Drug & supplement interaction

Spinach + Empagliflozin, Metformin Hydrochloride

Empagliflozin, Metformin Hydrochloride brand name: Synjardy XR.

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

Spinach has a moderate interaction with Empagliflozin, Metformin Hydrochloride. 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 Empagliflozin, Metformin Hydrochloride

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Empagliflozin, Metformin Hydrochloride

Empagliflozin, Metformin Hydrochloride 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 with Synjardy XR (which combines empagliflozin and metformin) and spinach. Both of those medicines already work to lower your blood sugar, and there's some early research hinting that a spinach-heavy meal may nudge your post-meal glucose down a little too. So in theory, piling on a lot of spinach could add to the sugar-lowering effect and bump up your risk of going too low.

Honestly, this is a theoretical, pharmacology-based concern, and a normal serving of spinach in your diet is very unlikely to cause trouble. If you start eating large amounts daily or use concentrated spinach extracts, just keep an eye out for lows (shakiness, sweating, dizziness) and check your readings. Chat with your pharmacist or doctor before making big changes.

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 Empagliflozin, Metformin Hydrochloride 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. Empagliflozin, Metformin Hydrochloride)
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 Empagliflozin, Metformin Hydrochloride

This page covers Spinach only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Empagliflozin, Metformin Hydrochloride page lists 258 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 · 218 moderate · 38 minor.

From our pharmacist’s overview on the Empagliflozin, Metformin Hydrochloride page

“Synjardy XR pairs two glucose-lowering medicines, empagliflozin and metformin, which is exactly why its 258-ingredient supplement list warrants real caution. The dominant pattern is additive.”

Reviewed by 2 · Jul 18, 2026

Open the Empagliflozin, Metformin Hydrochloride 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 Empagliflozin, Metformin Hydrochloride 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 Empagliflozin, Metformin Hydrochloride 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 5%

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

29 days ago today
Medication Empagliflozin, Metformin Hydrochloride
Top half

#949 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 Empagliflozin, Metformin Hydrochloride, 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 Empagliflozin, Metformin Hydrochloride supplement interactions › Every supplement checked against Empagliflozin, Metformin Hydrochloride, 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 Empagliflozin, Metformin Hydrochloride Together: Common Questions

Can you take Spinach with Empagliflozin, Metformin Hydrochloride?
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 Empagliflozin, Metformin Hydrochloride 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 Empagliflozin, Metformin Hydrochloride 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.