Interactions on record — worth a quick check against your medications. Based on 7 of 8 ingredients. Check your meds →
Dietary supplement

Blood Sugar Health Ingredients & Drug Interactions

by Sanutra Wellness

Blood Sugar Health label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Blood Sugar Health against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Blood Sugar Health is a dietary supplement by Sanutra Wellness with 8 active ingredients. Its ingredients are commonly taken for flavoring and culinary use, digestive complaints like bloating and indigestion, boosting absorption of other supplements.Based on those ingredients, 1,282 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Black Pepper fruit extract, Gymnema sylvestre leaf extract, Cinnamon bark extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Blood Sugar Health by Sanutra Wellness

Ask about any prescription or over-the-counter medication and we check it for interactions with Blood Sugar Health by Sanutra Wellness — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Blood Sugar Health by Sanutra Wellness

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 12, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 8 of its 8 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Blood Sugar Health contains eight active ingredients, each traditionally used for blood sugar management. Black Pepper fruit extract supplies piperine, which aids nutrient absorption.

Fenugreek seed fiber, Cinnamon bark extract, Phaseolus vulgaris seed extract (from kidney beans), Salacia reticulata bark extract, Momordica charantia fruit extract (bitter melon), and Gymnema sylvestre leaf extract are all botanical concentrates studied for their effects on glucose metabolism. Pterocarpus marsupium wood extract is also included.

The capsule contains one inactive ingredient: Magnesium Stearate, a common binding agent.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: maintain blood sugar level within normal range.
  • We looked for evidence on: Diabetes, Impaired glucose tolerance (prediabetes), Metabolic syndrome, Blood glucose control, Hyperglycemia.
  • The strongest evidence on file: Fenugreek is rated "Possibly Effective" for Diabetes (Natural Medicines).
  • Also on file: Phaseolus Vulgaris is rated "Insufficient Reliable Evidence To Rate" for Diabetes.
  • Also on file: Fenugreek is rated "Insufficient Reliable Evidence To Rate" for Impaired glucose tolerance (prediabetes), Metabolic syndrome.

The evidence for these ingredients in managing blood sugar is limited. Fenugreek seed is rated Possibly Effective for diabetes, and Phaseolus vulgaris is rated Possibly Effective for obesity.

For the rest—Black Pepper, Cinnamon bark, Salacia, Momordica charantia (bitter melon), and Gymnema—the data in our files shows Insufficient Reliable Evidence to rate their effectiveness for diabetes or related conditions. This doesn't mean they don't work; it means the studies we hold don't yet establish it clearly enough to make a confident claim.

The evidence, ingredient by ingredient Black Pepper Fenugreek Cassia Cinnamon Phaseolus Vulgaris Salacia Bitter Melon Gymnema

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Black Pepper is generally well tolerated at food levels, though concentrated supplements warrant caution. Most common side effects are burning aftertaste, indigestion, and altered taste.

Fenugreek is generally well tolerated as food but may cause abdominal pain, bloating, diarrhea, indigestion, gas, low blood sugar (hypoglycemia), and nausea at supplement doses. Cinnamon is generally safe in food amounts; at high supplement doses there is concern about liver damage from its coumarin content.

Phaseolus vulgaris extract is well tolerated orally, with occasional digestive upset (constipation, diarrhea, gas, nausea, stomach pain). Salacia is generally well tolerated short-term but may cause gas, bloating, burping, stomach pain, nausea, and diarrhea—effects that appear dose-related.

Momordica charantia (bitter melon) causes gastrointestinal upset in about 3 to 16% of patients (heartburn, nausea, vomiting, diarrhea, constipation, gas, stomach discomfort). Gymnema is generally well tolerated short-term; one rare case of drug-induced hepatitis (liver inflammation) was reported after heavy tea use.

All ingredients carry rare risks of allergic reaction in sensitive individuals.

Side effects, ingredient by ingredient Black Pepper Fenugreek Cassia Cinnamon Phaseolus Vulgaris Salacia Bitter Melon Gymnema

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 7 of the 7 matched ingredients can interact with medications — Phaseolus Vulgaris, Fenugreek, Bitter Melon, Black Pepper, Gymnema, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,283 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Blood Sugar Health, double-check these medication types with your pharmacist or doctor: antidiabetes drugs (moderate risk of low blood sugar), blood thinners and antiplatelet drugs like warfarin and clopidogrel (moderate risk of increased bleeding), seizure medications like phenytoin (moderate risk of drug buildup), HIV medications like nevirapine (moderate risk of drug buildup), heart and blood pressure drugs like propranolol and metoprolol (moderate risk of drug buildup), theophylline for breathing (moderate risk of drug buildup), drugs metabolized by the liver enzyme CYP1A2 or CYP2C9, and cancer medications like pazopanib (moderate risk). No interactions are documented for Pterocarpus marsupium wood extract, as we hold no data for it.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product is designed for people interested in botanical support for blood sugar, but it carries serious interactions with diabetes drugs, blood thinners, heart and seizure medications, and several others. If you take any prescription medications—especially for diabetes, heart conditions, seizures, blood clotting, or HIV—do not start this product without checking your exact drugs first using the search tool on this page.

Talk to your pharmacist or doctor before use.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 7 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2015.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Blood Sugar Health, straight from the product label.

Brand Sanutra Wellness
Barcode (UPC) 767382033612
Net contents 180 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Jan 23, 2015
DSLD ID 41441
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Blood Sugar Health by Sanutra Wellness, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
90
UPC/BARCODE
767382033612
IngredientAmount% DV
Black Pepper fruit extract5 mg--
Fenugreek seed fiber400 mg--
Cinnamon bark extract200 mg--
Phaseolus vulgaris seed extract100 mg--
Pterocarpus marsupium wood extract WS50 mg--
Salacia reticulata bark extract50 mg--
Momordica charantia fruit extract25 mg--
Gymnema sylvestre leaf extract25 mg--

Other ingredients: Magnesium Stearate

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)

Fenumannans(R), Cinnamon Bark Extract, Fabenol(R) Max, Pterocarpus Wood Extract WS, Salaretin(R), Momordicin(R) and GS4 Plus(R) help to maintain blood sugar level already within the normal range. BioPerine(R) improves absorption of the nutrient.

Patent Numbers: BioPerine(R) US 5,536,506, US 5,744,151, US 5,972,382, US 6,054,585, EP0810868, JP3963513, CA2247467

Fenumannans(R), Fabenol(R), Salaretin(R), Momordicin(R), GS4 Plus(R) and BioPerine(R) are registered trademarks of Sabinsa Corporation.

Suggested/Recommended/Usage/Directions

Suggested Use: Take two capsules three times a day.

Precautions

Precautions/Warnings: Do not use if bottle seal is missing, torn or damaged.

If you are pregnant, nursing, taking any medication or have a medical condition, consult your healthcare practitioner before taking any dietary supplement.

Keep out of reach of children.

Storage

Store in a cool place.

FDA Disclaimer Statement

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

General Statements

SUPPORT FORMULA

Seals/Symbols

Fabenol(R)

BioPerine(R)

FDA Statement of Identity

Herbal Dietary Supplement

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Blood Sugar Health by Sanutra Wellness label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Blood Sugar Health label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Blood Sugar Health by Sanutra Wellness

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container90 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Black Pepper fruit extract

Interacts with
1,019 drugs
5 mg per serving

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to he...

Black Pepper fruit extract monograph & interactions

Fenugreek seed fiber

Interacts with
389 drugs
400 mg per serving Form: Galactomannan

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. So...

Fenugreek seed fiber monograph & interactions

Cinnamon bark extract

Interacts with
442 drugs
200 mg per serving Form: Polyphenols

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evi...

Cinnamon bark extract monograph & interactions

Phaseolus vulgaris seed extract

Interacts with
86 drugs
100 mg per serving

Phaseolus vulgaris, the common bean, is widely eaten as food, and a concentrated white bean extract is marketed as a 'carb blocker' for weight loss. S...

Phaseolus vulgaris seed extract monograph & interactions

Pterocarpus marsupium wood extract WS

50 mg per serving Form: Pterocarposide

Salacia reticulata bark extract

Interacts with
86 drugs
50 mg per serving Form: Mangiferin

Salacia is a plant used in Ayurvedic medicine, mostly studied for lowering blood sugar after meals. Some small human studies suggest it may modestly b...

Salacia reticulata bark extract monograph & interactions

Momordica charantia fruit extract

Interacts with
282 drugs
25 mg per serving Form: Charantin

Bitter melon is a tropical fruit eaten as food and used in traditional medicine, most often for blood sugar control. While some small studies hint it...

Momordica charantia fruit extract monograph & interactions

Gymnema sylvestre leaf extract

Interacts with
851 drugs
25 mg per serving Form: Gymnemic Acid

Gymnema is an Ayurvedic herb best known for possibly helping lower blood sugar and reducing the taste of sweetness on the tongue. Some early human stu...

Gymnema sylvestre leaf extract monograph & interactions

Other (inactive) ingredients: Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Blood Sugar Health by Sanutra Wellness Drug Interactions

Want to check YOUR meds against Blood Sugar Health?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,282Drugs
1,176 Moderate 106 Minor

Ingredients driving the most interactions

Black Pepper fruit extract 1,019
Gymnema sylvestre leaf extract 851
Cinnamon bark extract 442
Fenugreek seed fiber 389
Momordica charantia fruit extract 282

Individual Drug Interactions

The ingredients in Blood Sugar Health interact with 1,282 drugs. Click any drug to see the details.

7 of the 8 ingredients in Blood Sugar Health interact with drugs. Each result below shows which ingredient is responsible. Black Pepper fruit extract Gymnema sylvestre leaf extract Cinnamon bark extract Fenugreek seed fiber Momordica charantia fruit extract Phaseolus vulgaris seed extract Salacia reticulata bark extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Blood Sugar Health with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Black Pepper fruit extract17 drug types · 1,019 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Atorvastatin (Lipitor)

Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.

Likelihood Probable Evidence D
Nevirapine (Viramune)

Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.

Likelihood Probable Evidence D
P-Glycoprotein Substrates

Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.

Likelihood Possible Evidence B
Propranolol (Inderal)

Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.

Likelihood Possible Evidence B
Rifampin (Rifadin)

Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.

Likelihood Possible Evidence B
Theophylline

Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.

Likelihood Possible Evidence D
Amoxicillin (Amoxil, Trimox)

Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.

Likelihood Possible Evidence D
Black Pepper fruit extract full monograph & interactions

Gymnema sylvestre leaf extract6 drug types · 851 drugs

Antidiabetes Drugs

Theoretically, taking gymnema with antidiabetes drugs might increase the risk of hypoglycemia.
Gymnema reduces blood glucose levels in some human and animal research. In human studies, it has been shown to enhance the blood glucose lowering effects of hypoglycemic drugs. However, other research in adults with prediabetes or metabolic syndrome suggests that gymnema does not reduce fasting levels of blood glucose. Until more is known, monitor blood glucose levels closely.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, gymnema might increase levels of drugs metabolized by CYP1A2.
Animal and in vitro research shows that gymnema can inhibit the CYP1A2 enzyme. In one animal study, oral administration of gymnema for 7 days increased the plasma concentrations of phenacetin, a CYP1A2 substrate, by about 1.4-fold and reduced the clearance of phenacetin by about 29%.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, gymnema might increase or decrease levels of drugs metabolized by CYP2C9.
Animal research shows that gymnema can induce the CYP2C9 enzyme. In one animal study, gymnema caused a 2.4-fold increase in the clearance of tolbutamide, a CYP2C9 substrate, in rats. In vitro research also shows that gymnema can inhibit CYP2C9.

Likelihood Possible Evidence D
Phenacetin

Theoretically, taking gymnema with phenacetin might increase the levels of phenacetin.
Animal research shows that gymnema, administered orally for 7 days, decreases the clearance of phenacetin in a dose-dependent manner by about 21% to 29% and increases plasma levels about 1.3- to 1.4-fold when compared to control.

Likelihood Possible Evidence D
Tolbutamide (Orinase)

Theoretically, taking gymnema with tolbutamide might the decrease levels of tolbutamide.
Animal research shows that gymnema, administered orally for 7 days, increases the clearance of tolbutamide by 2.4-fold when compared to control.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, gymnema might increase levels of drugs metabolized by CYP3A4.
One in vitro study using rat liver microsomes shows that gymnema can modestly inhibit the CYP3A4 enzyme. However, other in vitro research using human liver microsomes shows that gymnema does not affect CYP3A4 activity. Animal research also shows that gymnema does not alter the function of CYP3A4. In one study in rats, oral administration of gymnema for 7 days did not alter the clearance of amlodipine, a CYP3A4 substrate.

Likelihood Unlikely Evidence D
Gymnema sylvestre leaf extract full monograph & interactions

Cinnamon bark extract2 drug types · 442 drugs

Antidiabetes Drugs

Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Cassia cinnamon may lower blood glucose levels, and have additive effects in patients treated with antidiabetic agents. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Hepatotoxic Drugs

Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.

Likelihood Possible Evidence D
Cinnamon bark extract full monograph & interactions

Fenugreek seed fiber9 drug types · 389 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .

Likelihood Unlikely Evidence B
Antidiabetes Drugs

Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.

Likelihood Probable Evidence B
Clopidogrel (Plavix)

Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.

Likelihood Possible Evidence D
Metoprolol (Toprol)

Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.

Likelihood Probable Evidence B
Phenytoin (Dilantin)

Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Theophylline

Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.

Likelihood Possible Evidence D
Antihypertensive Drugs

Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.

Likelihood Possible Evidence C
Fenugreek seed fiber full monograph & interactions

Momordica charantia fruit extract3 drug types · 282 drugs

Antidiabetes Drugs

Taking bitter melon with antidiabetes drugs might increase the risk of hypoglycemia.
Bitter melon can lower blood glucose levels and might have additive effects when used with antidiabetes drugs. This might increase the risk of hypoglycemia in some patients. Monitor blood glucose levels closely.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

Theoretically, bitter melon might increase levels of P-glycoprotein substrates.
Bitter melon might inhibit the p-glycoprotein (P-gp) intestinal pump and increase intracellular levels of P-gp substrates. In vitro research in intestinal cells shows that 1-monopalmitin, a constituent of bitter melon, increases levels of daunomycin, a P-gp substrate. Additionally, drinking bitter melon juice has been associated with a case of acute pancreatitis in a patient who had been taking pazopanib, a P-gp substrate, for 8 years. Researchers theorize that inhibition of P-gp led to increased levels of pazopanib, resulting in pazopanib-induced pancreatitis.

Likelihood Possible Evidence D
Pazopanib (Votrient)

Theoretically, bitter melon might increase levels of pazopanib, potentially increasing the risk of adverse effects.
In one case, a 65-year-old patient taking pazopanib for 8 years for renal cell carcinoma experienced signs and symptoms consistent with acute pancreatitis 4 days after drinking bitter melon juice at a dose of 100-150 mL daily. The patient's symptoms, amylase levels, and lipase levels improved upon discontinuation of bitter melon and pazopanib. Pazopanib treatment was re-initiated with no further evidence of pancreatitis. Researchers theorize that inhibition of P-glycoprotein by bitter melon led to increased levels of pazopanib, a P-glycoprotein substrate, resulting in pazopanib-induced pancreatitis.

Likelihood Possible Evidence D
Momordica charantia fruit extract full monograph & interactions

Phaseolus vulgaris seed extract1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, Phaseolus vulgaris might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Small clinical studies suggest that Phaseolus vulgaris beans or bean pods, ingested alone or along with white mulberry leaf and bilberry, reduce blood glucose levels in some patients with diabetes.

Likelihood Possible Evidence D
Phaseolus vulgaris seed extract full monograph & interactions

Salacia reticulata bark extract1 drug type · 86 drugs

Antidiabetes Drugs

Salacia might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Clinical research suggests that salacia might lower blood glucose levels.

Likelihood Probable Evidence D
Salacia reticulata bark extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Blood Sugar Health, from the product label.

Sanutra Wellness

See all Sanutra Wellness products
Name
America's Finest, Inc. (AFI)
City
East Windsor
State
NJ
ZipCode
08520
Phone Number
800-350-3305
Web Address
www.afisupplements.com
Pharmacist Counseling Corner

Blood Sugar Health by Sanutra Wellness: Common Questions

Does Blood Sugar Health by Sanutra Wellness interact with any medications?
Yes. Based on its ingredients, Blood Sugar Health has a known interaction with 1,282 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Blood Sugar Health contains 8 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on diabetes medication?
Not without checking with your pharmacist first. Five of the seven checked ingredients—Fenugreek, Cinnamon, Phaseolus vulgaris, Salacia, Momordica charantia, and Gymnema—interact with diabetes drugs and may increase your risk of low blood sugar (hypoglycemia). Your dose may need adjusting, or you may need to skip this product altogether.
What are the most common side effects?
Digestive upset is most common: gas, bloating, diarrhea, nausea, abdominal pain, and indigestion. Black Pepper may cause burning aftertaste and altered taste. Most people tolerate these ingredients well in the short term, but they can trouble your stomach.
Is it safe to take during pregnancy?
No. Black Pepper is rated Likely Safe in pregnancy, but Fenugreek is rated Likely Unsafe—it may affect the uterus. Cinnamon, Phaseolus vulgaris, Salacia, Momordica charantia, and Gymnema all lack enough safety data in pregnancy, so they should be avoided. Talk to your doctor or pharmacist before use if you are pregnant or planning pregnancy.
Is it safe while breastfeeding?
The safety data is limited. Black Pepper is rated Likely Safe while breastfeeding, and Fenugreek is rated Possibly Safe (and is often used to boost milk supply, though the evidence is mixed). The other ingredients lack reliable safety information for breastfeeding, so discuss this product with your provider first.
Does it actually help with blood sugar?
The evidence is mixed. Fenugreek is rated Possibly Effective for diabetes based on clinical research showing it can lower fasting blood glucose. Phaseolus vulgaris is rated Possibly Effective for obesity. For the others—Black Pepper, Cinnamon, Salacia, Momordica charantia, and Gymnema—we don't have enough reliable evidence in our data to say whether they work for blood sugar or diabetes.
What is Gymnema and what does it do?
Gymnema sylvestre is a plant leaf extract traditionally used to support blood sugar control. It may lower blood glucose levels and can interact with liver enzymes that clear certain medications, potentially raising their blood levels. It is generally well tolerated short-term, though long-term safety isn't well studied.

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

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Blood Sugar Health label
Go deeper

The Full Monographs Behind Blood Sugar Health’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Black Pepper

Interacts with 1,019 drugs

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...

Read the full Black Pepper monograph → Herb & supplement monograph

Fenugreek

Interacts with 389 drugs

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...

Read the full Fenugreek monograph → Herb & supplement monograph

Cassia Cinnamon

Interacts with 442 drugs

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed a...

Read the full Cassia Cinnamon monograph → Herb & supplement monograph

Phaseolus Vulgaris

Interacts with 86 drugs

Phaseolus vulgaris, the common bean, is widely eaten as food, and a concentrated white bean extract is marketed as a 'carb blocker' for weight loss. Some small studies suggest it may modestl...

Read the full Phaseolus Vulgaris monograph → Herb & supplement monograph

Salacia

Interacts with 86 drugs

Salacia is a plant used in Ayurvedic medicine, mostly studied for lowering blood sugar after meals. Some small human studies suggest it may modestly blunt blood sugar spikes, but the evidenc...

Read the full Salacia monograph → Herb & supplement monograph

Bitter Melon

Interacts with 282 drugs

Bitter melon is a tropical fruit eaten as food and used in traditional medicine, most often for blood sugar control. While some small studies hint it may modestly lower blood sugar, the evid...

Read the full Bitter Melon monograph → Herb & supplement monograph

Gymnema

Interacts with 851 drugs

Gymnema is an Ayurvedic herb best known for possibly helping lower blood sugar and reducing the taste of sweetness on the tongue. Some early human studies are encouraging for blood sugar sup...

Read the full Gymnema monograph →
Sources

Sources & How We Checked

Blood Sugar Health's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 125 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Black Pepper 29 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
  4. Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
  5. Cohle SD, Trestrail JD III, Graham MA, et al. Fatal pepper aspiration. Am J Dis Child 1988;142:633-6. PubMed
  6. Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
  7. Velpandian T, Jasuja R, Bhardwaj RK, et al. Piperine in food: interference in the pharmacokinetics of phenytoin. Eur J Drug Metab Pharmacokinet 2001;26:241-7. PubMed
  8. Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
  9. Munakata, M., Kobayashi, K., Niisato-Nezu, J., Tanaka, S., Kakisaka, Y., Ebihara, T., Ebihara, S., Haginoya, K., Tsuchiya, S., and Onuma, A. Olfactory stimulation using black pepper oil facilitates oral feeding in pediatric patients receiving long-term en
  10. Myers, B. M., Smith, J. L., and Graham, D. Y. Effect of red pepper and black pepper on the stomach. Am J Gastroenterol 1987;82(3):211-214.
  11. Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78. PubMed
  12. Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.
  13. Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
  14. Usia, T., Iwata, H., Hiratsuka, A., Watabe, T., Kadota, S., and Tezuka, Y. CYP3A4 and CYP2D6 inhibitory activities of Indonesian medicinal plants. Phytomedicine. 2006;13(1-2):67-73. PubMed
  15. Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
  16. Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
  17. Lawless, H. and Stevens, D. A. Effects of oral chemical irritation on taste. Physiol Behav. 1984;32(6):995-998. PubMed
  18. Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
  19. Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
  20. Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
  21. Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186. PubMed
  22. Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
  23. Marotta, R. B. and Floch, M. H. Diet and nutrition in ulcer disease. Med Clin North Am 1991;75(4):967-979. PubMed
  24. Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
  25. Gimenez L, Zacharisen M. Severe pepper allergy in a young child. WMJ. 2011 Jun;110(3):138-9.
  26. Ren T, Yang M, Xiao M, Zhu J, Xie W, Zuo Z. Time-dependent inhibition of carbamazepine metabolism by piperine in anti-epileptic treatment. Life Sci. 2019;218:314-323. PubMed
  27. Thomas AB, Choudhary DC, Raje A, Nagrik SS. Pharmacokinetics and pharmacodynamic herb-drug interaction of piperine with atorvastatin in rats. J Chromatogr Sci 2021;59(4):371-80. PubMed
  28. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  29. Lin F, Hu Y, Zhang Y, Zhao L, Zhong D, Liu J. Predicting Food-Drug Interactions between Piperine and CYP3A4 Substrate Drugs Using PBPK Modeling. Int J Mol Sci 2024;25(20):10955. PubMed

See these in context on the Black Pepper monograph →

Fenugreek 30 references
  1. Madar Z, Thorne R. Dietary fiber. Prog Food Nutr Sci 1987;11:153-74.
  2. Sharma RD, Raghuram TC, Rao NS. Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr 1990;44:301-6.
  3. Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (Trigonella foenum graecum). Ann Allergy Asthma Immunol 1997;78:297-300. PubMed
  4. Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. PubMed
  5. Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty PubMed
  6. Yalcin SS, Tekinalp G, Ozalp I. Peculiar odor of traditional food and maple syrup urine disease. Pediatr Int 1999;41:108-9. PubMed
  7. Sewell AC, Mosandl A, Bohles H. False diagnosis of maple syrup urine disease owing to ingestion of herbal tea. N Engl J Med 1999;341:769.. PubMed
  8. Abdo MS, al-Kafawi AA. Experimental studies on the effect of Trigonella foenum-graecum (abstract). Planta Med 1969;17:14-8.
  9. Gupta A, Gupta R, Lal B. Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study. J Assoc Physicians India 2001;49:1057-61.
  10. Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact 2002;18:274-9. PubMed
  11. Chevassus H, Gaillard JB, Farret A, et al. A fenugreek seed extract selectively reduces spontaneous fat intake in overweight subjects. Eur J Clin Pharmacol 2010;66(5):449-55. PubMed
  12. Turkyilmaz C, Onal E, Hirfanoglu IM, et al. The effect of galactagogue herbal tea on breast milk production and short-term catch-up of birth weight in the first week of life. J Altern Complement Med 2011;17(2):139-42. PubMed
  13. Swafford S, Berens P. Effect of fenugreek on breast milk volume. Abstract presented at: 5th International Meeting of the Academy of Breastfeeding Medicine; September 11-13,2000, Tucson, Arizona.
  14. Abdel-Barry, J. A., Abdel-Hassan, I. A., Jawad, A. M., and al Hakiem, M. H. Hypoglycaemic effect of aqueous extract of the leaves of Trigonella foenum-graecum in healthy volunteers. East Mediterr.Health J 2000;6(1):83-88. DOI
  15. Parvizpur, A., Ahmadiani, A., and Kamalinejad, M. Probable role of spinal purinoceptors in the analgesic effect of Trigonella foenum (TFG) leaves extract. J Ethnopharmacol 3-8-2006;104(1-2):108-112. PubMed
  16. Mora, A., Herrrera, A., Lopez, C., Dahbi, G., Mamani, R., Pita, J. M., Alonso, M. P., Llovo, J., Bernardez, M. I., Blanco, J. E., Blanco, M., and Blanco, J. Characteristics of the Shiga-toxin-producing enteroaggregative Escherichia coli O104:H4 German ou
  17. Blanco, J. [Stx2a-producing enteroaggregative Escherichia coli O104:H4-ST678. Microbiological diagnostic already, for this and other STEC/VTEC serotypes!]. Enferm.Infecc.Microbiol.Clin. 2012;30(2):84-89.
  18. Beutin, L. and Martin, A. Outbreak of Shiga toxin-producing Escherichia coli (STEC) O104:H4 infection in Germany causes a paradigm shift with regard to human pathogenicity of STEC strains. J Food Prot. 2012;75(2):408-418. PubMed
  19. King LA, Nogareda F, Weill FX, Mariani-Kurkdjian P, Loukiadis E, Gault G, Jourdan-DaSilva N, Bingen E, Macé M, Thevenot D, Ong N, Castor C, Noël H, Van Cauteren D, Charron M, Vaillant V, Aldabe B, Goulet V, Delmas G, Couturier E, Le Strat Y, Combe C, Delm
  20. Reeder C, Legrand A, O'Connor-Von SK. The Effect of Fenugreek on Milk Production and Prolactin Levels in Mothers of Preterm Infants. Clinical Lactation 2013;4(4):159-165. DOI
  21. Al-Jenoobi FI, Ahad A, Mahrous GM, Al-Mohizea AM, AlKharfy KM, Al-Suwayeh SA. Effects of fenugreek, garden cress, and black seed on theophylline pharmacokinetics in beagle dogs. Pharm Biol 2015;53(2):296-300. PubMed
  22. Rao A, Steels E, Inder WJ, Abraham S, Vitetta L. Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease, increases testosterone levels and improves sexual function in healthy aging males in a doubl
  23. Steels E, Rao A, Vitetta L. Physiological aspects of male libido enhanced by standardized Trigonella foenum-graecum extract and mineral formulation. Phytother Res. 2011 Sep;25(9):1294-300.
  24. Gong J, Fang K, Dong H, Wang D, Hu M, Lu F. Effect of fenugreek on hyperglycaemia and hyperlipidemia in diabetes and prediabetes: A meta-analysis. J Ethnopharmacol. 2016 Dec 24;194:260-268. PubMed
  25. Ouzir M, El Bairi K, Amzazi S. Toxicological properties of fenugreek (Trigonella foenum graecum). Food Chem Toxicol. 2016 Oct;96:145-54. PubMed
  26. Khodamoradi K, Khosropanah MH, Ayati Z, et al. The Effects of Fenugreek on Cardiometabolic Risk Factors in Adults: A Systematic Review and Meta-analysis. Complement Ther Med. 2020;52:102416. PubMed
  27. Alkharfy K, Jan B, Alotaibi K, et al. Clopidogrel-herb Interactions: A Pharmacokinetic and Pharmacodynamic Assessment in a Rat Model. Curr Drug Metab 2021;22(12):969-977. PubMed
  28. Bin Jardan YA, Ahad A, Raish M, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effects of garden cress, fenugreek and black seed on the pharmacodynamics of metoprolol: an herb-drug interaction study in rats with hypertension. Pharm Biol 2021;59(1):1088-1097. PubMed
  29. Al-Mohizea AM, Ahad A, El-Maghraby GM, et al. Effects of Nigella sativa, Lepidium sativum and Trigonella foenum-graecum on sildenafil disposition in beagle dogs. Eur J Drug Metab Pharmacokinet. 2015;40(2):219-24. PubMed
  30. Alkharfy KM, Al-Jenoobi FI, Al-Mohizea AM, et al. Effects of Lepidium sativum, Nigella sativa and Trigonella foenum-graceum on phenytoin pharmacokinetics in beagle dogs. Phytother Res. 2013;27(12):1800-4.

See these in context on the Fenugreek monograph →

Cassia Cinnamon 20 references
  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215-8. PubMed
  3. De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Dermatitis 1999;40:165. PubMed
  4. Drake TE, Maibach HI. Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste. Arch Dermatol 1976;112:202-3.
  5. Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
  6. Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75. PubMed
  7. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009;22:507-12. PubMed
  8. Akilen, R., Tsiami, A., Devendra, D., and Robinson, N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet.Med. 2010; PubMed
  9. Lu T, Sheng H Wu J Cheng Y Zhu J Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res. 2012;32(6):408-412. PubMed
  10. Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
  11. Altschuler JA, Casella SJ, MacKenzie TA, Curtis KM. The effect of cinnamon on A1C among adolescents with type 1 diabetes. Diabetes Care 2007;30(4):813-6. PubMed
  12. Stoecker BR, Zhan Z, Luo R, et al. Cinnamon extract lowers blood glucose in hyperglycemic subjects. FASEB J. 2010;22:722.1 (Abstract only). DOI
  13. Admani S, Hill H, Jacob SE. Cinnamon Sugar Scrub Dermatitis: "Natural" Is Not Always Best. Pediatr Dermatol. 2017;34(1):e42-e43. PubMed
  14. Isaac-Renton M, Li MK, Parsons LM. Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermatitis. 2015;26(3):116-21. PubMed
  15. Vandersall A, Katta R. Eyelid dermatitis as a manifestation of systemic contact dermatitis to cinnamon. Dermatitis. 2015 Jul-Aug;26(4):189. PubMed
  16. Wickenberg J, Lindstedt S, Nilsson J, Hlebowicz J. Cassia cinnamon does not change the insulin sensitivity or the liver enzymes in subjects with impaired glucose tolerance. Nutr J 2014 Sep 24;13:96. PubMed
  17. Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep 2015;16:250-4. PubMed
  18. Shekarchizadeh-Esfahani P, Heydarpour F, Izadi F, Jalili C. The effect of cinnamon supplementation on liver enzymes in adults: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2021;58:102699. PubMed
  19. Bernaola J, Valverde-Monge M, Otal-Buesa M, Cullen D, Heras-Mendaza F. Cinnamon allergic contact cheilitis. Contact Dermatitis 2023;88(5):418-419. PubMed
  20. Patel K, Howard M, Tate B. Cheilitis caused by allergic contact dermatitis to cinnamon in chai tea: A case report. Contact Dermatitis 2023;88(3):239-240. PubMed

See these in context on the Cassia Cinnamon monograph →

Phaseolus Vulgaris 11 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Birketvedt GS, Travis A, Langbakk B, Florholmen JR. Dietary supplementation with bean extract improves lipid profile in overweight and obese subjects. Nutrition 2002;18:729-33.. PubMed
  3. FDA Center for Food Safety and Nutrition. What are some of the questionable weight loss products? http://www.cfsan.fda.gov/~dms/qa-nut4.html. (Accessed 20 December 2003).
  4. Onakpoya I, Aldaas S, Terry R, Ernst E. The efficacy of Phaseolus vulgaris as a weight-loss supplement: a systematic review and meta-analysis of randomised clinical trials. Br J Nutr 2011;106:196-202.
  5. Rodhouse JC, Haugh CA, Roberts D, Gilbert RJ. Red kidney bean poisoning in the UK: an analysis of 50 suspected incidents between 1976 and 1989. Epidemiol Infect 1990;105(3):485-91. PubMed
  6. Spiewak R, Dutkiewicz J. Occupational contact dermatitis to Phaseolus vulgaris in a farmer - a case report. Ann Agric Environ Med 2000;7(1):55-9.
  7. Tjokroprawiro A, Pikir BS, Budhiarta AA, et al. Metabolic effects of onion and green beans on diabetic patients. Tohoku J Exp Med 1983;141 Suppl:671-6. PubMed
  8. Boivin M, Flourie B, Rizza RA, Go VL, DiMagno EP. Gastrointestinal and metabolic effects of amylase inhibition in diabetics. Gastroenterology. 1988;94(2):387-94. PubMed
  9. Ionescu-Tirgoviste, C., Popa, E., Mirodon, Z., Simionescu, M., and Mincu, I. [The effect of a plant mixture on the metabolic equilibrium in patients with type-2 diabetes mellitus]. Rev.Med Interna Neurol.Psihiatr.Neurochir.Dermatovenerol.Med Interna 1989
  10. He S, Simpson BK, Sun H, et al. Phaseolus vulgaris lectins: a systematic review of characteristics and health implications. Crit Rev Food Sci Nutr 2015 Oct 19:0. PubMed
  11. Jalal SM, Alsultan AA, Alotaibi HH, Mary E, Alabdullatif AAI. Effect of Phaseolus vulgaris on urinary biochemical parameters among patients with kidney stones in Saudi Arabia. Nutrients. 2020 Oct 30;12(11):3346. PubMed

See these in context on the Phaseolus Vulgaris monograph →

Salacia 5 references
  1. Heacock PM, Hertzler SR, Williams JA, Wolf BW. Effects of a medical food containing an herbal alpha-glucosidase inhibitor on postprandial glycemia and insulinemia in healthy adults. J Am Diet Assoc 2005;105:65-71.
  2. Collene AL, Hertzler SR, Williams JA, Wolf BW. Effects of a nutritional supplement containing Salacia oblonga extract and insulinogenic amino acids on postprandial glycemia, insulinemia, and breath hydrogen responses in healthy adults. Nutrition 2005;21:8 PubMed
  3. Jayawardena MH, de Alwis NM, Hettigoda V, Fernando DJ. A double blind randomised placebo controlled cross over study of a herbal preparation containing Salacia reticulata in the treatment of type 2 diabetes. J Ethnopharmacol 2005;97:215-8. PubMed
  4. Williams JA, Choe YS, Noss MJ, et al. Extract of Salacia oblonga lowers acute glycemia in patients with type 2 diabetes. Am J Clin Nutr 2007;86:124-30. PubMed
  5. Kajimoto O, Kawamori S, Shimoda H, et al. Effects of a Diet Containing Salacia reticulata on Mild Type 2 Diabetes in Humans. A Placebo-controlled, Cross-over Trial. Nippon Eiyo Shokuryo Gakkaishi 2000;53(5):199-205. DOI

See these in context on the Salacia monograph →

Bitter Melon 18 references
  1. Leatherdale B, Panesar RK, Singh G, et al. Improvement in glucose tolerance due to Momordica charantia. Br Med J (Clin Res Ed) 1981;282:1823-4.
  2. Welihinda J, et al. Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes. J Ethnopharmacol 1986;17:277-82. PubMed
  3. Srivastava Y, Venkatakrishna-Bhatt H, Verma Y, et al. Antidiabetic and adaptogenic properties of Momordica charantia extract: An experimental and clinical evaluation. Phytother Res 1993;7:285-9.
  4. Baldwa VS, Bhandari CM, Pangaria A, Goyal RK. Clinical trial in patients with diabetes mellitus of an insulin-like compound obtained from plant sources. Ups J Med Sci 1977;82:39-41. PubMed
  5. Aslam M, Stockley IH. Interaction between curry ingredient (karela) and drug (chlorpropamide). Lancet 1979:1:607. PubMed
  6. Ahmad N, Hassan MR, Halder H, Bennoor KS. Effect of Momordica charantia (Karolla) extracts on fasting and postprandial serum glucose levels in NIDDM patients (abstract). Bangladesh Med Res Counc Bull 1999;25:11-3.
  7. Basch E, Gabardi S, Ulbricht C. Bitter melon (Momordica charantia): a review of efficacy and safety. Am J Health Syst Pharm 2003;60:356-9. PubMed
  8. Yin RV, Lee NC, Hirpara H, Phung OJ. T. The effect of bitter melon (Mormordica charantia) in patients with diabetes mellitus: s systematic review and meta-analysis. Nutr Diabetes. 2014;4:e145.
  9. Rahman IU, Khan RU, Rahman KU, Bashir M. Lower hypoglycemic but higher antiatherogenic effects of bitter melon than glibenclamide in type 2 diabetic patients. Nutr J. 2015;14:13. PubMed
  10. Alam MA, Uddin R, Subhan N, Rahman MM, Jain P, Reza HM. Beneficial role of bitter melon supplementation in obesity and related complications in metabolic syndrome. J Lipids. 2015;2015:496169. PubMed
  11. Konishi T, Satsu H, Hatsugai Y, et al. Inhibitory effect of a bitter melon extract on the P-glycoprotein activity in intestinal Caco-2 cells. Br J Pharmacol. 2004;143(3):379-87. PubMed
  12. Peter EL, Kasali FM, Deyno S, et al. Momordica charantia L. lowers elevated glycaemia in type 2 diabetes mellitus patients: Systematic review and meta-analysis. J Ethnopharmacol. 2019;231:311-24. doi: 10.1016/j.jep.2018.10.033. PubMed
  13. Cortez-Navarrete M, Martínez-Abundis E, Pérez-Rubio KG, González-Ortiz M, Méndez-Del Villar M. Momordica charantia administration improves insulin secretion in type 2 diabetes mellitus. J Med Food. 2018;21(7):672-7. doi: 10.108
  14. Kim SK, Jung J, Jung JH, et al. Hypoglycemic efficacy and safety of Momordica charantia (bitter melon) in patients with type 2 diabetes mellitus. Complement Ther Med. 2020 Aug;52:102524. doi: 10.1016/j.ctim.2020.102524. PubMed
  15. Unsal O, Sütcüoglu O, Yazici O. Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: a case of acute pancreatitis. J Oncol Pharm Pract 2022;28(2):486-8.
  16. Bae W, Kim S, Choi J, et al. Acute interstitial nephritis associated with ingesting a Momordica charantia extract: a case report. Medicine (Baltimore) 2021;100(27):e26606. PubMed
  17. Chattopadhyay K, Wang H, Kaur J, et al. Effectiveness and Safety of Ayurvedic Medicines in Type 2 Diabetes Mellitus Management: A Systematic Review and Meta-Analysis. Front Pharmacol. 2022;13:821810. Published 2022 Jun 8. PubMed
  18. Kim B, Lee HS, Kim HJ, et al. Momordica charantia (bitter melon) efficacy and safety on glucose metabolism in Korean prediabetes participants: a 12-week, randomized clinical study. Food Sci Biotechnol 2022;32(5):697-704. PubMed

See these in context on the Bitter Melon monograph →

Gymnema 12 references
  1. Shanmugasundaram ER, Rajeswari G, Baskaran K, et al. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharmacol 1990;30:281-94. PubMed
  2. Baskaran K, Kizar Ahamath B, Radha Shanmugasundaram K, Shanmugasundaram ER. Antidiabetic effect of leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharmacol 1990;30:295-300.
  3. Kamble B, Gupta A, Moothedath I, Khatal L, Janrao S, Jadhav A, et al. Effects of Gymnema sylvestre extract on the pharmacokinetics and pharmacodynamics of glimepiride in streptozotocin induced diabetic rats. Chem Biol Interact. 2016;245:30-8. PubMed
  4. Tiwari P, Mishra BN, Sangwan NS. Phytochemical and pharmacological properties of Gymnema sylvestre: an important medicinal plant. Biomed Res Int. 2014; 2014:830285.
  5. Fabio GD, Romanucci V, De Marco A, Zarrelli A. Triterpenoids from Gymnema sylvestre and their pharmacological activities. Molecules. 2014;19(8):10956-81. PubMed
  6. Shiyovich A, Sztarkier I, Nesher L. Toxic hepatitis induced by Gymnema sylvestre, a natural remedy for type 2 diabetes mellitus. Am J Med Sci. 2010;340(6):514-7. PubMed
  7. Zuniga LY, Gonzalez-Ortiz M, Martinez-Abundis E. Effect of gymnema sylvestre administration on metabolic syndrome, insulin sensitivity, and insulin secretion. J Med Food. 2017 Aug;20(8):750-54.
  8. Rammohan B, Samit K, Chinmoy D, et al. Human cytochrome P450 enzyme modulation by gymnema sylvestre: a predictive safety evaluation by LC-MS/MS. Pharmacogn Mag. 2016 Jul;12(Suppl 4):S389-S394.
  9. Vaghela M, Sahu N, Kharkar P, Pandita N. In vivo pharmacokinetic interaction by ethanolic extract of gymnema sylvestre with CYP2C9 (tolbutamide), CYP3A4 (amlodipine) and CYP1A2 (phenacetin) in rats. Chem Biol Interact. 2017 Dec 25;278:141-151. PubMed
  10. Vaghela M, Iyer K, Pandita N. In vitro inhibitory effect of gymnema sylvestre extracts and total gymnemic acids fraction on select cytochrome P450 activities in rat liver microsomes. Eur J Drug Metab Pharmacokinet. 2017 Oct 10. PubMed
  11. Gaytán Martínez LA, Sánchez-Ruiz LA, Zuñiga LY, González-Ortiz M, Martínez-Abundis E. Effect of Gymnema sylvestre administration on glycemic control, insulin secretion, and insulin sensitivity in patients with impaired glucose tolerance. J Med Food. 2021;
  12. Philips CA, Theruvath AH, Ravindran R. Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use. BMJ Case Rep 2022;15(3):e247867. PubMed

See these in context on the Gymnema monograph →

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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