Drug & supplement interaction

Rhubarb + Acarbose

Acarbose brand names: Precose, Prandase, Glucobay.

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

Rhubarb has a moderate interaction with Acarbose. Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Rhubarb and Acarbose

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Acarbose

Acarbose falls under HEPATOTOXIC DRUGS — the group Rhubarb interacts with.

Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases 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 gist for acarbose (Precose): this isn't about rhubarb changing how acarbose works or how your body handles it. Acarbose mostly stays in your gut and slows sugar absorption after meals. The concern is a different one. On rare occasions, acarbose itself can stress the liver, and rhubarb root, especially in concentrated supplement form, has been loosely tied to liver injury too. The worry is that stacking two things that can each bother the liver might add up.

I want to be honest that this is theoretical, based mostly on animal studies and a handful of unclear human reports, so don't panic. Eating rhubarb stalks in a pie is very different from taking strong root capsules daily. If you do use rhubarb supplements, mention it to your pharmacist or doctor, and watch for yellowing skin, dark urine, or unusual fatigue.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Byeon JH, Kil JH, Ahn YC, Son CG. Systematic review of published data on herb induced liver injury. J Ethnopharmacol 2019;233:190-6. PubMed
  2. Zhao D, Feng SX, Zhang HJ, et al. Pharmacokinetics, tissue distribution and excretion of five rhubarb anthraquinones in rats after oral administration of effective fraction of anthraquinones from rheum officinale. Xenobiotica. 2021;51(8):916-925. 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

Rhubarb Also Interacts With Other Medications

Rhubarb has 657 moderate known drug interactions in our database — the Acarbose one above is one of them. If you take anything else, check it against the full list below.

Moderate 657 No known interaction 2,173 (incl. Acarbose)
Taking anything else?

Check Another of Your Medications Against Rhubarb

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

From our Q&A

Questions About Rhubarb or Acarbose

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rhubarb or Acarbose, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Acarbose

This page covers Rhubarb only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acarbose page lists 281 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 · 240 moderate · 37 minor.

From our pharmacist’s overview on the Acarbose page

“Acarbose (Precose, Glucobay) is taken with meals to blunt the blood sugar rise after eating, and its supplement list calls for genuine care, starting with the four major-rated entries: heavy alcohol and the herb Siberian cocklebur can strain the liver alongside acarbose, while activated charcoal can soak up oral drugs and cut what reac…”

Reviewed by 2 · Jul 18, 2026

Open the Acarbose interaction page

One more smart check

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

We hold 133 real supplement products containing Rhubarb, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rhubarb. Your product may carry other ingredients that interact with Acarbose too, on top of Rhubarb — 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 Rhubarb and Acarbose 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 Rhubarb
Top 25%

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

29 days ago today
Medication Acarbose
Steady interest

#1,590 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 Rhubarb

What is Rhubarb?

Rhubarb
  • Constipation
  • Digestive upset
  • Menopausal symptoms
  • Kidney and liver conditions (traditional)
  • Pancreatitis (hospital/traditional use)

Rhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal claims are backed by limited or low-quality evidence, and the root can cause cramping and diarrhea. The leaves are toxic and should never be eaten, and rhubarb supplements are best avoided in pregnancy and breastfeeding.

Read the full Rhubarb monograph & all interactions
Medication

About Acarbose

What Is Acarbose Used For?

Brand names: Precose, Prandase, Glucobay

Acarbose tablets are used to help control blood sugar in adults with type 2 diabetes. They are always used together with a proper diet and regular exercise — not as a replacement for them.

Acarbose can be used on its own or combined with other diabetes medicines such as sulfonylureas, insulin, or metformin to get better blood sugar control.

See full Acarbose drug information
Keep checking

Other Drugs & Rhubarb

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

0Major
657Moderate
0Minor
2,172No known interaction
657 Moderate 2,172 No interaction
Moderate

657 interactions

Showing 60 of 657 moderate interactions — see all 657 on the Rhubarb page.

No interaction 2,172 drugs checked — show the list

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

Showing the 60 most looked-up of 2,172 medications checked with no known interaction — see the full Rhubarb list.

See the full Rhubarb interactions page
See every supplement checked against Acarbose, 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
Rhubarb monograph › Uses, safety, and every drug interaction in one place Acarbose supplement interactions › Every supplement checked against Acarbose, ranked by severity Acarbose 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 Rhubarb and Acarbose Together: Common Questions

Can you take Rhubarb with Acarbose?
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 Rhubarb and Acarbose 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 Acarbose and Rhubarb?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.