Drug & supplement interaction

Sesame + Nateglinide

Nateglinide brand name: Starlix.

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

Nateglinide falls into 2 drug categories that Sesame can interact with; the most serious is rated moderate. Theoretically, sesame might increase the levels and clinical effects of CYP2C9 substrates.

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

Sesame and Nateglinide

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

Why Are There 2 Interactions?

Sesame interacts with whole categories of medication. Nateglinide falls into 2 of those categories, so it can interact with Sesame 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 Sesame interacts with.

Theoretically, sesame might increase the levels and clinical effects of CYP2C9 substrates.
In vitro, sesame inhibits CYP2C9. However, 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 gist for Starlix (nateglinide): your liver uses an enzyme called CYP2C9 to help clear this medicine out of your system. Sesame, at least in lab studies, can slow that same enzyme down. In theory, that could let nateglinide linger a bit longer and push its effect harder, and since this drug works by prompting your pancreas to release insulin, the main worry would be low blood sugar (shakiness, sweating, dizziness, confusion, or feeling suddenly hungry).

Now, the honest part: this is only seen in test-tube and animal research, not in real people, so it's mostly theoretical. Everyday amounts of sesame on a bagel or in tahini almost certainly won't matter. Concentrated sesame supplements are the bigger question mark. If you take those, just give your pharmacist or doctor a heads-up.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. von Moltke LL, Weemhoff JL, Bedir E, et al. Inhibition of human cytochromes P450 by components of Ginkgo biloba. J Pharm Pharmacol 2004;56:1039-44.
Moderate

ANTIDIABETES DRUGS

2 of 2

Nateglinide also falls under ANTIDIABETES DRUGS.

Taking sesame oil with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical studies show that sesame oil can decrease plasma glucose and glycated hemoglobin (HbA1c) levels. Some clinical research in patients taking glibenclamide shows that using sesame oil or a blend of sesame oil and rice bran oil in place of other oil for cooking reduces plasma glucose more than glibenclamide alone. Monitor blood glucose levels closely. Dose adjustments might be necessary.
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: nateglinide already works by nudging your pancreas to release more insulin around mealtimes, which lowers your blood sugar. Sesame, mainly as sesame oil used in cooking, may gently push blood sugar down too. Put the two together and the worry is that your sugar could dip a little lower than expected.

If that happens, you might notice signs of low blood sugar (hypoglycemia) like shakiness, sweating, dizziness, irritability, or a fast heartbeat. I'll be honest though, this is a theoretical concern based mostly on how sesame oil behaved in small studies, and an occasional sesame seed on a bun or a bit of sesame in cooking is very unlikely to cause trouble. Larger, regular use of sesame oil is where to pay attention. Keep checking your sugars as usual, and chat with your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sankar, D., Rao, M. R., Sambandam, G., and Pugalendi, K. V. A pilot study of open label sesame oil in hypertensive diabetics. J Med Food 2006;9(3):408-412. PubMed
  2. Ramesh, B., Saravanan, R., and Pugalendi, K. V. Influence of sesame oil on blood glucose, lipid peroxidation, and antioxidant status in streptozotocin diabetic rats. J Med Food 2005;8(3):377-381. PubMed
  3. Devarajan S, Chatterjee B, Urata H, et al. A blend of sesame and rice bran oils lowers hyperglycemia and improves the lipids. Am J Med. 2016;129(7):731-9. PubMed
  4. Yargholi A, Najafi MH, Zareian MA, Hawkins J, Shirbeigi L, Ayati MH. The effects of sesame consumption on glycemic control in adults: A systematic review and meta-analysis of randomized clinical trial. Evid Based Complement Alternat Med 2021;2021:2873534. PubMed
  5. Sohouli MH, Haghshenas N, Hernández-Ruiz Á, Shidfar F. Consumption of sesame seeds and sesame products has favorable effects on blood glucose levels but not on insulin resistance: A systematic review and meta-analysis of controlled clinical trials. Phytot PubMed
  6. Atefi M, Entezari MH, Vahedi H, Hassanzadeh A. The effects of sesame oil on metabolic biomarkers: a systematic review and meta-analysis of clinical trials. J Diabetes Metab Disord 2022;21(1):1065-1080. 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

Sesame Also Interacts With Other Medications

Sesame has 342 moderate, 185 minor 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 342 Minor 185 No known interaction 2,303 (incl. Nateglinide)
Taking anything else?

Check Another of Your Medications Against Sesame

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

Everything else you take

See Every Supplement That Interacts With Nateglinide

This page covers Sesame 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 Sesame as Part of a Dietary Supplement Product? Check It for Interactions

We hold 434 real supplement products containing Sesame, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sesame. Your product may carry other ingredients that interact with Nateglinide too, on top of Sesame — 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 Sesame 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 Sesame
Top half

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

29 days ago today
Medication Nateglinide
Steady interest

#1,955 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 Sesame

What is Sesame?

  • Heart and cholesterol health
  • Blood pressure support
  • Source of healthy fats and minerals
  • Skin and hair care (topical oil)
  • Antioxidant support
  • Cooking and nutrition

Sesame is a nutritious seed and oil widely used in cooking and traditional medicine, and it provides healthy fats, fiber, and antioxidant compounds called lignans. Some early research suggests sesame may modestly help with cholesterol and blood pressure, but the evidence is limited. Sesame is also a common, sometimes serious, food allergen, so people with seed allergies should be careful.

Read the full Sesame 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 & Sesame

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

0Major
342Moderate
185Minor
2,302No known interaction
342 Moderate 185 Minor 2,302 No interaction
Moderate

342 interactions

Showing 60 of 342 moderate interactions — see all 342 on the Sesame page.

Minor

185 interactions

Showing 60 of 185 minor interactions — see all 185 on the Sesame page.

No interaction 2,302 drugs checked — show the list

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

Showing the 60 most looked-up of 2,302 medications checked with no known interaction — see the full Sesame list.

See the full Sesame 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
Sesame 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 Sesame and Nateglinide Together: Common Questions

Can you take Sesame 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 Sesame and Nateglinide?
Nateglinide belongs to more than one drug category, and Sesame 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 Sesame 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 Sesame?

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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.