Drug & supplement interaction

Sage + Nateglinide

Nateglinide brand name: Starlix.

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

Nateglinide falls into 2 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C9.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sage and Nateglinide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Sage interacts with whole categories of medication. Nateglinide falls into 2 of those categories, so it can interact with Sage in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Nateglinide

Nateglinide falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Sage interacts with.

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C9.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C9. So far, this interaction has not been reported in humans.
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 short version: your body uses a liver enzyme called CYP2C9 to break down nateglinide. In lab dishes, water-based sage extracts seemed to slow that same enzyme down. If that happened in a person, nateglinide could hang around longer and work a little harder than expected, which mainly means a higher chance of low blood sugar (hypoglycemia), with symptoms like shakiness, sweating, dizziness, fast heartbeat, or confusion.

I want to be honest about the strength of this, though. This is theoretical, seen only in test-tube studies, and has never actually been reported in people. A sprinkle of sage in cooking is very unlikely to matter; concentrated sage capsules, extracts, or oils are where I'd be more cautious. If you want to take sage regularly, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
Moderate

ANTIDIABETES DRUGS

2 of 2

Nateglinide also falls under ANTIDIABETES DRUGS.

Theoretically, taking sage with antidiabetes drugs might increase the risk of hypoglycemia.
In patients with polycystic ovary syndrome (PCOS) or inadequately controlled type 2 diabetes, common sage (Salvia officinalis) has demonstrated hypoglycemic activity. However, other clinical research in patients with inadequately controlled type 2 diabetes shows that common sage extract does not lower fasting blood glucose levels.
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 simple version: nateglinide (Starlix) already works by telling your pancreas to push out more insulin right around mealtime, which lowers your blood sugar. Some research suggests sage may have its own mild blood-sugar-lowering effect. So if you stack the two, the worry is that your sugar could dip too low, what we call hypoglycemia. That can feel like shakiness, sweating, dizziness, a fast heartbeat, or sudden hunger.

I want to keep this in perspective, though. The evidence is mixed and on the weaker side, and sprinkling sage on dinner is very unlikely to cause trouble. The bigger question is with concentrated sage extracts or capsules taken daily. If you're using those, just give your pharmacist or doctor a heads-up so they can keep an eye on your readings. Don't change anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kianbakht S, Dabaghian FH. Improved glycemic control and lipid profile in hyperlipidemic type 2 diabetic patients consuming Salvia officinalis L. leaf extract: a randomized placebo. Controlled clinical trial. Complement Ther Med. 2013;21(5):441-6. PubMed
  2. Amini L, Mojab F, Jahanfar S, Sepidarkish M, Raoofi Z, Maleki-Hajiagha A. Efficacy of Salvia officinalis extract on the prevention of insulin resistance in euglycemic patients with polycystic ovary syndrome: A double-blinded placebo-controlled clinical tr
  3. Behradmanesh S, Derees F, Rafieian-Kopaei M. Effect of Salvia officinalis on diabetic patients. J Renal Inj Prev. 2013;2(2):51-4.

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

Sage Also Interacts With Other Medications

Sage has 1,295 moderate known drug interactions in our database — the Nateglinide one above is among them. If you take anything else, check it against the full list below.

Moderate 1,295 No known interaction 1,535 (incl. Nateglinide)
Taking anything else?

Check Another of Your Medications Against Sage

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

Everything else you take

See Every Supplement That Interacts With Nateglinide

This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nateglinide page lists 290 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Siberian Cocklebur (major), Acai (moderate), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 2 major · 241 moderate · 47 minor.

From our pharmacist’s overview on the Nateglinide page

“People who take nateglinide (Starlix) with meals for type 2 diabetes are often drawn to supplements marketed for blood sugar, and that overlap is why these 290 interactions warrant real caution. Some 239 of the ingredients affect blood sugar on their own, most pushing it lower, so stacking them on nateglinide raises the odds of hypogly…”

Reviewed by 2 · Jul 18, 2026

Open the Nateglinide interaction page

One more smart check

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

We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Your product may carry other ingredients that interact with Nateglinide too, on top of Sage — 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 Sage and Nateglinide 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 Sage
Top 25%

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

29 days ago today
Medication Nateglinide
Steady interest

#2,038 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 Sage

What is Sage?

Sage
  • Sore throat and mouth irritation
  • Digestive upset
  • Excessive sweating
  • Memory and thinking
  • Menopause symptoms (hot flashes)
  • General antioxidant support

Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.

Read the full Sage monograph & all interactions
Medication

About Nateglinide

What Is Nateglinide Used For?

Brand name: Starlix

Nateglinide tablets are used to help improve blood sugar (glucose) control in adults with type 2 diabetes. It is always used together with diet and exercise — not as a replacement for them.

Nateglinide is not for type 1 diabetes, and it is not used to treat diabetic ketoacidosis (a serious complication where the blood becomes dangerously acidic).

See full Nateglinide drug information
Keep checking

Other Drugs & Sage

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

0Major
1,295Moderate
0Minor
1,534No known interaction
1,295 Moderate 1,534 No interaction
Moderate

1,295 interactions

Showing 60 of 1,295 moderate interactions — see all 1,295 on the Sage page.

No interaction 1,534 drugs checked — show the list

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

Showing the 60 most looked-up of 1,534 medications checked with no known interaction — see the full Sage list.

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

Can you take Sage with Nateglinide?
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 2 interactions listed for Sage and Nateglinide?
Nateglinide belongs to more than one drug category, and Sage 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 Sage and Nateglinide 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 Nateglinide and Sage?

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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.