Drug & supplement interaction

Red Sandalwood + Exenatide

Exenatide brand names: Byetta, Bydureon.

Moderate Interaction
The bottom line Moderate

Red Sandalwood has a moderate interaction with Exenatide. Animal research shows that an aqueous extra of red sandalwood bark reduces blood glucose levels.

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

Red Sandalwood and Exenatide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Exenatide

Exenatide falls under ANTIDIABETES DRUGS — the group Red Sandalwood interacts with.

Animal research shows that an aqueous extra of red sandalwood bark reduces blood glucose levels. Red sandalwood bark extract 250 mg/kg orally daily lowers blood glucose in a rat model of diabetes. Theoretically, red sandalwood extract might have additive effects when used concomitantly with antidiabetes drugs and may increase the risk of hypoglycemia. Monitor blood glucose levels close. Dosage adjustments may be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), and tolbutamide (Orinase).
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 exenatide (Byetta or Bydureon) and red sandalwood: this isn't about your liver breaking the drug down differently. Instead, it's about adding two blood-sugar-lowering effects together. Exenatide already nudges your pancreas to release insulin and slows your stomach down. In animal studies, red sandalwood bark extract also lowered blood sugar. So in theory, taking both could push your sugar down a little too far.

I'll be honest, this is based only on rat research, so it's a theoretical concern, not something we've clearly seen in people. Still, if you did add it, keep an eye out for low-sugar signs like shakiness, sweating, or feeling lightheaded. Check your glucose more closely and chat with your pharmacist or doctor before starting it.

References
  1. El-Badawy RE, Ibrahim KA, Hassan NS, El-Sayed WM. Pterocarpus santalinus ameliorates streptozotocin-induced diabetes mellitus via anti-inflammatory pathways and enhancement of insulin function. Iran J Basic Med Sci 2019;22(8):932-939.

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

Red Sandalwood Also Interacts With Other Medications

Red Sandalwood has 86 moderate known drug interactions in our database — the Exenatide 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 Red Sandalwood

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

Everything else you take

See Every Supplement That Interacts With Exenatide

This page covers Red Sandalwood only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Exenatide page lists 239 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Siberian Cocklebur (major), Acai (moderate), African Wild Potato (moderate), Agaricus Mushroom (moderate) and Agmatine (moderate).

By severity: 1 major · 208 moderate · 30 minor.

From our pharmacist’s overview on the Exenatide page

“Because exenatide (Byetta, Bydureon) exists to lower blood sugar, nearly every supplement on this list pulls at that same lever, and I treat that as a genuine warning rather than a footnote. Most entries, including everyday items like fenugreek, bitter melon, flaxseed, and ginseng, can drop glucose further and raise the odds of hypogly…”

Reviewed by 2 · Jul 18, 2026

Open the Exenatide interaction page

One more smart check

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

We hold 7 real supplement products containing Red Sandalwood, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Red Sandalwood. Your product may carry other ingredients that interact with Exenatide too, on top of Red Sandalwood — 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 Red Sandalwood and Exenatide 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 Red Sandalwood
Top half

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

29 days ago today
Medication Exenatide
Top half

#1,051 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 Red Sandalwood

What is Red Sandalwood?

  • Skin care and complexion
  • Acne and skin blemishes
  • Inflammation and minor wounds
  • Digestive complaints (traditional use)
  • Coloring and flavoring agent

Red Sandalwood (Pterocarpus santalinus) is a hardwood used in traditional medicine and in skin and cosmetic preparations, valued for its red pigment and astringent properties. Solid human evidence for its health benefits is very limited, and most claims come from traditional use or laboratory studies. If you want to try it, talk with your pharmacist or doctor first, especially before taking it internally.

Read the full Red Sandalwood monograph & all interactions
Medication

About Exenatide Injection

What Is Exenatide Injection Used For?

Brand names: Byetta, Bydureon

Exenatide injection is used as an addition to diet and exercise to improve blood sugar control in adults with type 2 diabetes. It is not a substitute for healthy lifestyle changes — it works best when combined with them.

It should not be used together with other exenatide-containing products. The brands Byetta, Bydureon, and BYDUREON BCise all contain exenatide and should never be combined with each other.

See full Exenatide Injection drug information
Keep checking

Other Drugs & Red Sandalwood

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

0Major
86Moderate
0Minor
2,743No known interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Red Sandalwood page.

No interaction 2,743 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 Red Sandalwood and Exenatide Together: Common Questions

Can you take Red Sandalwood with Exenatide?
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 Red Sandalwood and Exenatide 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 Exenatide and Red Sandalwood?

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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.