Drug & supplement interaction

Quercetin + 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 Quercetin can interact with; the most serious is rated moderate. Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.

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

Quercetin and pioglitazone, metformin

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

Why Are There 3 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 3

Why this applies to pioglitazone, metformin

pioglitazone, metformin falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Quercetin interacts with.

Theoretically, concomitant use might alter the effects and adverse effects of CYP3A4 substrates.
A small clinical study in healthy volunteers shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of a single dose of cyclosporine (Neoral, Sandimmune), a substrate of CYP3A4. Animal research also shows that pretreatment with quercetin increases plasma levels and prolongs the half-life of losartan (Cozaar) and quetiapine (Seroquel), substrates of CYP3A4. Other laboratory research also shows that quercetin inhibits CYP3A4. However, one clinical study shows that quercetin can increase the metabolism of midazolam, a substrate of CYP3A4, and decrease serum concentrations of midazolam by about 24% in some healthy individuals, suggesting possible induction of CYP3A4.
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 practical picture with ActoPlus Met. Of its two ingredients, only pioglitazone is processed by the liver enzyme CYP3A4, and that's where quercetin theoretically comes in. Metformin is cleared by your kidneys, so quercetin isn't expected to touch it. Neither drug is a prodrug, so they don't need this enzyme to switch on.

The lab and animal data on quercetin are mixed, with some studies suggesting it slows CYP3A4 (which could nudge pioglitazone levels up, slightly raising the chance of fluid retention or swelling) and one suggesting it speeds the enzyme up. This is mostly theoretical and far from proven. Food amounts of quercetin almost certainly don't matter; concentrated supplements are the bigger question. If you'd like to add one, just run it past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John's wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther 2000;294:88-95. DOI
  2. DiCenzo R, Frerichs V, Larppanichpoonphol P, et al. Effect of quercetin on the plasma and intracellular concentrations of saquinavir in healthy adults. Pharmacotherapy 2006;26:1255-61. PubMed
  3. Choi JS, Choi BC, Choi KE. Effect of quercetin on the pharmacokinetics of oral cyclosporine. Am J Health Syst Pharm 2004;61:2406-9. PubMed
  4. Choi JS, Jo BW, Kim YC. Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin. Eur J Pharm Biopharm 2004;57:313-8. PubMed
  5. Duan KM, Wang SY, Ouyang W, Mao YM, Yang LJ. Effect of quercetin on CYP3A activity in Chinese healthy participants. J Clin Pharmacol 2012;52(6):940-6. PubMed
  6. Zhao Q, Wei J, Zhang H. Effects of quercetin on the pharmacokinetics of losartan and its metabolite EXP3174 in rats. Xenobiotica 2019;49(5):563-8. PubMed
  7. Bhutani P, Rajanna PK, Paul AT. Impact of quercetin on pharmacokinetics of quetiapine: insights from in-vivo studies in wistar rats. Xenobiotica. 2020:1-7.
Moderate

ANTIDIABETES DRUGS

2 of 3

pioglitazone, metformin also falls under ANTIDIABETES DRUGS.

Theoretically, concomitant use of quercetin and antidiabetes drugs might increase the risk of hypoglycemia.

Clinical research suggests that a combination of quercetin, myricetin, and chlorogenic acid reduce levels of fasting glucose in patients with type 2 diabetes, including those already taking antidiabetes agents. The effect of quercetin alone is unknown.
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 ActoPlus Met (that combo of pioglitazone and metformin) plus a quercetin supplement: both are working to lower your blood sugar, so stacking them could nudge your numbers a little lower than expected. In practice that might show up as the usual signs of low blood sugar, like feeling shaky, sweaty, dizzy, or unusually hungry or tired.

I want to be honest about how solid this is. The concern is mostly theoretical, and the human study that hinted at lower fasting glucose used quercetin mixed with two other compounds, so we don't really know what quercetin does on its own. Food amounts are very unlikely to matter. Before starting a high-dose supplement, just check with your pharmacist or doctor, and keep an eye on your readings.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ahrens MJ, Thompson DL. Effect of emulin on blood glucose in type 2 diabetics. J Med Food. 2013;16(3):211-5. PubMed
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

3 of 3

pioglitazone, metformin also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, concomitant use might increase the levels and adverse effects of CYP2C8 substrates.

In vitro research shows that quercetin inhibits CYP2C8. Inhibition of paclitaxel (Taxol) metabolism via CYP2C8 has been reported in vitro. However, a small study in humans found no effect of quercetin on rosiglitazone (Avandia), which is also a CYP2C8 substrate.
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 with ActoPlus Met. The pioglitazone half is partly cleared by a liver enzyme called CYP2C8. On paper, quercetin can slow that same enzyme down, so in theory pioglitazone could build up a bit and its effects (and side effects) could be stronger. With pioglitazone that might mean things like fluid retention, swelling in the ankles, weight gain, or a greater push on blood sugar. The metformin piece isn't really handled by this enzyme, so it's mostly along for the ride here.

The honest part: this is a theoretical concern from lab studies only. When researchers tested quercetin with a close cousin drug in real people, they saw no meaningful effect. Food amounts of quercetin almost certainly don't matter. If you're using high-dose supplements, just give your pharmacist or doctor a heads-up and watch your blood sugar and any new swelling.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kim KA, Park PW, Kim HK, et al. Effect of quercetin on the pharmacokinetics of rosiglitazone, a CYP2C8 substrate, in healthy subjects. J Clin Pharmacol 2005;45:941-6. PubMed
  2. Choi JS, Jo BW, Kim YC. Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin. Eur J Pharm Biopharm 2004;57:313-8. PubMed
  3. Vaclavikova R, Horsky S, Simek P, Gut I. Paclitaxel metabolism in rat and human liver microsomes is inhibited by phenolic antioxidants. Naunyn Schmiedebergs Arch Pharmacol 2003;368:200-9. 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

Quercetin Also Interacts With Other Medications

Quercetin has 1,168 moderate 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.

Moderate 1,168 No known interaction 1,662 (incl. pioglitazone, metformin)
Taking anything else?

Check Another of Your Medications Against Quercetin

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

Everything else you take

See Every Supplement That Interacts With pioglitazone, metformin

This page covers Quercetin 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

One more smart check

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

We hold 4,589 real supplement products containing Quercetin, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Quercetin. Your product may carry other ingredients that interact with pioglitazone, metformin too, on top of Quercetin — 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 Quercetin 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 Quercetin
Top 5%

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

29 days ago today
Medication pioglitazone, metformin
Steady interest

#2,092 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 Quercetin

What is Quercetin?

Quercetin
  • Seasonal allergies
  • Antioxidant support
  • Heart and blood pressure health
  • Anti-inflammatory support
  • Immune support
  • Exercise recovery

Quercetin is a plant flavonoid with antioxidant and anti-inflammatory properties found in many common foods and sold as a supplement. While early research is interesting for allergies, blood pressure, and inflammation, strong human evidence is limited for most uses. It is generally well tolerated in food amounts, but talk to your pharmacist or doctor before taking high-dose supplements.

Read the full Quercetin monograph & all interactions
Keep checking

Other Drugs & Quercetin

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

0Major
1,168Moderate
0Minor
1,661No known interaction
1,168 Moderate 1,661 No interaction
Moderate

1,168 interactions

Showing 60 of 1,168 moderate interactions — see all 1,168 on the Quercetin page.

No interaction 1,661 drugs checked — show the list

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

Showing the 60 most looked-up of 1,661 medications checked with no known interaction — see the full Quercetin list.

See the full Quercetin 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
Quercetin 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 Quercetin and pioglitazone, metformin Together: Common Questions

Can you take Quercetin 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 Quercetin and pioglitazone, metformin?
pioglitazone, metformin belongs to more than one drug category, and Quercetin 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 Quercetin 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.