This lists the major side effects and current FDA boxed ("black box") warnings for every medication in the calculator, plus general safety notes for supplements (supplements aren’t FDA-regulated as drugs, so they have no boxed warnings by definition). This is general information, not a substitute for reading the actual prescribing information or talking with your provider or pharmacist.

“Black Box” data as of July 2026. Boxed warnings can be added, changed, or removed as the FDA reviews new data (canagliflozin’s amputation warning being a real example -- added in 2017, removed in 2020). For the absolute most current black box recommendations, click here to search the FDA’s own label database directly.

Acarbose (Precose) Medication

Very common GI effects (flatulence, diarrhea, abdominal pain) from unabsorbed carbohydrate fermentation. Rare hepatotoxicity/elevated liver enzymes at high doses.

Albiglutide (Tanzeum (Disc.)) Medication

Nausea, diarrhea, injection site reactions. Warnings (not boxed) for acute pancreatitis.

Alogliptin (Nesina) Medication

FDA Warning (not boxed) for heart failure risk based on the EXAMINE trial. Class effects: joint pain, rare acute pancreatitis, rare bullous pemphigoid (skin blistering).

Apple cider vinegar (Apple Cider Vinegar) Supplement

Undiluted use can erode tooth enamel and irritate the esophagus/throat. At high intake, may compound potassium-lowering effects of diuretics or affect digoxin levels.

Berberine (Berberine-500) Supplement

GI upset (diarrhea, constipation, cramping) is common. Inhibits several CYP450 enzymes, so it can interact with many prescription drugs. Avoid in pregnancy (uterine stimulant / can cross the placenta).

Bitter melon (Bitter Melon) Supplement

GI upset. Can cause hypoglycemia, especially combined with other glucose-lowering agents. Avoid in pregnancy (may induce uterine contractions).

Bromocriptine (Cycloset) Medication

Nausea, dizziness, and orthostatic hypotension/syncope, most pronounced with the first dose. Taken within 2 hours of waking with food per labeling to reduce these effects.

Canagliflozin (Invokana) Medication

Genital mycotic infections, urinary tract infections, volume depletion. Warnings (not boxed) for diabetic ketoacidosis (can occur with near-normal glucose) and lower-limb amputation risk -- amputation was itself a boxed warning for canagliflozin from 2017 until the FDA removed it in August 2020 after newer trial data; it remains a standard warning today.

Chlorpropamide (Diabinese) Medication

Hypoglycemia, weight gain. Long half-life (~36 hours) gives it the highest risk of prolonged hypoglycemia in the class, plus a distinct risk of hyponatremia/SIADH -- a major reason it has fallen out of common use.

Cinnamon (Ceylon) (Ceylon Cinnamon) Supplement

Generally well tolerated. Important distinction: this refers specifically to Ceylon cinnamon -- the more common Cassia cinnamon contains meaningful coumarin, which is hepatotoxic in high/chronic doses.

Colesevelam (Welchol) Medication

Constipation, dyspepsia. Can raise triglycerides. Reduces absorption of fat-soluble vitamins and many oral medications -- other drugs should be taken several hours apart from colesevelam.

Curcumin/turmeric (Turmeric Curcumin) Supplement

GI upset at higher doses. May increase bleeding risk when combined with anticoagulants/antiplatelets. Poor bioavailability alone (often paired with piperine/black pepper extract).

Dapagliflozin (Farxiga) Medication

Genital mycotic infections, urinary tract infections, volume depletion. Warning (not boxed) for diabetic ketoacidosis.

Dulaglutide (Trulicity) Medication

Nausea, vomiting, diarrhea, abdominal pain. Warnings (not boxed) for acute pancreatitis and gallbladder disease.

Efpeglenatide (Efpeglenatide) Medication

GI side effects (nausea, vomiting, diarrhea) typical of the GLP-1 class were reported in trials.

Empagliflozin (Jardiance) Medication

Genital mycotic infections, urinary tract infections, volume depletion. Warning (not boxed) for diabetic ketoacidosis.

Ertugliflozin (Steglatro) Medication

Genital mycotic infections, urinary tract infections, volume depletion. Warning (not boxed) for diabetic ketoacidosis.

Exenatide (Short-acting) (Byetta) Medication

Nausea (common, dose-related), vomiting, diarrhea, injection site reactions. Warning (not boxed) for acute pancreatitis and renal impairment. Unlike the once-weekly formulation, Byetta does not carry the thyroid C-cell tumor boxed warning.

Exenatide (Weekly) (Bydureon) Medication

Nausea, diarrhea, injection site nodules (more common than with the twice-daily formulation). Warning (not boxed) for acute pancreatitis.

Fenugreek seeds (Fenugreek) Supplement

GI upset, a maple-syrup-like body/urine odor. May potentiate anticoagulants/antiplatelets. Avoid in pregnancy (uterine stimulant).

Ginger powder (Organic Ginger) Supplement

Mild GI upset/heartburn. Possible mild antiplatelet effect at high doses.

Glimepiride (Amaryl) Medication

Hypoglycemia, weight gain.

Glipizide (Glucotrol) Medication

Hypoglycemia, weight gain.

Glyburide (Diabeta, Glynase) Medication

Hypoglycemia (higher risk than glipizide/glimepiride, especially in the elderly or with renal impairment), weight gain.

Linagliptin (Tradjenta) Medication

DPP-4 inhibitor class effects: joint pain, rare acute pancreatitis, rare bullous pemphigoid. No heart-failure signal seen in linagliptin's outcomes trial (CARMELINA), unlike saxagliptin/alogliptin.

Liraglutide (Victoza) Medication

Nausea, vomiting, diarrhea. Warnings (not boxed) for acute pancreatitis and gallbladder disease.

Lixisenatide (Adlyxin) Medication

Nausea, vomiting, headache. Warning (not boxed) for acute pancreatitis. Does not carry the thyroid C-cell tumor boxed warning that applies to longer-acting GLP-1 agents.

Metformin (Glucophage) Medication

GI upset and diarrhea (common, often transient), metallic taste, vitamin B12 deficiency with long-term use.

Miglitol (Glyset) Medication

Same alpha-glucosidase inhibitor GI profile as acarbose (flatulence, diarrhea, abdominal pain). No significant hepatotoxicity signal reported.

Nateglinide (Starlix) Medication

Hypoglycemia (generally milder/shorter than sulfonylureas), mild weight gain, upper respiratory symptoms in trials.

Pioglitazone (Actos) Medication

Weight gain, edema, increased fracture risk (especially in women). Warning (not boxed) for a possible association with bladder cancer with long-term, high-dose use.

Pramlintide (Symlin) Medication

Nausea, vomiting, anorexia. Must never be mixed with insulin in the same syringe or injection.

Repaglinide (Prandin) Medication

Hypoglycemia, weight gain. Contraindicated with gemfibrozil -- this combination can raise repaglinide exposure roughly 8-fold and has caused severe, prolonged hypoglycemia.

Rosiglitazone (Avandia) Medication

Weight gain, edema, increased fracture risk (especially in women). Prescribing was restricted for several years (2010-2013) over a cardiovascular ischemic-event signal that was later found to be less clear-cut on FDA re-review; restrictions were lifted in 2013.

Saxagliptin (Onglyza) Medication

FDA Warning (not boxed) for heart failure risk based on the SAVOR-TIMI 53 trial. Class effects: joint pain, rare acute pancreatitis, rare bullous pemphigoid.

Semaglutide (Injectable) (Ozempic/Wegovy) Medication

Nausea, vomiting, diarrhea, constipation. Warnings (not boxed) for acute pancreatitis, gallbladder disease, and diabetic retinopathy complications (seen in SUSTAIN-6 with rapid glycemic improvement).

Semaglutide (Oral) (Rybelsus) Medication

Nausea, diarrhea, abdominal pain. Must be taken on an empty stomach with a small amount of water, waiting 30 minutes before other food, drink, or medications for adequate absorption.

Sitagliptin (Januvia) Medication

DPP-4 inhibitor class effects: joint pain, rare acute pancreatitis, rare bullous pemphigoid. No heart-failure signal in its outcomes trial (TECOS).

Tirzepatide (Mounjaro) Medication

Nausea, vomiting, diarrhea, injection site reactions. Warnings (not boxed) for acute pancreatitis and gallbladder disease.

Tolazamide (Tolinase) Medication

Hypoglycemia, weight gain. An older first-generation sulfonylurea, now rarely prescribed.

Tolbutamide (Orinase) Medication

Hypoglycemia, weight gain. Shortest half-life of the sulfonylureas; largely obsolete.

Viscous soluble fiber (Psyllium Husk) Supplement

Bloating, gas, especially without adequate fluid intake. Can reduce absorption of other oral medications taken at the same time -- space dosing by a couple of hours.