Berberine and Metformin
Supplement–drug interaction evidence from the TruthStack database.
| Severity | HIGH |
|---|---|
| Evidence Tier | Moderate |
| Interaction Type | PHARMACODYNAMIC RISK |
| Mechanism | PHARMACODYNAMIC |
| Last Reviewed | 2026-02-24 |
Summary
Both berberine and metformin lower blood glucose via overlapping mechanisms (AMPK activation). Combined use significantly increases hypoglycemia risk. Berberine also inhibits CYP3A4/CYP2D6. Monitor blood glucose closely and discuss with prescriber.
CYP Enzyme Pathway Overlap
Berberine and Metformin share activity on the following CYP enzymes:
| Enzyme | Berberine | Metformin |
|---|---|---|
| P-gp | INHIBITOR (MODERATE) | SUBSTRATE (MODERATE) |
Shared Pharmacodynamic Endpoints
Both compounds influence the same physiological endpoints in the same direction:
| Endpoint | Direction | Berberine | Metformin |
|---|---|---|---|
| BLOOD GLUCOSE | DECREASE | STRONG | STRONG |
Cumulative effect on shared endpoints may exceed individual compound profiles. This is relevant to discussion with a prescribing clinician.
API Reference
GET https://api.truthstack.co/v1/check?c1=Berberine&c2=Metformin
Open, unauthenticated. Returns JSON. Developer documentation
Sources
Primary: 32268543
Related Interactions
What this page is and is not. TruthStack is an informational reference database that describes published pharmacological findings. It does not provide medical advice, diagnosis, or treatment recommendations. The information on this page reflects flags in our database and should not replace consultation with a qualified healthcare provider. Always discuss supplement-drug combinations with your prescriber or pharmacist.