Herb & supplement monograph

Annatto Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Annatto interacts with medications. The heart of this page is the interaction list — every drug Annatto is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Annatto is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Annatto Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Annatto drug interaction appears low for most people, since the concerns identified so far rest on animal research rather than proven effects in humans. None of the listed interactions are rated major, and although a fair number of medications appear, they are all rated moderate and trace back to a single, poorly documented concern.

Interactions deserving the most attention

The one area worth watching is diabetes medications. Animal studies suggest annatto extracts might raise or lower blood sugar, so in theory it could blunt these drugs or add to their glucose-lowering effect. Because blood sugar control is closely monitored, people taking insulin or oral diabetes drugs should keep an eye on their readings and mention annatto to their prescriber. This has not been confirmed in human studies.

What the rest of the list means

The long list of interacting medications can look worrying, but nearly all of it reflects that one theoretical blood sugar concern applied across the many drugs used to treat diabetes. A predicted effect in animals or the lab does not mean a harmful interaction actually happens in people, and for annatto no interaction has been well documented in humans so far.

Check your medications against Annatto

Based on HelloPharmacist’s Annatto interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Annatto

86 medications have a known interaction with Annatto, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
AcarboseGlucobay, Prandase, Precose› AcetohexamideDymelor› AlbiglutideTanzeum› AlogliptinNesina› Alogliptin, MetforminKazano› Alogliptin, PioglitazoneOseni› Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi› CanagliflozinInvokana› Canagliflozin, MetforminInvokamet› Canagliflozin, Metformin HydrochlorideInvokamet XR› ChlorpropamideChlorpropam, Diabinese› DapagliflozinFarxiga› Dapagliflozin Propanediol, MetforminXigduo XR› Dapagliflozin Propanediol, Saxagliptin HydrochlorideQtern› Dapagliflozin, Metformin Hydrochloride, Saxagliptin HydrochlorideQternmet XR› Dasiglucagon HydrochlorideZegalogue› DulaglutideTrulicity› EmpagliflozinJardiance› Empagliflozin, Linagliptin, Metformin HydrochlorideTrijardy XR› Empagliflozin, MetforminSynjardy› Empagliflozin, Metformin HydrochlorideSynjardy XR› ErtugliflozinSteglatro› Ertugliflozin, Metformin HydrochlorideSegluromet› ExenatideBydureon, Byetta› Exenatide SyntheticBydureon BCISE› GliclazideDiamicron› GlimepirideAmaryl› GlipizideGlucotrol, Glucotrol XL› Glipizide, MetforminMetaglip› GlucagonBaqsimi, Glucagon›
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Annatto combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Annatto affects

Every type of medication (drug category) Annatto is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 1 drug category Annatto interacts with
Antidiabetes Drugs
Antidiabetes Drugs

Animal studies suggest that certain annatto extracts may have hypoglycemic or hyperglycemic effects. Theoretically, taking annatto with antidiabetes drugs could reduce the therapeutic effects of these drugs or increase the risk for additive hypoglycemia. Monitor blood glucose levels closely.

Likelihood Possible Evidence D
Monograph

Annatto: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Annatto is a plant-based coloring made from the seeds of the achiote tree and is widely used as a safe food dye. While it has a long history in traditional medicine and contains antioxidant compounds, there is little high-quality human research supporting its use as a supplement. It can trigger allergic reactions in some people, so use caution and talk with your pharmacist or doctor.

Annatto
Scientific name
Bixa orellana
Family
Bixaceae
Part used
Seeds (and the colored coating around them); leaves are sometimes used
Common forms
Food coloring, powder, seed extract, capsules, oil-based extracts
People commonly use it for
  • Natural food and cosmetic coloring
  • Source of antioxidants
  • Antimicrobial/anti-infective (traditional use)
  • Athletic performance and muscle soreness
  • Skin and bad-breath remedies (traditional use)

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Generally recognized as safe as a food coloring, but supplement use is not well studied and it can cause allergies in some people.

PregnancyInsufficient reliable information

There is insufficient reliable information available about the safety of annatto during pregnancy and breast-feeding.

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

There is insufficient reliable information available about the safety of annatto during pregnancy and breast-feeding.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Annatto is a natural coloring made from the seeds of the achiote tree (Bixa orellana). This small tree grows in tropical parts of Central and South America and is now found in many warm regions around the world. The tree produces spiky red pods filled with small seeds covered in a red-orange coating.

The seeds are ground into a powder or made into a paste or oil to add a yellow, orange, or red color to foods like cheese, butter, rice, and snack foods. People also use annatto to dye fabric and cosmetics. In addition to coloring, the seeds have a mild, slightly sweet and peppery flavor and are used as a spice in some cuisines.

Beyond cooking, annatto has been used in traditional medicine for many purposes, such as a source of antioxidants and as a folk remedy for skin and infections.

How it works

The orange-red color of annatto comes mainly from a pigment called bixin and a related compound called norbixin. These are types of carotenoids, the same family of plant pigments found in carrots and tomatoes.

In laboratory studies, these carotenoids act as antioxidants, meaning they may help neutralize unstable molecules called free radicals. Annatto also contains tocotrienols, which are a form of vitamin E. Some lab and animal research suggests possible antimicrobial and anti-inflammatory effects.

It is important to remember that most of this information comes from test-tube and animal research. What happens in a lab does not always carry over to real benefits in people.

Effectiveness

Does Annatto work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 4 uses evaluated
4 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.

For Annatto, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 4 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Athletic performance
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in adult male athletes shows that taking a specific supplement containing annatto powder 143 mg and ginger powder 190 mg (ReWin(d), Natural Origins), 6 capsules daily, increases muscle power during repeat eccentric exercise when compared with placebo. The supplement was taken for 4 weeks prior to, and 3 days after, the eccentric exercise. Another small clinical trial in male recreational runners aged 40-60 years with chronic knee discomfort shows that taking a product containing annatto seed, devil's claw root, and ginger rhizome in a ratio of 0.375:1:0.75 (Exten(d), Natural Origins), 2 grams orally daily in 3 divided doses for 4 weeks, reduces leg fat mass when compared with placebo. It is unclear if knee discomfort is improved, or whether the effects are due to annatto, other ingredients, or the combination.

Sources Ref 105505 Ref 109548
Insufficient Reliable Evidence To Rate Benign prostatic hyperplasia (BPH)
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in adults with BPH and moderate lower urinary tract symptoms shows that taking powdered annatto leaf 250 mg three times daily for 12 months does not improve symptoms when compared with placebo.

Sources Ref 31612
Insufficient Reliable Evidence To Rate Exercise-induced muscle soreness
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in adult male athletes shows that taking a specific supplement containing annatto powder 143 mg and ginger powder 190 mg (ReWin(d), Natural Origins), 6 capsules daily, reduces muscle soreness after eccentric exercise when compared with placebo. However, blood creatine kinase levels were not different between groups. The supplement was taken for 4 weeks prior to, and 3 days after, the eccentric exercise.

Sources Ref 105505
Insufficient Reliable Evidence To Rate Halitosis
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in adults with halitosis shows that applying annatto extract 20% to the tongue as a photosensitizer for antimicrobial photodynamic therapy (aPDT) immediately reduces volatile sulfur levels in the mouth when compared with baseline. However, after 7 days, volatile sulfur levels were similar to baseline levels. The changes in volatile sulfur levels were similar to those treated with tongue scraping or tongue scraping followed by aPDT. However, the study may have been inadequately powered to detect a difference between groups.

Sources Ref 105504

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

As a food coloring, annatto is widely used and generally considered safe in the small amounts found in foods. Less is known about the safety of concentrated supplement doses, which have not been well studied.

The main concern is allergic reactions. Some people have reported reactions to annatto in foods, ranging from mild to more serious. If you have known food or color allergies, be cautious.

For pregnancy and breastfeeding, the amounts used to color food are likely fine, but there is not enough information on the safety of supplement-strength annatto. To be safe, avoid concentrated supplements during pregnancy and breastfeeding unless your doctor approves. Children, older adults, and people with chronic illness should also check with a healthcare provider before using annatto supplements.

Side effects

When used as a food coloring, annatto rarely causes problems for most people. The most reported side effect is an allergic reaction. Symptoms can include hives, itching, swelling, stomach upset, or in rare cases more severe reactions such as trouble breathing.

If you notice signs of a serious allergic reaction, such as swelling of the lips, tongue, or throat, or difficulty breathing, stop using it and seek emergency medical care right away.

Because supplement doses are not well studied, other side effects are possible but not well documented.

Annatto: Reported Adverse Effects

Documented safety reports on Annatto from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, annatto leaf seems to be well tolerated. Rarely, annatto has been reported to cause constipation. When used as a coloring agent, annatto has been reported to cause allergic reactions, including anaphylaxis.

  1. Zegarra, L., Vaisberg, A., Loza, C., Aguirre, R. L., Campos, M., Fernandez, I., Talla, O., and Villegas, L. Double-blind randomized placebo-controlled study of Bixa orellana in patients with lower urinary tract symptoms associated to benign prostatic hyp
  2. Ebo, D. G., Ingelbrecht, S., Bridts, C. H., and Stevens, W. J. Allergy for cheese: evidence for an IgE-mediated reaction from the natural dye annatto. Allergy 2009;64(10):1558-1560.
  3. Nish, W. A., Whisman, B. A., Goetz, D. W., and Ramirez, D. A. Anaphylaxis to annatto dye: a case report. Ann.Allergy 1991;66(2):129-131.
  4. Koc E, Arca E, Surucu B, Kurumlu Z. An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic s
  5. Raddatz-Mota D, Pérez-Flores LJ, Carrari F, et al. Achiote (Bixa orellana L.): a natural source of pigment and vitamin E. J Food Sci Technol 2017;54(6):1729-1741.
Reports by condition
Constipation Gastrointestinal

Orally, annatto leaf powder has been reported to cause constipation. Annatto food coloring has been associated with an increase in symptoms of irritable bowel syndrome (IBS) in one case report. A woman with frequent symptoms of diarrhea, bloating, and abdominal pain experienced an improvement in all symptoms upon elimination of annatto-containing products; symptoms returned after these products were added back into her diet.

  1. Zegarra, L., Vaisberg, A., Loza, C., Aguirre, R. L., Campos, M., Fernandez, I., Talla, O., and Villegas, L. Double-blind randomized placebo-controlled study of Bixa orellana in patients with lower urinary tract symptoms associated to benign prostatic hyp
  2. Stein HL. Annatto and IBS. J Clin Gastroenterol 2009;43(10):1014-5.
Hypotension Immunologic

When used as a food coloring, annatto causes rare cases of allergic reactions in children and adults. Reactions have occurred after consumption of cereal, cheese, ice cream, and other foods containing annatto food coloring, and use of cosmetics containing annatto. Symptoms include urticaria, angioedema, severe hypotension, and anaphylaxis (31619,31621,95157.109549). One patient with a history of urticaria after using cosmetics, or ingesting food containing annatto, was given oral doses of annatto gradually increasing from 1 mg to 100 mg at hourly intervals. Severe urticaria requiring treatment with antihistamines and corticosteroids occurred with doses of 50-100 mg, while milder reactions started at around 20 mg. Reactions to annatto food coloring are possibly due to traces of seed protein.

  1. Sadowska B, Sztormowska M, Chelminska M. Annatto hypersensitivity after oral ingestion confirmed by placebo-controlled oral challenge. Ann Allergy Asthma Immunol. 2021 Oct;127(4):510-511.
  2. Raddatz-Mota D, Pérez-Flores LJ, Carrari F, et al. Achiote (Bixa orellana L.): a natural source of pigment and vitamin E. J Food Sci Technol 2017;54(6):1729-1741.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no established standard dose for annatto as a supplement. The amounts used to color foods are very small, and research has not defined a safe or effective dose for health purposes.

If you use an annatto supplement, follow the directions on the product label and do not exceed the recommended amount. Because supplement quality and strength can vary widely, it is a good idea to choose products from reputable brands and to check with your pharmacist or doctor before starting.

Pregnancy & Breastfeeding

Annatto & Pregnancy

Insufficient reliable information

There is insufficient reliable information available about the safety of annatto during pregnancy and breast-feeding.

Annatto & Breastfeeding

Insufficient reliable information

There is insufficient reliable information available about the safety of annatto during pregnancy and breast-feeding.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 15 references that drive our Annatto monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Fernandes, A. C., Almeida, C. A., Albano, F., Laranja, G. A., Felzenszwalb, I., Lage, C. L., de Sa, C. C., Moura, A. S., and Kovary, K. Norbixin ingestion did not induce any detectable DNA breakage in liver and kidney but caused a considerable impairment
  3. Russell, K. R., Morrison, E. Y., and Ragoobirsingh, D. The effect of annatto on insulin binding properties in the dog. Phytother Res 2005;19(5):433-436. PubMed
  4. Morrison, E. Y., Thompson, H., Pascoe, K., West, M., and Fletcher, C. Extraction of an hyperglycaemic principle from the annatto (Bixa orellana), a medicinal plant in the West Indies. Trop.Geogr.Med 1991;43(1-2):184-188.
  5. Zegarra, L., Vaisberg, A., Loza, C., Aguirre, R. L., Campos, M., Fernandez, I., Talla, O., and Villegas, L. Double-blind randomized placebo-controlled study of Bixa orellana in patients with lower urinary tract symptoms associated to benign prostatic hyp
  6. Russell, K. R., Omoruyi, F. O., Pascoe, K. O., and Morrison, E. Y. Hypoglycaemic activity of Bixa orellana extract in the dog. Methods Find.Exp.Clin.Pharmacol. 2008;30(4):301-305.
  7. Ebo, D. G., Ingelbrecht, S., Bridts, C. H., and Stevens, W. J. Allergy for cheese: evidence for an IgE-mediated reaction from the natural dye annatto. Allergy 2009;64(10):1558-1560. PubMed
  8. Nish, W. A., Whisman, B. A., Goetz, D. W., and Ramirez, D. A. Anaphylaxis to annatto dye: a case report. Ann.Allergy 1991;66(2):129-131.
  9. Stein HL. Annatto and IBS. J Clin Gastroenterol 2009;43(10):1014-5.
  10. Raddatz-Mota D, Pérez-Flores LJ, Carrari F, et al. Achiote (Bixa orellana L.): a natural source of pigment and vitamin E. J Food Sci Technol 2017;54(6):1729-1741. PubMed
  11. Koc E, Arca E, Surucu B, Kurumlu Z. An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic s
  12. Gonçalves MLL, da Mota ACC, Deana AM, et al. Antimicrobial photodynamic therapy with Bixa orellana extract and blue LED in the reduction of halitosis-A randomized, controlled clinical trial. Photodiagnosis Photodyn Ther. 2020 Jun;30:101751. PubMed
  13. Dominguez-Balmaseda D, Diez-Vega I, Larrosa M, et al. Effect of a blend of Zingiber officinale Roscoe and Bixa orellana L. herbal supplement on the recovery of delayed-onset muscle soreness induced by unaccustomed eccentric resistance training: A randomiz
  14. González-Gross M, Quesada-González C, Rueda J, et al. Analysis of effectiveness of a supplement combining Harpagophytum procumbens, Zingiber officinale and Bixa orellana in healthy recreational runners with self-reported knee pain: a pilot, randomized, tr
  15. Sadowska B, Sztormowska M, Chelminska M. Annatto hypersensitivity after oral ingestion confirmed by placebo-controlled oral challenge. Ann Allergy Asthma Immunol. 2021 Oct;127(4):510-511. PubMed
Keep reading

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.

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

Brand directory

Brands that make products with Annatto

380 brands in our database make a supplement containing Annatto.

Product directory

Supplement products with Annatto

1,881 products in our database contain Annatto. Open any to see its full ingredient list and every drug interaction we check.

Women Over 50 by Nature's Code Unknown Off market View ingredients & interactions Women's 40+ Multi Gold by NutriGold Capsule 90 Vegan Capsule(s) Off market View ingredients & interactions Women's 40+ Multi Gold by NutriGold Capsule 90 Organic Capsule(s) Off market View ingredients & interactions Women's 40+ Multi Gold by NutriGold Capsule 90 Capsule(s) Off market View ingredients & interactions Women's 40+ Multi Gold by NutriGold Capsule 90 Vegan Capsule(s) Off market View ingredients & interactions Women's 55+ Multi Gold by NutriGold Capsule 90 Capsule(s) Off market View ingredients & interactions Women's 55+ Multi Gold by NutriGold Capsule 90 Vegan Capsule(s) Off market View ingredients & interactions Women's 55+ Multi Gold by NutriGold Capsule 90 Vegan Capsule(s) Off market View ingredients & interactions Women's 55+ Multi Gold by NutriGold Capsule 90 Organic Capsule(s) Off market View ingredients & interactions Women's Daily Nutrition by Country Life Realfood Organics Tablet Or Pill 60 Easy to Swallow Tablet(s) Off market View ingredients & interactions Women's Daily Nutrition by Country Life Realfood Organics Tablet Or Pill 120 Easy to Swallow Tablet(s) Off market View ingredients & interactions Women's Daily Nutrition by Country Life Realfood Organics Tablet Or Pill 60 Easy to Swallow Tablet(s) Off market View ingredients & interactions Women's Daily Nutrition by Country Life Realfood Organics Tablet Or Pill 120 Easy to Swallow Tablet(s) Off market View ingredients & interactions Women's Multi by Natures Plus AgeLoss Tablet Or Pill 90 Tablet(s) Off market View ingredients & interactions Women's Multi by Nature's Plus AgeLoss Tablet Or Pill 90 Tablet(s) Off market View ingredients & interactions Women's Multi by Garden Of Life MyKind Organics Tablet Or Pill 60 Vegan Tablet(s) Off market View ingredients & interactions Women's Multi by Garden of Life MyKind Organics Tablet Or Pill 72 Vegan Tablet(s) Off market View ingredients & interactions Women's Multi by Natures Plus Source of Life Garden Tablet Or Pill 90 Vegan Tablet(s) Off market View ingredients & interactions Women's Multi by Natures Plus Source of Life Garden Tablet Or Pill 90 Vegan Tablet(s) Off market View ingredients & interactions Women's Multi by Nature's Plus Source of Life Garden Tablet Or Pill 90 Vegan Tablet(s) Off market View ingredients & interactions Women's Multi 40+ by Garden of Life MyKind Organics Tablet Or Pill 60 Vegan Tablet(s) Off market View ingredients & interactions Women's Multi Gold by NutriGold Capsule 90 Vegan Capsule(s) Off market View ingredients & interactions Women's Multi Gold by NutriGold Capsule 90 Capsule(s) Off market View ingredients & interactions Women's Multi Gold by NutriGold Capsule 90 Vegan Capsule(s) Off market View ingredients & interactions
Pharmacist Counseling Corner

Annatto: Common Questions

What is Annatto used for, and does it work?
People use Annatto for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Annatto interact with prescription medications?
Yes. We list 86 medications with a known interaction with Annatto. Use the checker above to see how Annatto interacts with a specific drug.
How are Annatto interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Annatto with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Annatto interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Annatto used for?
Annatto is mainly used as a natural orange-yellow coloring for foods, cosmetics, and fabrics. In traditional medicine it has been used as a source of antioxidants and as a folk remedy, but there is little solid human evidence for these health uses.
Is Annatto safe to eat?
For most people, Annatto used as a food coloring is considered safe. The main concern is that some people can have allergic reactions to it.
Can Annatto cause an allergic reaction?
Yes. Some people report allergic reactions to Annatto, which can include hives, itching, swelling, or stomach upset. Rarely, reactions can be more serious, so seek care right away if you have trouble breathing or swelling of the face or throat.
Is Annatto safe during pregnancy or breastfeeding?
Annatto in the small amounts used to color food is likely fine, but concentrated supplements have not been well studied. To be safe, avoid Annatto supplements during pregnancy and breastfeeding unless your doctor says otherwise.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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