Drug & supplement interaction

Picrorhiza + Sitagliptin

Sitagliptin brand names: Januvia, Zituvio.

Moderate Interaction
The bottom line Moderate

Picrorhiza has a moderate interaction with Sitagliptin. Evidence from animal research suggests that an extract of picrorhiza can reduce fasting and non-fasting blood sugar levels.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Picrorhiza and Sitagliptin

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Sitagliptin

Sitagliptin falls under ANTIDIABETES DRUGS — the group Picrorhiza interacts with.

Evidence from animal research suggests that an extract of picrorhiza can reduce fasting and non-fasting blood sugar levels. Theoretically, picrorhiza might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, 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 short version: in animal studies, Picrorhiza seemed to nudge blood sugar down on its own. Since sitagliptin (Januvia) is also working to lower your blood sugar, the worry is that the two together could push it a little too low. This isn't about Picrorhiza changing how your body breaks down sitagliptin; it's more of an additive effect, two things rowing in the same direction.

I'll be honest with you, this is based on lab and animal research, not solid human studies, so it's more of a theoretical caution than a proven problem. Still, if you decide to use both, keep an eye out for signs of low blood sugar like shakiness, sweating, dizziness, or feeling unusually hungry, and check your levels more often. Loop in your pharmacist or doctor before combining them so they can guide any monitoring.

References
  1. Joy, K. L. and Kuttan, R. Anti-diabetic activity of Picrorrhiza kurroa extract. J Ethnopharmacol 11-1-1999;67(2):143-148. 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

Picrorhiza Also Interacts With Other Medications

Picrorhiza has 206 moderate known drug interactions in our database — the Sitagliptin 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 Picrorhiza

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

From our Q&A

Questions About Picrorhiza or Sitagliptin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Picrorhiza or Sitagliptin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Sitagliptin

This page covers Picrorhiza only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sitagliptin 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.

Open the Sitagliptin interaction page

One more smart check

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

We hold 177 real supplement products containing Picrorhiza, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Picrorhiza. Your product may carry other ingredients that interact with Sitagliptin too, on top of Picrorhiza — 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 Picrorhiza and Sitagliptin 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 Picrorhiza
Top 25%

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

29 days ago today
Medication Sitagliptin
Top half

#851 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 Picrorhiza

What is Picrorhiza?

  • Liver support
  • Digestive complaints
  • Asthma and breathing problems
  • Skin conditions
  • Fever
  • Immune support

Picrorhiza (Picrorhiza kurroa) is a bitter Himalayan herb used in Ayurvedic medicine, mainly for liver and digestive complaints. Early lab and small human studies suggest possible liver-protective and anti-inflammatory effects, but high-quality evidence is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Picrorhiza monograph & all interactions
Medication

About Sitagliptin

What Is Sitagliptin Used For?

Brand names: Januvia, Zituvio

Sitagliptin is used alongside diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. It is available as tablets (Januvia, Zituvio, and generic sitagliptin products) and as an oral solution (Brynovin), all approved for this same use.

Sitagliptin is not for type 1 diabetes. It has not been studied in people with a history of pancreatitis, so its safety in that group is unknown.

See full Sitagliptin drug information
Keep checking

Other Drugs & Picrorhiza

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

0Major
206Moderate
0Minor
2,623No known interaction
Moderate

206 interactions

Showing 60 of 206 moderate interactions — see all 206 on the Picrorhiza page.

No interaction 2,623 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

Keep exploring
Pharmacist Counseling Corner

Taking Picrorhiza and Sitagliptin Together: Common Questions

Can you take Picrorhiza with Sitagliptin?
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 Picrorhiza and Sitagliptin 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 Sitagliptin and Picrorhiza?

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.