Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Sugar Balance Ingredients & Drug Interactions

by GSL Technology

Tablet Or Pill Category: Botanical
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Sugar Balance is a dietary supplement by GSL Technology with 4 active ingredients. Its ingredients are commonly taken for stress and energy support, immune support and colds, blood sugar management.Based on those ingredients, 1,007 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Gymnema Sylvestre Extract, Bitter Melon Extract, American Ginseng extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Sugar Balance by GSL Technology

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

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 4 of its 4 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Sugar Balance contains 4 active ingredients. American ginseng extract is included for immune support and has been studied for upper respiratory infections.

Gymnema and bitter melon are traditionally used to help with blood sugar, though the evidence for gymnema and bitter melon in diabetes is limited or mixed in the data we hold. Nopal (prickly pear cactus) extract has some evidence suggesting it may help with diabetes.

The tablet also contains inactive ingredients—dicalcium phosphate, cellulose, stearic acid, croscarmellose sodium, magnesium stearate, hydroxypropylmethylcellulose, and polyethylene glycol—which serve as binders, fillers, and capsule materials.

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: Support healthy glucose levels and insulin function.
  • We looked for evidence on: Diabetes, Impaired glucose tolerance (prediabetes), Metabolic syndrome, Hypercholesterolemia, Obesity, Type 2 diabetes — and 2 related terms.
  • The strongest evidence on file: Prickly Pear Cactus is rated "Possibly Effective" for Diabetes (Natural Medicines).
  • Also on file: Bitter Melon is rated "Insufficient Reliable Evidence To Rate" for Diabetes, Obesity, Impaired glucose tolerance (prediabetes), Metabolic syndrome.
  • Also on file: Gymnema is rated "Insufficient Reliable Evidence To Rate" for Diabetes, Obesity.

The evidence we hold is limited. American ginseng is rated possibly effective for upper respiratory infections, but it's not clear whether that applies to this formula.

Nopal is rated possibly effective for diabetes. For all the other uses listed in the data—gymnema for diabetes, obesity, or prediabetes; bitter melon for diabetes or other conditions—the evidence is rated insufficient to know whether they work.

If lowering blood sugar is your goal, talk with your doctor about whether the science behind these ingredients matches what you're hoping for.

The evidence, ingredient by ingredient American Ginseng Gymnema Bitter Melon Prickly Pear Cactus

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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

American ginseng, gymnema, bitter melon, and nopal are all generally well tolerated short-term in healthy adults, though long-term safety isn't well studied and quality varies between products. Headache is reported with ginseng.

Bitter melon can cause stomach upset—heartburn, nausea, diarrhea, constipation, abdominal discomfort, and flatulence—in about 3 to 16 percent of people in studies. Rare serious cases of liver inflammation and kidney injury have been reported with gymnema and bitter melon.

All four ingredients can lower blood sugar, so monitor your glucose if you're taking them. During pregnancy, American ginseng and gymnema are rated possibly unsafe, and bitter melon and nopal are best avoided because safety data is insufficient.

During breastfeeding, the data is too limited for all four ingredients—talk with your doctor or pharmacist for personalized advice.

Side effects, ingredient by ingredient American Ginseng Gymnema Bitter Melon Prickly Pear Cactus

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 4 of the 4 matched ingredients can interact with medications — Bitter Melon, Gymnema, Prickly Pear Cactus, American Ginseng.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,008 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 Sugar Balance, check with your doctor or pharmacist if you take blood thinners (especially warfarin), diabetes medications, immune-suppressing drugs, older antidepressants (MAOIs), heart medications, cancer drugs (particularly pazopanib), or any drug your pharmacist identifies as a CYP1A2, CYP2C9, or P-glycoprotein substrate. These are the major and moderate interactions documented for the ingredients in this product.

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. Major medication interactions have been identified, and safety information is well characterized.

Sugar Balance is marketed for blood sugar support, but evidence that it works is weak or missing for most of its ingredients. More importantly, it interacts with a large number of medications—including blood thinners, diabetes drugs, heart medications, and cancer drugs—so you need to check your prescriptions before you start.

Talk with your doctor or pharmacist about whether this product is right for you and safe alongside everything else you're taking.

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

Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 26, 2011.

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 Sugar Balance, straight from the product label.

Brand GSL Technology
Net contents 90 Tablet(s)
Market status On market
Date entered into DSLD Oct 26, 2011
DSLD ID 1659
Product type Botanical
Supplement form Tablet Or Pill
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 Sugar Balance by GSL Technology, 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:
3 Tablet(s)
Maximum serving Sizes:
6 Tablet(s)
Servings per container
90
IngredientAmount% DV
American Ginseng extract50 mg--
Gymnema Sylvestre Extract100 mg--
Bitter Melon Extract1000 mg--
Nopal Extract100 mg--

Other ingredients: Dicalcium Phosphate, Cellulose, Stearic Acid, Croscarmellose Sodium, Magnesium Stearate, Hydroxypropylmethylcullulose, Polyethylene Glycol

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)

GSL TECHNOLOGY (TM) is a Trademark of GSL Tech Inc.

GSL TECHNOLOGY(TM) Bitter Melon Extract is an amazing botanical that acts as a mediator between the body's cells and insulin, thereby decreasing resistance to proper insulin function. This unique formula may block excessive formation of glucose in the blood and enhance tolerance for blood sugars. However, this product is not a substitute for a program of exercise and a proper diet low in starches and sugars as prescribed by your doctor. -Bitter Melon: may break down the barrier that prevents cells from using the body's insulin. -Gymnema Sylvestre: may decrease glucose absorption and improve the ability to use glucose for energy. -Nopal: may decrease glucose absorption from the intestines while increasing the effectiveness of insulin. -American Ginseng: may enhances physical capacity which positively affects long-term sugar control.

TO SUPPORT & PROMOTE: -May Aid Insulin Function -May Promote Healthy Glucose Levels -Optimizes Weight Levels

FDA Disclaimer Statement

The statements presented on this package have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

FDA Statement of Identity

Dietary Supplement

Formula

Charantin 1%

Sugar Balance For Type II Diabetics

Formulation

ALL NATURAL: No preservatives, sugars, food allergens, artificial colors or flavors. No yeast, milk, lactose, wheat or corn.

VEGETARIAN TABLET

Precautions

Caution: This product can be a choking hazard. Keep out of reach of children. If you are taking medication, pregnant or nursing, consult your health professional. When combined with other medications that lower blood glucose, this product has the potential for hypoglycemia.

General Statements

Call Toll Free: (877) 572-9617 for info

GSL TECHNOLOGY Natural Guaranteed: We guarantee that all standardized herbal extracts in this formula have been laboratory tested to verify the active ingredients.

If you do not see positive results after taking 3 tablets a day for 1-2 weeks, please return the product with original receipt to GSL TECHNOLOGY within 30 days of purchase for a full refund.

MADE IN USA

Satisfaction Guaranteed: Freshness and safety sealed. Do not use if seals are broken or missing.

Suggested/Recommended/Usage/Directions

Recommended Use: Adults over 12 years of age should take 3 to 6 tablets daily with water at mealtimes. Take consistently with regular sugar monitoring for optimum benefit.

See for yourself

Sugar Balance by GSL Technology label

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

What’s inside

The Ingredients in Sugar Balance by GSL Technology

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Tablet(s) Dosage formTablet Or Pill 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.

American Ginseng extract

Interacts with
217 drugs
50 mg per serving

American ginseng is an herbal root used as an 'adaptogen' to support energy, stress, immune function, and blood sugar. Some uses—such as reducing the...

American Ginseng extract monograph & interactions

Gymnema Sylvestre Extract

Interacts with
851 drugs
100 mg per serving

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 Extract monograph & interactions

Bitter Melon Extract

Interacts with
282 drugs
1000 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...

Bitter Melon Extract monograph & interactions

Nopal Extract

Interacts with
86 drugs
100 mg per serving

Prickly pear cactus is a desert plant whose pads and fruit are eaten as food and taken as a supplement, mainly for blood sugar, cholesterol, and hango...

Nopal Extract monograph & interactions

Other (inactive) ingredients: Dicalcium Phosphate, Cellulose, Stearic Acid, Croscarmellose Sodium, Magnesium Stearate, Hydroxypropylmethylcullulose, Polyethylene Glycol. These complete the product’s ingredient list but are not active constituents.

Interaction report

Sugar Balance by GSL Technology Drug Interactions

Want to check YOUR meds against Sugar Balance?

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
1,007Drugs
2 Major 609 Moderate 396 Minor

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Sugar Balance 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.

Gymnema Sylvestre 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

Bitter Melon 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

American Ginseng extract4 drug types · 217 drugs

Warfarin (Coumadin)

American ginseng seems to decrease the effectiveness of warfarin therapy.
Healthy patients receiving warfarin 5 mg daily, who also take American ginseng 1 gram twice daily, seem to have a significantly reduced international normalized ratio (INR).

Likelihood Likely Evidence B
Antidiabetes Drugs

Theoretically, taking American ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
American ginseng seems to lower postprandial blood glucose. Theoretically, concomitant use with antidiabetes drugs might enhance blood glucose lowering effects and possibly cause hypoglycemia.

Likelihood Probable Evidence B
Immunosuppressants

Theoretically, American ginseng use might interfere with immunosuppressive therapy.
American ginseng seems to stimulate immune function. Theoretically, American ginseng might decrease the effectiveness of immunosuppressant drugs.

Likelihood Possible Evidence D
Monoamine Oxidase Inhibitors (Maois)

Theoretically, American ginseng can interfere with MAOI therapy.
There is one case report of insomnia, headache, and tremors when an unspecified ginseng product was used with phenelzine (Nardil), an MAOI. There is also one case report of hypomania when an unspecified ginseng product was used with phenelzine. Theoretically, American ginseng may interfere with MAOI therapy.

Likelihood Possible Evidence D

Nopal Extract1 drug type · 86 drugs

Antidiabetes Drugs

Combining prickly pear cactus with antidiabetes drugs might increase the risk of hypoglycemia.
Case reports show that combining prickly pear cactus with antidiabetes drugs such as chlorpropamide, glyburide, glipizide, and metformin can increase the risk of hypoglycemia in patients with type 2 diabetes. Advise patients to monitor glucose levels closely. Dose adjustments may be necessary.

Likelihood Probable Evidence D
The maker

Brand information

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

GSL Technology

See all GSL Technology products
Name
GSL Tech Inc.
Street Address
P.O. Box 1430
City
Baldwin Park
State
CA
ZipCode
91706
Phone Number
(877)572-9617
Web Address
www.GSLsupplements.com
Pharmacist Counseling Corner

Sugar Balance by GSL Technology: Common Questions

Does Sugar Balance by GSL Technology interact with any medications?
Yes. Based on its ingredients, Sugar Balance has a known interaction with 1,007 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Sugar Balance contains 4 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 Sugar Balance if I'm pregnant or breastfeeding?
The data advises against it. American ginseng and gymnema are rated possibly unsafe in pregnancy. Bitter melon and nopal have insufficient safety data, so they're best avoided during pregnancy too. For breastfeeding, all four ingredients lack enough safety information. Talk with your doctor or pharmacist for personalized advice—they know your situation and can help you decide.
What are the most common side effects?
Headache has been reported with American ginseng. Bitter melon most commonly causes stomach upset—heartburn, nausea, diarrhea, constipation, flatulence, and abdominal discomfort—in a small percentage of people. All ingredients can lower blood sugar, which is the main safety concern if you're on diabetes medication.
Does Sugar Balance actually work for blood sugar?
The evidence is limited. Nopal has some research suggesting it may help with diabetes, but the data rates it only possibly effective. For gymnema and bitter melon used in diabetes, the evidence we hold is rated insufficient—meaning we don't have enough reliable studies to know if they work. Talk with your doctor about whether the science backs up what you're hoping it will do.
Why does this product interact with so many medications?
Sugar Balance has four active ingredients, and each one touches different drug-processing pathways in your body. American ginseng affects blood thinners and immune drugs. Gymnema inhibits liver enzymes that clear many medications. Bitter melon blocks a protein pump that moves drugs across your gut. Together, they create a wide network of possible interactions—that's why it's so important to check your exact prescriptions before starting.
Can I take this with my diabetes medication?
All four ingredients in this product can lower blood sugar, so combining them with diabetes drugs raises the risk of low blood sugar (hypoglycemia). If you take insulin or oral diabetes medications, you must talk with your doctor or pharmacist before starting Sugar Balance—they can tell you if it's safe for you and whether your dosing needs adjustment.
Is this product safe to use long-term?
The safety data we hold covers short-term use in healthy adults, but long-term safety isn't well studied. Quality and dosing also vary between products. If you're thinking about taking it regularly, discuss that with your doctor or pharmacist.

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

Not sure if Sugar Balance is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.

Sugar Balance label
Sources

Sources & How We Checked

Sugar Balance'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 51 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.

American Ginseng 12 references
  1. Shader RI, Greenblatt DJ. Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985;5:65. PubMed
  2. Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987;7:201-2. PubMed
  3. Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692-3. PubMed
  4. Vuksan V, Sievenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009-13. PubMed
  5. Vuksan V, Stavro MP, Sievenpiper JL, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care 2000;23:1221-6. PubMed
  6. Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8..
  7. McElhaney JE, Gravenstein S, Cole SK, et al. A Placebo-Controlled Trial of a Proprietary Extract of North American Ginseng (CVT-E002) to Prevent Acute Respiratory Illness in Institutionalized Older Adults. J Am Geriatr Soc 2004;52:13-9. PubMed
  8. Yuan CS, Wei G, Dey L, et al. American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled trial. Ann Intern Med 2004;141:23-7.
  9. Predy GN, Goel V, Lovlin R, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005;173:1043-8.. PubMed
  10. McElhaney JE, Goel V, Toane B, et al. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. J Altern Complement Med 2006;12:153-7. PubMed
  11. Predy GN, Goel V, Lovlin RE, et al. Immune modulating effects of daily supplementation of COLD-fX (a proprietary extract of North American ginseng) in healthy adults. J Clin Biochem Nutr 2006;39:162-167. DOI
  12. Stavro PM, Woo M, Leiter LA, et al. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006;47(4):791-6. PubMed

See these in context on the American Ginseng 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 →

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 →

Prickly Pear Cactus 9 references
  1. Meckes-Lozyoa M, Roman-Ramos R. Opuntia streptacantha; a coadjutor in the treatment of diabetes mellitus. Am J Chin Med 1986;14:116-8.
  2. Rayburn K, Martinez R, Escobedo M, et al. Glycemic effects of various species of nopal (Opuntia sp.) in type 2 diabetes mellitus. Texas J Rural Health 1998;26:68-76.
  3. Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5.
  4. Sobieraj DM, Freyer CW. Probable hypoglycemic adverse drug reaction associated with prickly pear cactus, glipizide, and metformin in a patient with type 2 diabetes mellitus. Ann Pharmacother 2010;44:1334-7. PubMed
  5. Kleiner, O., Cohen, Z., and Mares, A. J. Low colonic obstruction due to Opuntia ficus indica seeds: the aftermath of enjoying delicious cactus fruits. Acta Paediatr. 2002;91(5):606-607.
  6. Steinberg, J. M. and Eitan, A. Prickly pear fruit bezoar presenting as rectal perforation in an elderly patient. Int J Colorectal Dis. 2003;18(4):365-367. PubMed
  7. Meckes-Lozyoa, M. and Roman-Ramos, R. Opuntia streptacantha: a coadjutor in the treatment of diabetes mellitus. Am J Chin Med 1986;14(3-4):116-118.
  8. Onakpoya IJ, O'Sullivan J, Heneghan CJ. The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition. 2015;31(5):640-6. PubMed
  9. Han EH, Lim MK, Lee S, et al. Efficacy of Ethanolic Extract of Opuntia ficus-indica var. saboten Stems for Improving Cognitive Function in Elderly Subjects 55-85 Years of Age: A Randomized, Double-Blind, Placebo-Controlled Study. J Med Food 2020;23(11):11

See these in context on the Prickly Pear Cactus 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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