Drug & supplement interaction

Winter Cherry + Pioglitazone

Pioglitazone brand name: Actos.

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

Winter Cherry has a moderate interaction with Pioglitazone. In animal diabetic models, winter cherry extract decreases blood glucose.

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

Winter Cherry and Pioglitazone

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

Moderate

ANTIDIABETES DRUGS

Why this applies to Pioglitazone

Pioglitazone falls under ANTIDIABETES DRUGS — the group Winter Cherry interacts with.

In animal diabetic models, winter cherry extract decreases blood glucose. This effect has not been shown in humans. Theoretically, winter cherry might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
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 basic idea with Winter Cherry (ashwagandha) and pioglitazone (Actos). In animal studies, this herb seemed to lower blood sugar on its own. Pioglitazone already works to bring your blood sugar down by making your body more sensitive to insulin. So in theory, stacking the two could push your sugar a little lower than expected, which we call an additive effect.

I want to be honest about how weak this evidence is. The blood sugar drop has only been seen in lab and animal studies, not in people. Still, if you take both, it makes sense to watch for signs of low blood sugar like shakiness, sweating, dizziness, or feeling foggy. Please loop in your pharmacist or doctor before adding it, especially if you check your sugars at home so they can guide you.

Contact Dr. Brian directly if you have additional questions on this interaction

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

Winter Cherry Also Interacts With Other Medications

Winter Cherry has 155 moderate known drug interactions in our database — the Pioglitazone one above is one of them. If you take anything else, check it against the full list below.

Moderate 155 No known interaction 2,675 (incl. Pioglitazone)
Taking anything else?

Check Another of Your Medications Against Winter Cherry

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

Everything else you take

See Every Supplement That Interacts With Pioglitazone

This page covers Winter Cherry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the 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 Pioglitazone page

“Most of what appears on this pioglitazone (Actos) list shares one trait: the ingredients lower blood sugar on their own, which sounds helpful until you remember pioglitazone already does that job for people with type 2 diabetes. Stacked together, they can push glucose too low, and I would read this list with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Pioglitazone interaction page

How much people look this up

Where Winter Cherry and 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 Winter Cherry
Steady interest

#1,071 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pioglitazone
Steady interest

#2,347 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 Winter Cherry

What is Winter Cherry?

  • Stress and anxiety
  • Fatigue and low energy
  • Sleep support
  • General vitality and tonic
  • Athletic performance

Winter Cherry is another name for ashwagandha (Withania somnifera), an herb long used in Ayurvedic medicine, most often for stress, sleep, and energy. Some small studies suggest it may help with stress and anxiety, but the evidence is still limited and not definitive. It is generally well tolerated short-term, but pregnant women should avoid it, and anyone with a health condition should check with a pharmacist or doctor first.

Read the full Winter Cherry monograph & all interactions
Medication

About Pioglitazone

What Is Pioglitazone Used For?

Brand name: Actos

Pioglitazone tablets — sold as Actos and under the generic names Pioglitazone and Pioglitazone Hydrochloride — are used to improve blood sugar (glucose) control in adults with type 2 diabetes. They are taken along with diet and exercise, either alone or combined with other diabetes medicines such as a sulfonylurea, metformin, or insulin.

Pioglitazone is not for type 1 diabetes or diabetic ketoacidosis (a serious complication where the blood becomes too acidic). It only works when the body is still producing some of its own insulin.

See full Pioglitazone drug information
Keep checking

Other Drugs & Winter Cherry

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

0Major
155Moderate
0Minor
2,674No known interaction
155 Moderate 2,674 No interaction
Moderate

155 interactions

Showing 60 of 155 moderate interactions — see all 155 on the Winter Cherry page.

No interaction 2,674 drugs checked — show the list

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

Showing the 60 most looked-up of 2,674 medications checked with no known interaction — see the full Winter Cherry list.

See the full Winter Cherry interactions page
See every supplement checked against Pioglitazone, 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
Winter Cherry monograph › Uses, safety, and every drug interaction in one place Pioglitazone supplement interactions › Every supplement checked against Pioglitazone, ranked by severity Pioglitazone drug information › The full plain-English guide to this medication 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 Winter Cherry and Pioglitazone Together: Common Questions

Can you take Winter Cherry with 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 Winter Cherry and 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

Still Have a Question About Pioglitazone and Winter Cherry?

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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.