Drug & supplement interaction

Tree Turmeric + rosiglitazone, glimepiride

rosiglitazone, glimepiride brand name: Avandaryl.

Moderate Interaction
The bottom line Moderate

rosiglitazone, glimepiride falls into 2 drug categories that Tree Turmeric can interact with; the most serious is rated moderate. Theoretically, tree turmeric might increase the levels and clinical effects of drugs metabolized by CYP2C9.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Tree Turmeric and rosiglitazone, glimepiride

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Tree Turmeric interacts with whole categories of medication. rosiglitazone, glimepiride falls into 2 of those categories, so it can interact with Tree Turmeric in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to rosiglitazone, glimepiride

rosiglitazone, glimepiride falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Tree Turmeric interacts with.

Theoretically, tree turmeric might increase the levels and clinical effects of drugs metabolized by CYP2C9.
Preliminary clinical evidence suggests that berberine, a constituent of tree turmeric, can inhibit CYP2C9.
Severity Moderate Likelihood Possible Evidence B

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

Your Avandaryl combo packs two diabetes medicines, and one of them, glimepiride, gets cleared by a liver enzyme called CYP2C9. Berberine, the active piece of tree turmeric, appears to slow that enzyme down. When that happens, glimepiride can hang around longer and hit harder than usual. Since glimepiride already lowers blood sugar (and on top of that, berberine itself nudges blood sugar down), the real concern here is low blood sugar: shakiness, sweating, dizziness, confusion, or a racing heart.

This is based on early, limited human research, so it is a possible issue rather than a sure thing. Still, please loop in your pharmacist or doctor before adding tree turmeric, and keep an eye on your sugar readings if you do.

References
  1. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
Moderate

ANTIDIABETES DRUGS

2 of 2

rosiglitazone, glimepiride also falls under ANTIDIABETES DRUGS.

Theoretically, tree turmeric, taken alone or in combination with milk thistle, might increase the risk of hypoglycemia in patients taking antidiabetes drugs.
Clinical research shows that taking a product containing tree turmeric and milk thistle extracts can lower blood glucose levels, glycated hemoglobin (HbA1c), and insulin resistance in patients with type 2 diabetes, including those on antidiabetic agents. Additionally, clinical research suggests that berberine, a constituent of tree turmeric, can lower blood glucose levels.
Severity Moderate Likelihood Probable Evidence A

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

Avandaryl combines two diabetes medicines: rosiglitazone, which helps your body use insulin better, and glimepiride, which prompts your pancreas to release more insulin. Tree turmeric (and the berberine in it) also nudges blood sugar downward on its own. So when you stack the two together, the lowering effects can add up, and your sugar may drop lower than you intend.

The piece I'd watch most is glimepiride, since that one can already cause low blood sugar (shakiness, sweating, dizziness, confusion, or feeling faint). Adding tree turmeric could make those moments more likely. This isn't a reason to panic, but please loop in your pharmacist or doctor before starting it. They may want to check your readings more closely or adjust your dose.

References
  1. Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. PubMed
  2. Yin, J., Xing, H., and Ye, J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008;57(5):712-717. PubMed
  3. Zhang, H., Wei, J., Xue, R., Wu, J. D., Zhao, W., Wang, Z. Z., Wang, S. K., Zhou, Z. X., Song, D. Q., Wang, Y. M., Pan, H. N., Kong, W. J., and Jiang, J. D. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin re
  4. Wei, W., Zhao, H., Wang, A., Sui, M., Liang, K., Deng, H., Ma, Y., Zhang, Y., Zhang, H., and Guan, Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndro
  5. Derosa G, Romano D, D'Angelo A, Maffioli P. Berberis aristata/Silybum marianum fixed combination (Berberol(®)) effects on lipid profile in dyslipidemic patients intolerant to statins at high dosages: a randomized, placebo-controlled, clinical trial. Phyto PubMed
  6. Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:8 PubMed
  7. Di Pierro F, Villanova N, Agostini F, Marzocchi R, Soverini V, Marchesini G. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control. Diabetes Metab Syndr Obes. 2012;5:213-7. 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

Tree Turmeric Also Interacts With Other Medications

Tree Turmeric has 2 major, 1,157 moderate known drug interactions in our database — the rosiglitazone, glimepiride one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Tree Turmeric

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

Everything else you take

See Every Supplement That Interacts With rosiglitazone, glimepiride

This page covers Tree Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the rosiglitazone, glimepiride page lists 308 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), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 2 major · 258 moderate · 48 minor.

From our pharmacist’s overview on the rosiglitazone, glimepiride page

“Siberian cocklebur worries me most on this page. Its seeds have caused severe, worsening drops in blood sugar in people, and rosiglitazone with glimepiride (Avandaryl) already pulls glucose down through two separate mechanisms, so these pairings deserve real vigilance.”

Reviewed by 2 · Jul 18, 2026

Open the rosiglitazone, glimepiride interaction page

One more smart check

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

We hold 51 real supplement products containing Tree Turmeric, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tree Turmeric. Your product may carry other ingredients that interact with rosiglitazone, glimepiride too, on top of Tree Turmeric — 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 Tree Turmeric and rosiglitazone, glimepiride 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 Tree Turmeric
Steady interest

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

29 days ago today
Medication rosiglitazone, glimepiride
Top 25%

#681 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 Tree Turmeric

What is Tree Turmeric?

  • Blood sugar support
  • High cholesterol
  • Digestive complaints
  • Skin and eye conditions
  • Antimicrobial uses
  • Liver support

Tree turmeric (Berberis aristata) is a shrub used in traditional Indian (Ayurvedic) medicine, valued mainly for its berberine content. Early research suggests possible benefits for blood sugar and cholesterol, but high-quality human evidence is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Tree Turmeric monograph & all interactions
Keep checking

Other Drugs & Tree Turmeric

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

2Major
1,157Moderate
0Minor
1,670No known interaction
Major

2 interactions

Moderate

1,157 interactions

Showing 60 of 1,157 moderate interactions — see all 1,157 on the Tree Turmeric page.

No interaction 1,670 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 Tree Turmeric and rosiglitazone, glimepiride Together: Common Questions

Can you take Tree Turmeric with rosiglitazone, glimepiride?
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.
Why are there 2 interactions listed for Tree Turmeric and rosiglitazone, glimepiride?
rosiglitazone, glimepiride belongs to more than one drug category, and Tree Turmeric interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Tree Turmeric and rosiglitazone, glimepiride 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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