Drug & supplement interaction

Terminalia Bellirica + Alogliptin, Metformin

Alogliptin, Metformin brand name: Kazano.

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

Terminalia Bellirica has a moderate interaction with Alogliptin, Metformin. Theoretically, concomitant use of Terminalia bellirica with antidiabetes drugs could affect blood sugar control and 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

Terminalia Bellirica 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 Terminalia Bellirica interacts with.

Theoretically, concomitant use of Terminalia bellirica with antidiabetes drugs could affect blood sugar control and increase the risk of hypoglycemia.
Animal research suggests that Terminalia bellirica fruit extract, alone or in combination with Terminalia chebula and Indian gooseberry, has hypoglycemic effects. This activity has not been shown 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

Kazano combines two diabetes medicines, alogliptin and metformin, that already work to bring your blood sugar down. The thinking here is simple: Terminalia bellirica may also lower blood sugar on its own, so stacking it on top of Kazano could push your levels lower than expected. If that happens, you might notice signs of low blood sugar (hypoglycemia) like shakiness, sweating, dizziness, a fast heartbeat, or feeling confused or unusually hungry.

I want to be honest about the strength of this concern. The blood-sugar-lowering effect has only been seen in animal studies, not proven in people, so this is more of a theoretical caution than a confirmed problem. Still, if you'd like to try this supplement, check in with your pharmacist or doctor first and keep an eye on your readings.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Das A, Naveen J, Sreerama YN, Gnanesh Kumar BS, Baskaran V. Low-glycemic foods with wheat, barley and herbs (Terminalia chebula, Terminalia bellerica and Emblica officinalis) inhibit a-amylase, a-glucosidase and DPP-IV activity in high fat and low dose st

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

Terminalia Bellirica Also Interacts With Other Medications

Terminalia Bellirica has 85 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 85 No known interaction 2,745 (incl. Alogliptin, Metformin)
Taking anything else?

Check Another of Your Medications Against Terminalia Bellirica

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

Everything else you take

See Every Supplement That Interacts With Alogliptin, Metformin

This page covers Terminalia Bellirica 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

How much people look this up

Where Terminalia Bellirica 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 Terminalia Bellirica
Steady interest

#1,055 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Alogliptin, Metformin
Top 25%

#606 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 Terminalia Bellirica

What is Terminalia Bellirica?

  • Digestive complaints and constipation
  • Respiratory issues like cough and sore throat
  • Antioxidant support
  • General wellness in Ayurvedic medicine
  • Cholesterol and metabolic support

Terminalia bellirica, often called 'Bibhitaki,' is a fruit long used in Ayurvedic medicine and is one of the three ingredients in the popular blend Triphala. Early laboratory and small human studies suggest possible antioxidant and metabolic effects, but high-quality evidence in people is limited. Talk with your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or take other medicines.

Read the full Terminalia Bellirica monograph & all interactions
Keep checking

Other Drugs & Terminalia Bellirica

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

0Major
85Moderate
0Minor
2,744No known interaction
85 Moderate 2,744 No interaction
Moderate

85 interactions

Showing 60 of 85 moderate interactions — see all 85 on the Terminalia Bellirica page.

No interaction 2,744 drugs checked — show the list

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

Showing the 60 most looked-up of 2,744 medications checked with no known interaction — see the full Terminalia Bellirica list.

See the full Terminalia Bellirica 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
Terminalia Bellirica 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 Terminalia Bellirica and Alogliptin, Metformin Together: Common Questions

Can you take Terminalia Bellirica 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 Terminalia Bellirica 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

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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.