Drug & supplement interaction

Spinach + Alogliptin, Metformin

Alogliptin, Metformin brand name: Kazano.

Moderate Interaction
Medically reviewed by · Updated December 2022
The bottom line Moderate

Spinach has a moderate interaction with Alogliptin, Metformin. There are claims that spinach leaves have hypoglycemic effects.

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

Spinach and Alogliptin, Metformin

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Alogliptin, Metformin

Alogliptin, Metformin falls under ANTIDIABETES DRUGS — the group Spinach interacts with.

There are claims that spinach leaves have hypoglycemic effects. Evidence from clinical research suggests that consumption of a spinach-rich meal reduces post-meal blood glucose levels. Theoretically, spinach might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
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: Kazano combines two diabetes medicines (alogliptin and metformin) that already work to bring your blood sugar down. Spinach has a mild blood-sugar-lowering effect of its own, so in theory the two could stack and nudge your numbers a little lower than expected. If that happens, you might notice signs of low blood sugar like shakiness, sweating, dizziness, or feeling unusually hungry or irritable.

I want to keep this in perspective. This is a theoretical concern based on how spinach behaves, and a normal serving of spinach as part of a meal is very unlikely to cause trouble. Concentrated spinach supplements are the bigger unknown. Just keep an eye on your readings, and chat with your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Gustafsson, K., Asp, N. G., Hagander, B., and Nyman, M. Satiety effects of spinach in mixed meals: comparison with other vegetables. Int.J.Food Sci.Nutr. 1995;46(4):327-334. 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

Spinach Also Interacts With Other Medications

Spinach has 87 moderate known drug interactions in our database — the Alogliptin, Metformin one above is one of them. If you take anything else, check it against the full list below.

Moderate 87 No known interaction 2,743 (incl. Alogliptin, Metformin)
Taking anything else?

Check Another of Your Medications Against Spinach

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

Everything else you take

See Every Supplement That Interacts With Alogliptin, Metformin

This page covers Spinach only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alogliptin, Metformin page lists 257 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), African Wild Potato (moderate) and Agaricus Mushroom (moderate).

By severity: 2 major · 217 moderate · 38 minor.

From our pharmacist’s overview on the Alogliptin, Metformin page

“Kazano combines alogliptin and metformin to lower blood sugar, and nearly everything on this list pushes on that same lever, so I treat these pairings with real caution. Most entries are herbs and supplements that lower glucose on their own, and stacked on the drug they raise the risk of hypoglycemia, a sugar drop steep enough to cause…”

Reviewed by 2 · Jul 18, 2026

Open the Alogliptin, Metformin interaction page

One more smart check

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

We hold 3,925 real supplement products containing Spinach, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Spinach. Your product may carry other ingredients that interact with Alogliptin, Metformin too, on top of Spinach — 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 Spinach and Alogliptin, Metformin 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 Spinach
Top 10%

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

29 days ago today
Medication Alogliptin, Metformin
Steady interest

#1,701 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 Spinach

What is Spinach?

  • General nutrition and antioxidant support
  • Eye health
  • Heart health and blood pressure
  • Athletic performance
  • Constipation and digestive support

Spinach is a nutrient-dense leafy green that is a healthy part of a balanced diet, providing vitamins, minerals, fiber, and antioxidants. While it is very safe as a food, concentrated supplements and extracts are far less studied, and most specific health claims are not strongly proven. People prone to kidney stones or taking blood thinners should be mindful of its oxalate and vitamin K content.

Read the full Spinach monograph & all interactions
Keep checking

Other Drugs & Spinach

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

0Major
87Moderate
0Minor
2,742No known interaction
87 Moderate 2,742 No interaction
Moderate

87 interactions

Showing 60 of 87 moderate interactions — see all 87 on the Spinach page.

No interaction 2,742 drugs checked — show the list

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

Showing the 60 most looked-up of 2,742 medications checked with no known interaction — see the full Spinach list.

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

Can you take Spinach with Alogliptin, Metformin?
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 Spinach and Alogliptin, Metformin 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 Alogliptin, Metformin and Spinach?

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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.