Drug & supplement interaction

Sida Cordifolia + Pioglitazone

Pioglitazone brand name: Actos.

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

Sida Cordifolia has a moderate interaction with Pioglitazone. Theoretically, Sida cordifolia might reduce the effectiveness of antidiabetes drugs.

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

Sida Cordifolia 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 Sida Cordifolia interacts with.

Theoretically, Sida cordifolia might reduce the effectiveness of antidiabetes drugs.
Sida cordifolia contains ephedrine. Clinical research shows that ephedrine can increase blood glucose levels.
Severity Moderate Likelihood Probable Evidence B

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 thing to know about pairing this herb with pioglitazone (Actos). Pioglitazone works by making your body more sensitive to insulin so your blood sugar stays in a healthy range. Sida cordifolia naturally contains ephedrine, a stimulant that can actually push blood sugar up. So the two work against each other, and the herb may blunt how well your pioglitazone controls your numbers.

In plain terms, you could see higher blood sugar readings even though you're taking your medication faithfully. This is considered a probable but moderate concern, and the evidence is on the weaker side. Beyond the sugar issue, the ephedrine can also strain your heart and blood pressure, which is its own worry. Please check with your pharmacist or doctor before using this supplement, and don't change your pioglitazone on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Haller CA, Jacob P 3rd, Benowitz NL. Enhanced stimulant and metabolic effects of combined ephedrine and caffeine. Clin Pharmacol Ther 2004;75:259-73.

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

Sida Cordifolia Also Interacts With Other Medications

Sida Cordifolia has 337 major, 107 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.

Major 337 Moderate 107 No known interaction 2,386 (incl. Pioglitazone)
Taking anything else?

Check Another of Your Medications Against Sida Cordifolia

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

Everything else you take

See Every Supplement That Interacts With Pioglitazone

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

We hold 48 real supplement products containing Sida Cordifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sida Cordifolia. Your product may carry other ingredients that interact with Pioglitazone too, on top of Sida Cordifolia — 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 Sida Cordifolia 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 Sida Cordifolia
Top half

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

29 days ago today
Medication Pioglitazone
Steady interest

#1,768 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 Sida Cordifolia

What is Sida Cordifolia?

Sida Cordifolia
  • Weight loss and energy
  • Asthma and breathing problems
  • Joint and muscle pain
  • Fever and cough
  • General fatigue or 'tonic'

Sida cordifolia (bala or country mallow) is a traditional Ayurvedic plant that naturally contains ephedrine, a powerful stimulant. Because of this, many supplements containing it have been banned or restricted, and it carries real risks to the heart and blood pressure. There is little reliable human evidence that it works, so most people should avoid it and talk with a pharmacist or doctor first.

Read the full Sida Cordifolia 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 & Sida Cordifolia

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

337Major
107Moderate
0Minor
2,385No known interaction
337 Major 107 Moderate 2,385 No interaction
Major

337 interactions

Showing 60 of 337 major interactions — see all 337 on the Sida Cordifolia page.

Moderate

107 interactions

Showing 60 of 107 moderate interactions — see all 107 on the Sida Cordifolia page.

No interaction 2,385 drugs checked — show the list

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

Showing the 60 most looked-up of 2,385 medications checked with no known interaction — see the full Sida Cordifolia list.

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

Can you take Sida Cordifolia 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 Sida Cordifolia 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 Sida Cordifolia?

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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.