Drug & supplement interaction

White Horehound + Alogliptin, Pioglitazone

Alogliptin, Pioglitazone brand name: Oseni.

Moderate Interaction
The bottom line Moderate

White Horehound has a moderate interaction with Alogliptin, Pioglitazone. Evidence from animal research suggests that white horehound might lower blood glucose.

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

White Horehound and Alogliptin, Pioglitazone

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Alogliptin, Pioglitazone

Alogliptin, Pioglitazone falls under ANTIDIABETES DRUGS — the group White Horehound interacts with.

Evidence from animal research suggests that white horehound might lower blood glucose. However, preliminary clinical research suggests that white horehound only slightly lowers blood glucose when taken in combination with antidiabetic agents, suggesting that the effect may not be clinically significant. Until more is known, use with caution. Theoretically, white horehound may have additive effects when used by patients taking antidiabetic drugs. The dose of diabetes medications might need to be adjusted. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.
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

Here's the simple version: Oseni combines two diabetes medicines, alogliptin and pioglitazone, that both work to lower your blood sugar. White horehound, the bitter herb you'll find in old cough drops, has shown in some early research that it may nudge blood sugar down a little too. So the concern is an additive effect, meaning the two together could lower your glucose more than the medicine alone.

The good news is the human evidence is weak, and what we have suggests any extra drop is small and probably not a big deal for most people. Still, it's worth knowing the signs of low blood sugar (shakiness, sweating, dizziness, confusion). The occasional horehound cough drop almost certainly won't matter, but a daily concentrated supplement is a different story. Please check with your pharmacist or doctor before adding it.

References
  1. Roman, Ramos R., Alarcon-Aguilar, F., Lara-Lemus, A., and Flores-Saenz, J. L. Hypoglycemic effect of plants used in Mexico as antidiabetics. Arch.Med.Res 1992;23:59-64.
  2. Novaes AP, Rossi C, Poffo C, et al. Preliminary evaluation of the hypoglycemic effect of some Brazilian medicinal plants. Therapie. 2001;56(4):427-30.
  3. Herrera-Arellano, A., Aguilar-Santamaria, L., Garcia-Hernandez, B., Nicasio-Torres, P., and Tortoriello, J. Clinical trial of Cecropia obtusifolia and Marrubium vulgare leaf extracts on blood glucose and serum lipids in type 2 diabetics. Phytomedicine 200 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

White Horehound Also Interacts With Other Medications

White Horehound has 257 moderate known drug interactions in our database — the Alogliptin, Pioglitazone 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 White Horehound

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

Everything else you take

See Every Supplement That Interacts With Alogliptin, Pioglitazone

This page covers White Horehound only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alogliptin, Pioglitazone page lists 356 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 309 moderate · 41 minor.

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

“Someone taking Oseni (alogliptin and pioglitazone) for type 2 diabetes often shops the very shelf this list comes from, and the pairing deserves genuine caution. Of the 356 ingredients on file, 239 also lower blood sugar, so stacking them on top of the pill can drop glucose too far.”

Reviewed by 2 · Jul 18, 2026

Open the Alogliptin, Pioglitazone interaction page

How much people look this up

Where White Horehound and Alogliptin, Pioglitazone 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 White Horehound
Steady interest

#1,046 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Alogliptin, Pioglitazone
Top half

#807 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 White Horehound

What is White Horehound?

White Horehound
  • Cough and chest congestion
  • Sore throat
  • Bronchitis
  • Digestive upset and poor appetite
  • Bloating and gas

White horehound is a traditional bitter herb used mainly for coughs, sore throats, and mild digestive complaints, and it is a common flavoring in old-fashioned cough drops. Solid human evidence supporting these uses is limited, so view it as a folk remedy rather than a proven treatment. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy.

Read the full White Horehound monograph & all interactions
Keep checking

Other Drugs & White Horehound

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

0Major
257Moderate
0Minor
2,572No known interaction
Moderate

257 interactions

Showing 60 of 257 moderate interactions — see all 257 on the White Horehound page.

No interaction 2,572 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 White Horehound and Alogliptin, Pioglitazone Together: Common Questions

Can you take White Horehound with Alogliptin, Pioglitazone?
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 White Horehound and Alogliptin, Pioglitazone 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.