Herb & supplement monograph

Spinach Drug Interactions, Uses, Effectiveness, Safety & More

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

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

But these pages have grown well beyond that into a full monograph — what Spinach 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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Spinach 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 Spinach drug interaction appears low for most people. None of the listed interactions are rated major, and the concerns fall into just two medication groups, both supported by limited evidence.

Interactions deserving the most attention

The clearest concern is with warfarin. Spinach is rich in vitamin K, which works against this blood thinner, and human research shows that eating spinach every day for a week can require a warfarin dose change, while having it with a single meal did not push clotting tests out of range. People on warfarin should keep their spinach intake steady from day to day rather than avoid it. There is also a theoretical concern with diabetes medications, since a spinach-rich meal may lower blood sugar after eating, which could add to the effect of these drugs.

What the rest of the list means

Although many medications appear on the list, nearly all of them are individual drugs within these two groups. The diabetes concern is largely theoretical, and even the warfarin effect depends on how much spinach is eaten and how regularly, so occasional servings are unlikely to cause meaningful problems for most people.

Check your medications against Spinach

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

Interaction report

Drugs that interact with Spinach

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

2,830 drugs
AcarboseGlucobay, Prandase, Precose
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Acarbose interaction Acarbose drug page: uses, dosage & side effects
AcetohexamideDymelor
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Acetohexamide interaction
AlbiglutideTanzeum
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Albiglutide interaction
AlogliptinNesina
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Alogliptin interaction Alogliptin drug page: uses, dosage & side effects
Alogliptin, MetforminKazano
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Alogliptin, Metformin interaction
Alogliptin, PioglitazoneOseni
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Alogliptin, Pioglitazone interaction
Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interaction
CanagliflozinInvokana
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Canagliflozin interaction Canagliflozin drug page: uses, dosage & side effects
Canagliflozin, MetforminInvokamet
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Canagliflozin, Metformin interaction
Canagliflozin, Metformin HydrochlorideInvokamet XR
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Canagliflozin, Metformin Hydrochloride interaction
ChlorpropamideChlorpropam, Diabinese
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Chlorpropamide interaction
DapagliflozinFarxiga
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Dapagliflozin interaction Dapagliflozin drug page: uses, dosage & side effects
Dapagliflozin Propanediol, MetforminXigduo XR
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Dapagliflozin Propanediol, Metformin interaction
Dapagliflozin Propanediol, Saxagliptin HydrochlorideQtern
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Dapagliflozin Propanediol, Saxagliptin Hydrochloride interaction
Dapagliflozin, Metformin Hydrochloride, Saxagliptin HydrochlorideQternmet XR
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride interaction
Dasiglucagon HydrochlorideZegalogue
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Dasiglucagon Hydrochloride interaction Dasiglucagon Hydrochloride drug page: uses, dosage & side effects
DulaglutideTrulicity
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Dulaglutide interaction Dulaglutide drug page: uses, dosage & side effects
EmpagliflozinJardiance
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Empagliflozin interaction Empagliflozin drug page: uses, dosage & side effects
Empagliflozin, Linagliptin, Metformin HydrochlorideTrijardy XR
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Empagliflozin, Linagliptin, Metformin Hydrochloride interaction
Empagliflozin, MetforminSynjardy
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Empagliflozin, Metformin interaction
Empagliflozin, Metformin HydrochlorideSynjardy XR
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Empagliflozin, Metformin Hydrochloride interaction
ErtugliflozinSteglatro
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Ertugliflozin interaction Ertugliflozin drug page: uses, dosage & side effects
Ertugliflozin, Metformin HydrochlorideSegluromet
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Ertugliflozin, Metformin Hydrochloride interaction
ExenatideBydureon, Byetta
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Exenatide interaction Exenatide drug page: uses, dosage & side effects
Exenatide SyntheticBydureon BCISE
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Exenatide Synthetic interaction Exenatide Synthetic drug page: uses, dosage & side effects
GliclazideDiamicron
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Gliclazide interaction
GlimepirideAmaryl
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Glimepiride interaction Glimepiride drug page: uses, dosage & side effects
GlipizideGlucotrol, Glucotrol XL
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Glipizide interaction Glipizide drug page: uses, dosage & side effects
Glipizide, MetforminMetaglip
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Glipizide, Metformin interaction
GlucagonBaqsimi, Glucagon
Moderate Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects.

Read the full Spinach + Glucagon interaction Glucagon drug page: uses, dosage & side effects
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 Spinach 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 Spinach affects

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

All 2 drug categories Spinach interacts with
Antidiabetes DrugsWarfarin (coumadin)
Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects. Evidence from clinical research suggests that consumption of a spinach-rich meal reduces post-meal blood glucose levels. Theoretically, spinach might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Spinach contains vitamin K, which can interfere with the activity of warfarin.
In human research, although eating spinach with one meal does not result in coagulation test results outside the therapeutic range, daily consumption for one week necessitates dose adjustment of warfarin. Individuals using anticoagulants should consume a consistent daily amount of spinach to maintain the effect of anticoagulant therapy.

Likelihood Possible Evidence D
Monograph

Spinach: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Spinach is a nutrient-dense leafy green that is a healthy part of a balanced diet, providing vitamins, minerals, fiber, and antioxidants. While it is very safe as a food, concentrated supplements and extracts are far less studied, and most specific health claims are not strongly proven. People prone to kidney stones or taking blood thinners should be mindful of its oxalate and vitamin K content.

Scientific name
Spinacia oleracea
Family
Amaranthaceae
Part used
Leaves
Common forms
Fresh or cooked leaves, powders, juice, capsules, and extracts
People commonly use it for
  • General nutrition and antioxidant support
  • Eye health
  • Heart health and blood pressure
  • Athletic performance
  • Constipation and digestive support

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

Safety at a glance
OverallLikely safe

Spinach is safe and nutritious as a food for most people.

PregnancyLikely Safe

When used in amounts commonly found in foods; avoid medicinal amounts.

Read the full pregnancy detail
BreastfeedingLikely Safe

When used in amounts commonly found in foods; avoid medicinal amounts.

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

Spinach (Spinacia oleracea) is a leafy green vegetable that has been eaten for hundreds of years. It is thought to have originated in ancient Persia and is now grown all over the world. It can be eaten raw in salads or cooked in many dishes.

Spinach is best known as a food, but it is also sold as a supplement in the form of powders, juices, capsules, and concentrated extracts. People use it because it is rich in vitamins, minerals, fiber, and plant antioxidants.

How it works

Spinach contains many nutrients that may explain its possible benefits. These include vitamins A, C, K, and folate, plus minerals like iron, magnesium, and potassium. It also provides fiber.

Spinach is rich in antioxidants such as lutein, zeaxanthin, and various plant pigments that may help protect cells from damage. It also contains dietary nitrates, which the body can convert into compounds that relax blood vessels and may affect blood flow.

It is important to know that many of these mechanisms come from laboratory studies, animal research, or studies of overall diet. They do not prove that spinach supplements will produce specific health effects in people.

Effectiveness

Does Spinach work?

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

Evidence overview · 5 uses evaluated
5 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 Spinach, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 5 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Cognitive function
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming spinach is beneficial for cognitive function.

Insufficient Reliable Evidence To Rate Muscle strength
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral spinach is beneficial for muscle strength.

Insufficient Reliable Evidence To Rate Nonalcoholic fatty liver disease (NAFLD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral spinach can reduce the risk of developing NAFLD.

Insufficient Reliable Evidence To Rate Obesity
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming spinach is beneficial for weight loss.

Insufficient Reliable Evidence To Rate Polycystic ovary syndrome (PCOS)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral spinach-derived thylakoids are beneficial for PCOS.

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, spinach is very safe for most people. Concentrated supplements and extracts are less studied, so use them with more caution and follow product labels.

A few groups should be careful:

  • People prone to kidney stones: Spinach is high in oxalates, which can contribute to certain types of kidney stones. If you have a history of stones, talk to your doctor about how much spinach is right for you.
  • People on blood thinners: Spinach is high in vitamin K, which affects blood clotting. Large or sudden changes in spinach intake can be a concern—discuss this with your pharmacist or doctor (specific drug interactions are covered elsewhere).
  • People with thyroid concerns: Spinach contains compounds called goitrogens, which in very large amounts could affect the thyroid, though this is unlikely with normal food amounts.

Pregnancy and breastfeeding: Eating spinach as a normal food is considered safe and even helpful because of its folate content. However, concentrated spinach supplements have not been well studied in pregnancy or breastfeeding, so it is best to stick to food amounts and check with your doctor before using supplements.

Side effects

Spinach is generally well tolerated as a food. Some people may notice gas or bloating from its fiber content, especially when eating large amounts.

Because of its high oxalate content, frequent large servings could increase the risk of kidney stones in people who are prone to them. Rarely, some people may have an allergy to spinach. As with any leafy green, washing it well helps reduce the risk of foodborne illness.

Spinach: Reported Adverse Effects

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

Orally, spinach is well tolerated when consumed as a food.

Serious Adverse Effects (Rare):

Orally: In infants under 4 months of age, methemoglobinemia has been reported.

All routes of administration: Allergies in sensitive individuals.

Reports by condition
Asthma Pulmonary/Respiratory

Lung inflammation associated with allergic alveolitis has been reported after inhalation of spinach powder. The powder has also been reported to induce occupational asthma in a spinach factory worker.

  1. Schreiber, J., Muller, E., Becker, W. M., Zabel, P., Schlaak, M., and Amthor, M. [Spinach powder-induced exogenous allergic alveolitis]. Pneumologie 1998;52(1):61-65.
  2. Schuller, A., Morisset, M., Maadi, F., Kolopp Sarda, M. N., Fremont, S., Parisot, L., Kanny, G., and Moneret-Vautrin, D. A. Occupational asthma due to allergy to spinach powder in a pasta factory. Allergy 2005;60(3):408-409.
Dermatitis Dermatologic

Topically, contact dermatitis has been reported from spinach in a 54-year-old female farmer.

  1. Roller, E., Meller, S., Homey, B., Ruzicka, T., and Neumann, N. J. [Contact dermatitis caused by spinach, hedge mustard and chives]. Hautarzt 2003;54(4):374-375.
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 official standardized dose for spinach. As a food, it can be enjoyed in normal serving sizes as part of a balanced diet.

For supplements such as powders, capsules, or extracts, a proven dose has not been established. If you choose to use a spinach supplement, follow the directions on the product label and talk to a pharmacist or doctor first. More is not always better, especially given spinach's oxalate and vitamin K content.

Pregnancy & Breastfeeding

Spinach & Pregnancy

Likely Safe

When used in amounts commonly found in foods; avoid medicinal amounts.

Spinach & Breastfeeding

Likely Safe

When used in amounts commonly found in foods; avoid medicinal amounts.

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 6 references that drive our Spinach 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. Karlson, B., Leijd, B., and Hellstrom, K. On the influence of vitamin K-rich vegetables and wine on the effectiveness of warfarin treatment. Acta Med Scand. 1986;220(4):347-350. PubMed
  3. Roller, E., Meller, S., Homey, B., Ruzicka, T., and Neumann, N. J. [Contact dermatitis caused by spinach, hedge mustard and chives]. Hautarzt 2003;54(4):374-375.
  4. Schuller, A., Morisset, M., Maadi, F., Kolopp Sarda, M. N., Fremont, S., Parisot, L., Kanny, G., and Moneret-Vautrin, D. A. Occupational asthma due to allergy to spinach powder in a pasta factory. Allergy 2005;60(3):408-409. PubMed
  5. Gustafsson, K., Asp, N. G., Hagander, B., and Nyman, M. Satiety effects of spinach in mixed meals: comparison with other vegetables. Int.J.Food Sci.Nutr. 1995;46(4):327-334. PubMed
  6. Schreiber, J., Muller, E., Becker, W. M., Zabel, P., Schlaak, M., and Amthor, M. [Spinach powder-induced exogenous allergic alveolitis]. Pneumologie 1998;52(1):61-65.
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 Spinach

622 brands in our database make a supplement containing Spinach.

Product directory

Supplement products with Spinach

4,291 products in our database contain Spinach. Open any to see its full ingredient list and every drug interaction we check.

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Pharmacist Counseling Corner

Spinach: Common Questions

What is Spinach used for, and does it work?
People use Spinach 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 Spinach interact with prescription medications?
Yes. We list 88 medications with a known interaction with Spinach. Use the checker above to see how Spinach interacts with a specific drug.
How are Spinach 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 Spinach 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 Spinach 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.
Is Spinach good for you?
Yes. Spinach is a nutrient-rich vegetable that provides vitamins, minerals, fiber, and antioxidants, and it can be a healthy part of a balanced diet.
Is it better to eat Spinach raw or cooked?
Both can be healthy. Cooking can reduce some oxalates and make certain nutrients easier to absorb, while raw Spinach keeps more of some heat-sensitive vitamins. Eating it both ways is a good approach.
Can Spinach cause kidney stones?
Spinach is high in oxalates, which can contribute to certain kidney stones in people who are prone to them. If you have a history of kidney stones, ask your doctor about how much Spinach is right for you.
Are Spinach supplements as good as eating Spinach?
Whole Spinach as a food is well studied and provides a balance of nutrients. Concentrated supplements are far less studied, and their benefits are not well proven, so eating the actual vegetable is usually the better choice.

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

Keep exploring

Products that contain Spinach

A rotating sample of real supplements in our database that list Spinach — open any to see its full ingredients and every drug interaction we check.

See all 4,291 products with Spinach →
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