Drug & supplement interaction

Pu-erh Tea + pioglitazone, metformin

pioglitazone, metformin brand name: ActoPlus Met.

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

pioglitazone, metformin falls into 3 drug categories that Pu-erh Tea can interact with; the most serious is rated moderate. Theoretically, caffeine might increase the levels and clinical effects of pioglitazone.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Pu-erh Tea and pioglitazone, metformin

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Pu-erh Tea interacts with whole categories of medication. pioglitazone, metformin falls into 3 of those categories, so it can interact with Pu-erh Tea in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

PIOGLITAZONE (Actos)

1 of 3
Theoretically, caffeine might increase the levels and clinical effects of pioglitazone.
Pu-erh tea contains caffeine. Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.
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 simple version: your combo pill (ActoPlus Met) contains pioglitazone and metformin. The interaction on file is only with the pioglitazone part, and it comes from animal and lab research, not human studies. In those studies, the caffeine in pu-erh tea seemed to let pioglitazone hang around a bit longer in the body, which slightly boosted its blood-sugar-lowering effect.

If that held true in people, the main thing to watch would be low blood sugar (shakiness, sweating, dizziness, or feeling lightheaded). Honestly though, this is theoretical and weak evidence, and a normal cup or two of tea is unlikely to cause trouble. I wouldn't lose sleep over it, but if you drink pu-erh daily or use concentrated extracts, mention it to your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Alshabi AM, Alkahtani SA, Shaikh IA, Habeeb MS. Caffeine modulates pharmacokinetic and pharmacodynamic profiles of pioglitazone in diabetic rats: Impact on therapeutics. Saudi Med J 2021;42(2):151-160. PubMed
Minor

ANTIDIABETES DRUGS

2 of 3

Why this applies to pioglitazone, metformin

pioglitazone, metformin falls under ANTIDIABETES DRUGS — the group Pu-erh Tea interacts with.

Theoretically, taking pu-erh tea with antidiabetes drugs might interfere with blood glucose control.
Pu-erh tea contains caffeine. Reports claim that caffeine might increase or decrease blood sugar levels.
Severity Minor Likelihood Unlikely Evidence B

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: your ActoPlus Met combo (pioglitazone plus metformin) works to bring your blood sugar down. Pu-erh tea contains caffeine, and caffeine can nudge blood sugar in either direction depending on the person. The concern is mostly theoretical, and it's rated as minor and unlikely, so a cup or two of pu-erh as a normal drink shouldn't throw off your diabetes control for most people.

That said, if you drink a lot of pu-erh or take concentrated tea extracts, just keep an eye on your readings. Watch for signs your numbers are running off, like shakiness, sweating, or feeling unusually thirsty or tired. If you notice anything unusual, check your glucose and chat with your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Watson JM, Jenkins EJ, Hamilton P, et al. Influence of caffeine on the frequency and perception of hypoglycemia in free-living patients with type 1 diabetes. Diabetes Care 2000;23:455-9. PubMed
  2. Bell DG, Jacobs I, Ellerington K. Effect of caffeine and ephedrine ingestion on anaerobic exercise performance. Med Sci Sports Exerc 2001;33:1399-403. PubMed
Minor

Metformin (Glucophage)

3 of 3
Theoretically, metformin might increase the levels and adverse effects of caffeine.
Pu-erh tea contains caffeine. Animal research suggests that metformin can reduce caffeine metabolism. Theoretically, concomitant use can increase caffeine serum concentrations and the risk of caffeine adverse effects.
Severity Minor 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 thing to know about your ActoPlus Met (which combines pioglitazone and metformin) and pu-erh tea: the concern here isn't really about your blood sugar medicine itself. Instead, it's about the caffeine in the tea. Some animal research hints that the metformin part may slow down how your body clears caffeine, so caffeine could linger a bit longer than usual.

In practice, that might mean you feel the typical caffeine effects more strongly, things like feeling jittery, a racing heart, or trouble sleeping. I want to be honest though: this is a theoretical idea based on lab and animal data, and it's rated as minor. A cup or two of tea is unlikely to cause real trouble for most folks. If you drink a lot of pu-erh or notice the jitters, just mention it to your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mohiuddin, M., Azam, A. T., Amran, M. S., and Hossain, M. A. In vive effects of gliclazide and metformin on the plasma concentration of caffeine in healthy rats. Pak.J Biol Sci 5-1-2009;12(9):734-737.

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

Pu-erh Tea Also Interacts With Other Medications

Pu-erh Tea has 9 major, 447 moderate, 210 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.

Major 9 Moderate 447 Minor 210 No known interaction 2,164 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Pu-erh Tea

Covers the 2,830 medications we’ve checked against Pu-erh Tea. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Pu-erh Tea 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

How much people look this up

Where Pu-erh Tea 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 Pu-erh Tea
Steady interest

#1,428 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication pioglitazone, metformin
Steady interest

#2,200 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 Pu-erh Tea

What is Pu-erh Tea?

  • Weight management
  • Cholesterol and heart health
  • Digestion after meals
  • Mental alertness
  • General antioxidant support

Pu-erh tea is a fermented, aged form of tea made from the same plant as green and black tea. It is enjoyed worldwide as a beverage and is sometimes promoted for weight loss, cholesterol, and digestion, but human evidence for these uses is limited. As a normal drink it is generally well tolerated, though it does contain caffeine.

Read the full Pu-erh Tea monograph & all interactions
Keep checking

Other Drugs & Pu-erh Tea

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

9Major
447Moderate
210Minor
2,163No known interaction
9 Major 447 Moderate 210 Minor 2,163 No interaction
Major

9 interactions

Moderate

447 interactions

Showing 60 of 447 moderate interactions — see all 447 on the Pu-erh Tea page.

Minor

210 interactions

Showing 60 of 210 minor interactions — see all 210 on the Pu-erh Tea page.

No interaction 2,163 drugs checked — show the list

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

Showing the 60 most looked-up of 2,163 medications checked with no known interaction — see the full Pu-erh Tea list.

See the full Pu-erh Tea 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
Pu-erh Tea 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 Pu-erh Tea and pioglitazone, metformin Together: Common Questions

Can you take Pu-erh Tea 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 3 interactions listed for Pu-erh Tea and pioglitazone, metformin?
pioglitazone, metformin belongs to more than one drug category, and Pu-erh Tea 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 Pu-erh Tea 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

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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.