Drug & supplement interaction

Terminalia + Dulaglutide

Dulaglutide brand name: Trulicity.

Moderate Interaction
The bottom line Moderate

Terminalia has a moderate interaction with Dulaglutide. Theoretically, concomitant use of Terminalia bellirica or Terminalia chebula 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 and Dulaglutide

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Dulaglutide

Dulaglutide falls under ANTIDIABETES DRUGS — the group Terminalia interacts with.

Theoretically, concomitant use of Terminalia bellirica or Terminalia chebula with antidiabetes drugs could affect blood sugar control and increase the risk of hypoglycemia.
Animal and in vitro research shows that Terminalia bellirica and Terminalia chebula fruit and seed extract have hypoglycemic effects.
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 thing with Trulicity (dulaglutide): it already works to lower your blood sugar. Some Terminalia species, mainly Terminalia bellirica and Terminalia chebula, may also nudge blood sugar down a bit on their own. Put the two together and, in theory, your numbers could dip lower than expected. That might show up as shakiness, sweating, feeling lightheaded, irritability, or a racing heart, which are the classic signs of low blood sugar.

I want to be honest about the strength of this: it's theoretical, based mostly on lab and animal studies, not solid human research. For most people it may not cause a problem, but since you're managing diabetes, it's worth a quick chat with your pharmacist or doctor before adding Terminalia, and keep an eye on your glucose readings.

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. Rao, N. K. and Nammi, S. Antidiabetic and renoprotective effects of the chloroform extract of Terminalia chebula Retz. seeds in streptozotocin-induced diabetic rats. BMC.Complement Altern.Med 2006;6:17. PubMed
  3. Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced
  4. Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.
  5. 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
  6. Eltimamy M, Elshamarka M, Aboelsaad M, Sayed M, Moawad H. Effects of alcoholic extract of Terminalia Chebula dried fruit on blood biochemical profile in diabetic rats. J Diabetes Metab Disord 2022;21(1):159-170. 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

Terminalia Also Interacts With Other Medications

Terminalia has 932 moderate known drug interactions in our database — the Dulaglutide 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 Terminalia

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

Everything else you take

See Every Supplement That Interacts With Dulaglutide

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dulaglutide page lists 239 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Siberian Cocklebur (major), Acai (moderate), African Wild Potato (moderate), Agaricus Mushroom (moderate) and Agmatine (moderate).

By severity: 1 major · 208 moderate · 30 minor.

From our pharmacist’s overview on the Dulaglutide page

“Because dulaglutide (Trulicity) already lowers blood sugar in people with type 2 diabetes, nearly every entry on this page deserves genuine respect, and one demands it outright. Almost all of these supplements pull glucose in one direction or the other, so the danger that matters most is hypoglycemia, blood sugar dropping too low.”

Reviewed by 2 · Jul 18, 2026

Open the Dulaglutide interaction page

One more smart check

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

We hold 306 real supplement products containing Terminalia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Terminalia. Your product may carry other ingredients that interact with Dulaglutide too, on top of Terminalia — 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 Terminalia and Dulaglutide 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
Top 25%

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

29 days ago today
Medication Dulaglutide
Steady interest

#1,792 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

What is Terminalia?

Terminalia
  • Heart health and circulation
  • Digestive problems (constipation, diarrhea)
  • Cholesterol support
  • Antioxidant and anti-inflammatory support
  • Immune support

Terminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible benefits for heart and cholesterol health, but the evidence is limited and not strong enough to recommend it as a treatment. Talk to your pharmacist or doctor before using it, especially if you have a heart condition.

Read the full Terminalia monograph & all interactions
Medication

About Dulaglutide Injection

What Is Dulaglutide Injection Used For?

Brand name: Trulicity

Trulicity (dulaglutide) injection is used alongside diet and exercise to improve blood sugar control in adults and children 10 years and older with type 2 diabetes mellitus. It is not for type 1 diabetes.

Trulicity is also used in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors to lower the risk of major heart events — specifically cardiovascular death, non-fatal heart attack, or non-fatal stroke.

See full Dulaglutide Injection drug information
Keep checking

Other Drugs & Terminalia

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

0Major
932Moderate
0Minor
1,897No known interaction
Moderate

932 interactions

Showing 60 of 932 moderate interactions — see all 932 on the Terminalia page.

No interaction 1,897 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 Terminalia and Dulaglutide Together: Common Questions

Can you take Terminalia with Dulaglutide?
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 and Dulaglutide 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 Dulaglutide and Terminalia?

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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.