Drug & supplement interaction

Salacia + Pioglitazone

Pioglitazone brand name: Actos.

Moderate Interaction
The bottom line Moderate

Salacia has a moderate interaction with Pioglitazone. Salacia might increase the risk of hypoglycemia when taken with antidiabetes drugs.

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

Salacia and Pioglitazone

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Pioglitazone

Pioglitazone falls under ANTIDIABETES DRUGS — the group Salacia interacts with.

Salacia might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Clinical research suggests that salacia might lower blood glucose levels.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: both of these work to lower your blood sugar, just in different ways. Your pioglitazone (Actos) makes your body more sensitive to its own insulin, while Salacia seems to slow how fast you absorb sugar from a meal, so less sugar hits your bloodstream at once. Stack them together and the combined effect could push your blood sugar lower than you intend.

If that happens, you might feel shaky, sweaty, dizzy, irritable, or lightheaded, the usual signs of low blood sugar. I'll be honest, this concern is based on how these work rather than strong studies on the exact pair, so it's not a reason to panic. Still, don't add Salacia on your own. Check with your pharmacist or doctor first, and keep an eye on your sugar readings if you do start it.

References
  1. Jayawardena MH, de Alwis NM, Hettigoda V, Fernando DJ. A double blind randomised placebo controlled cross over study of a herbal preparation containing Salacia reticulata in the treatment of type 2 diabetes. J Ethnopharmacol 2005;97:215-8. PubMed
  2. Williams JA, Choe YS, Noss MJ, et al. Extract of Salacia oblonga lowers acute glycemia in patients with type 2 diabetes. Am J Clin Nutr 2007;86:124-30. PubMed
  3. Kajimoto O, Kawamori S, Shimoda H, et al. Effects of a Diet Containing Salacia reticulata on Mild Type 2 Diabetes in Humans. A Placebo-controlled, Cross-over Trial. Nippon Eiyo Shokuryo Gakkaishi 2000;53(5):199-205. DOI

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

Salacia Also Interacts With Other Medications

Salacia has 85 moderate known drug interactions in our database — the Pioglitazone 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 Salacia

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

Everything else you take

See Every Supplement That Interacts With Pioglitazone

This page covers Salacia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pioglitazone page lists 356 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 309 moderate · 41 minor.

From our pharmacist’s overview on the Pioglitazone page

“Most of what appears on this pioglitazone (Actos) list shares one trait: the ingredients lower blood sugar on their own, which sounds helpful until you remember pioglitazone already does that job for people with type 2 diabetes. Stacked together, they can push glucose too low, and I would read this list with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Pioglitazone interaction page

One more smart check

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

We hold 34 real supplement products containing Salacia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Salacia. Your product may carry other ingredients that interact with Pioglitazone too, on top of Salacia — 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 Salacia and Pioglitazone 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 Salacia
Top half

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

29 days ago today
Medication Pioglitazone
Steady interest

#2,340 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 Salacia

What is Salacia?

Salacia
  • Blood sugar control
  • Type 2 diabetes support
  • Weight management
  • Obesity
  • Traditional Ayurvedic remedy

Salacia is a plant used in Ayurvedic medicine, mostly studied for lowering blood sugar after meals. Some small human studies suggest it may modestly blunt blood sugar spikes, but the evidence is limited and far from conclusive. If you have diabetes or take other medicines, talk with your pharmacist or doctor before using it.

Read the full Salacia monograph & all interactions
Medication

About Pioglitazone

What Is Pioglitazone Used For?

Brand name: Actos

Pioglitazone tablets — sold as Actos and under the generic names Pioglitazone and Pioglitazone Hydrochloride — are used to improve blood sugar (glucose) control in adults with type 2 diabetes. They are taken along with diet and exercise, either alone or combined with other diabetes medicines such as a sulfonylurea, metformin, or insulin.

Pioglitazone is not for type 1 diabetes or diabetic ketoacidosis (a serious complication where the blood becomes too acidic). It only works when the body is still producing some of its own insulin.

See full Pioglitazone drug information
Keep checking

Other Drugs & Salacia

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

0Major
85Moderate
0Minor
2,744No known interaction
Moderate

85 interactions

Showing 60 of 85 moderate interactions — see all 85 on the Salacia page.

No interaction 2,744 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 Salacia and Pioglitazone Together: Common Questions

Can you take Salacia with Pioglitazone?
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 Salacia and Pioglitazone 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 Pioglitazone and Salacia?

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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.