Drug & supplement interaction

Red Sandalwood + Troglitazone

Troglitazone brand name: Rezulin.

Moderate Interaction
The bottom line Moderate

Red Sandalwood has a moderate interaction with Troglitazone. 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 Troglitazone

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Troglitazone

Troglitazone 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: Troglitazone (Rezulin) is a medicine that helps lower your blood sugar. Some animal studies suggest red sandalwood bark extract may also nudge blood sugar down a bit. So if you took both together, the worry is they could stack up and push your sugar too low.

If that happened, you might feel shaky, sweaty, dizzy, confused, or unusually hungry, the classic signs of low blood sugar (hypoglycemia). I want to be honest, though: this concern comes only from lab and rat studies, not from people, so it's really more of a theoretical heads-up than a proven problem. If you're thinking about red sandalwood, check with your pharmacist or doctor first and keep an eye on your blood sugar readings.

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 Troglitazone 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 Troglitazone

This page covers Red Sandalwood only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Troglitazone page lists 280 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Acai (moderate).

By severity: 4 major · 239 moderate · 37 minor.

From our pharmacist’s overview on the Troglitazone page

“Most people taking troglitazone (Rezulin) are managing type 2 diabetes, and this list reflects that. The great majority of the 280 flagged ingredients act on blood sugar, most lowering it and a few raising it, so pairing them with a diabetes medication makes glucose control less predictable and can tip it too low.”

Reviewed by 2 · Jul 18, 2026

Open the Troglitazone 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 Troglitazone 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 Troglitazone 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

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

29 days ago today
Medication Troglitazone
Steady interest

#1,960 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
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 Troglitazone Together: Common Questions

Can you take Red Sandalwood with Troglitazone?
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 Troglitazone 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 Troglitazone 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.