Supplements and Pioglitazone hydrochloride.
Pioglitazone hydrochloride, sold under the brand name Actos, is classified under "drugs used in diabetes" in the BNF.
Pioglitazone hydrochloride (brand names Actos) sits at NHSBSA prescribing rank 199 in the 2024/25 PCA statistics. The BNF classifies it under "drugs used in diabetes". This means it sits outside the high-volume therapeutic classes (statins, PPIs, ACE inhibitors, SSRIs) where supplement-interaction surfaces are densely studied, and the published evidence base for specific supplement pairs is correspondingly thinner. Where interactions are documented in the Distil database, they are listed below with their clinical-reference citation; where pairs have not been explicitly assessed, the missing-item form at the bottom of the page routes them into our next curation pass. Anyone combining Pioglitazone hydrochloride with a regular supplement stack benefits from explicit GP or pharmacist awareness rather than assuming no interaction exists by default.
Below are the 5 documented pairs we have explicitly assessed against Pioglitazone hydrochloride in the Distil database: 5 amber. The pairs cluster around 2 mechanisms: Reduced glucose control and Additive glucose lowering. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Reduced glucose control
Amber Does Melatonin interact with ?
Melatonin can blunt the body's insulin response and raise blood sugar after eating, which works against the blood-sugar control that pioglitazone is helping with. The effect is strongest when melatonin and food are taken close together, so if you take pioglitazone it is best to keep melatonin well away from your evening meal and to mention it to your prescriber if your blood sugar is being monitored.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive glucose lowering
Amber Does Alpha Lipoic Acid interact with ?
Alpha lipoic acid may lower blood sugar by improving how your body responds to insulin. Pioglitazone works the same way, by improving insulin sensitivity, so the two may add up. The combination is usually manageable, but monitor your glucose when you start alpha lipoic acid or change the dose.
Evidence: Supported by human study data.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Berberine interact with ?
Berberine lowers blood sugar, and pioglitazone improves how your body uses insulin. Taken together the glucose-lowering effect adds up, though pioglitazone rarely causes low blood sugar by itself. Monitor your glucose when you start berberine and tell your GP.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Garlic Extract interact with ?
Garlic supplements may lower blood sugar a little on their own. Pioglitazone also lowers blood sugar but rarely pushes it too low on its own, so the combination is generally manageable. Monitor your glucose when you start a garlic supplement or change the dose.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Holy Basil interact with ?
Holy basil (tulsi) may lower blood sugar on its own. Pioglitazone also lowers blood sugar by improving insulin sensitivity, so the two may add up. The combination is usually manageable, but monitor your glucose when you start holy basil or change the dose.
Evidence: Limited human data, from small studies or case reports, alongside a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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