Drug & supplement interaction

Sesame + Pioglitazone

Pioglitazone brand name: Actos.

Moderate Interaction
The bottom line Moderate

Sesame has a moderate interaction with Pioglitazone. Taking sesame oil with antidiabetes drugs might increase the risk of hypoglycemia.

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

Sesame 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 Sesame interacts with.

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: sesame oil seems to nudge blood sugar down on its own, and pioglitazone (Actos) is already working to lower your blood sugar by making your body more sensitive to insulin. Stack the two and they could add up, so your numbers might dip lower than expected. That can show up as shakiness, sweating, dizziness, hunger, or feeling foggy, the usual signs of low blood sugar.

I want to be honest about the strength of this: it's mostly theoretical, based on how sesame behaves, plus some early studies in people on a different diabetes pill. A drizzle of sesame oil on dinner is unlikely to cause trouble. Larger, daily cooking-oil amounts are where I'd pay closer attention. Keep an eye on your readings and check with your doctor or pharmacist before changing anything.

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 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 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 Pioglitazone

This page covers Sesame 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 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 Pioglitazone 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 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 Sesame
Top half

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

29 days ago today
Medication Pioglitazone
Steady interest

#2,076 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 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 & 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
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
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 Sesame and Pioglitazone Together: Common Questions

Can you take Sesame 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 Sesame 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

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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.