy and stamina

Octacosanol is a waxy long-chain alcohol from plant sources that is most often promoted for exercise endurance and cholesterol support, but solid human evidence is limited and results are mixed. It appears generally well tolerated in supplement amounts, but it is not a proven treatment for any condition, so talk with your pharmacist or doctor before using it.

Read the full Octacosanol monograph & all interactions
Medication

About Pioglitazone

What Is Pioglitazone Used For?

Brand name: Actos

Pioglitazone tablets — sold as Actos and under the generic names Pioglitazone and Pioglitazone Hydrochloride — are used to improve blood sugar (glucose) control in adults with type 2 diabetes. They are taken along with diet and exercise, either alone or combined with other diabetes medicines such as a sulfonylurea, metformin, or insulin.

Pioglitazone is not for type 1 diabetes or diabetic ketoacidosis (a serious complication where the blood becomes too acidic). It only works when the body is still producing some of its own insulin.

See full Pioglitazone drug information
Keep checking

Other Drugs & Octacosanol

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

0Major
247Moderate
0Minor
2,582No known interaction
Moderate

247 interactions

Showing 60 of 247 moderate interactions — see all 247 on the Octacosanol page.

No interaction 2,582 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 Octacosanol and Pioglitazone Together: Common Questions

Can you take Octacosanol with Pioglitazone?
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 Octacosanol and Pioglitazone 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 and Octacosanol?

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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.