Drug & supplement interaction

Red Sandalwood + Pramlintide

Pramlintide brand name: Symlin.

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

Red Sandalwood has a moderate interaction with Pramlintide. 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 Pramlintide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Pramlintide

Pramlintide 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 simple version: Pramlintide (Symlin) already works hard to bring your blood sugar down after meals, and you pair it with mealtime insulin too. Red sandalwood, at least in early animal studies, also seems to nudge blood sugar lower. Stack those two together and the worry is that they could add up and push your sugar too low.

I want to be honest about the evidence here, it's weak. This comes from rat research, not people, so we really don't know how much (if any) effect a human supplement dose would have. Still, since low blood sugar with pramlintide can mean shakiness, sweating, confusion, or worse, it's worth being cautious. Please check with your pharmacist or doctor before combining them, and keep an eye on your glucose readings.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Pramlintide one above is one of them. If you take anything else, check it against the full list below.

Moderate 86 No known interaction 2,744 (incl. Pramlintide)
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 Pramlintide

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

“The single entry rated major on the pramlintide (Symlin) list is Siberian cocklebur, which has caused severe hypoglycemia in humans, not just in lab studies. That matters more than usual here because pramlintide is injected at mealtimes alongside insulin, and a dangerous low is already the main hazard of that pairing.”

Reviewed by 2 · Jul 18, 2026

Open the Pramlintide 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 Pramlintide 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 Pramlintide 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

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

29 days ago today
Medication Pramlintide
Steady interest

#1,997 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 Pramlintide Injection

What Is Pramlintide Injection Used For?

Brand name: Symlin

SymlinPen (pramlintide) is used as an add-on treatment for adults with type 1 or type 2 diabetes who already use mealtime insulin but still haven't reached their target blood sugar levels — even with optimal insulin therapy.

It is not a replacement for insulin. It works alongside insulin, given right before major meals, to reduce the spike in blood sugar that happens after eating.

See full Pramlintide 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
86 Moderate 2,743 No 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

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

Showing the 60 most looked-up of 2,743 medications checked with no known interaction — see the full Red Sandalwood list.

See the full Red Sandalwood interactions page
See every supplement checked against Pramlintide, 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
Red Sandalwood monograph › Uses, safety, and every drug interaction in one place Pramlintide supplement interactions › Every supplement checked against Pramlintide, ranked by severity Pramlintide Injection drug information › The full plain-English guide to this medication 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 Red Sandalwood and Pramlintide Together: Common Questions

Can you take Red Sandalwood with Pramlintide?
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 Pramlintide 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 Pramlintide 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.