Drug & supplement interaction

Acerola + Tibolone

Tibolone brand name: Livial.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Acerola has a minor interaction with Tibolone. Theoretically, concomitant use of acerola with estrogens might increase estrogenic effects.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Acerola and Tibolone

Here is the interaction we found between these two, with the evidence behind it.

Minor

ESTROGENS

Why this applies to Tibolone

Tibolone falls under ESTROGENS — the group Acerola interacts with.

Theoretically, concomitant use of acerola with estrogens might increase estrogenic effects.
Acerola contains vitamin C. Increases in plasma estrogen levels of up to 55% have occurred under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with acerola and tibolone. Acerola is basically a concentrated source of vitamin C, and the theory is that high doses of vitamin C may slow how your body breaks down estrogen. Since tibolone acts partly like an estrogen in the body, the worry is that its hormone-like effects could nudge slightly higher.

In practice, this is a minor, theory-based concern. The vitamin C bump in estrogen levels mostly shows up in women who were low on vitamin C to begin with. If your levels are already normal, extra vitamin C usually does nothing. Food amounts of acerola are very unlikely to matter. If you take concentrated acerola and notice things like breast tenderness, bloating, or spotting, just check in with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
  2. Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
  3. Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Acerola Also Interacts With Other Medications

Acerola has 39 moderate, 88 minor known drug interactions in our database — the Tibolone one above is one of them. If you take anything else, check it against the full list below.

Moderate 39 Minor 88 No known interaction 2,703 (incl. Tibolone)
Taking anything else?

Check Another of Your Medications Against Acerola

Covers the 2,830 medications we’ve checked against Acerola. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Tibolone

This page covers Acerola only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tibolone page lists 80 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Aletris (moderate), Alfalfa (moderate) and Andarine (moderate).

By severity: 2 major · 62 moderate · 16 minor.

From our pharmacist’s overview on the Tibolone page

“Grapefruit is the risk I would learn first with tibolone (Livial), a hormone therapy used for menopause symptoms. Grapefruit can raise estrogen levels in the blood, magnifying both the drug's effects and its side effects, and it shares major status with activated charcoal, which soaks up medications in the gut and can blunt tibolone's…”

Reviewed by 2 · Jul 18, 2026

Open the Tibolone interaction page

One more smart check

Taking Acerola as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2,642 real supplement products containing Acerola, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Acerola. Your product may carry other ingredients that interact with Tibolone too, on top of Acerola — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Acerola and Tibolone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Acerola
Top 10%

#132 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tibolone
Steady interest

#2,815 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Acerola

What is Acerola?

Acerola
  • Vitamin C source
  • Immune support
  • Antioxidant support
  • General wellness
  • Skin health

Acerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and antioxidants. While vitamin C itself has well-known roles in the body, strong human studies showing that acerola specifically treats or prevents disease are limited. It is generally considered safe in food amounts, but check with your pharmacist or doctor before using concentrated supplements.

Read the full Acerola monograph & all interactions
Keep checking

Other Drugs & Acerola

Browse every other medication we’ve checked against Acerola — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
39Moderate
88Minor
2,702No known interaction
39 Moderate 88 Minor 2,702 No interaction
Moderate

39 interactions

Minor

88 interactions

Showing 60 of 88 minor interactions — see all 88 on the Acerola page.

No interaction 2,702 drugs checked — show the list

We also checked Acerola against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,702 medications checked with no known interaction — see the full Acerola list.

See the full Acerola interactions page
See every supplement checked against Tibolone, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

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

Keep exploring
Acerola monograph › Uses, safety, and every drug interaction in one place Tibolone supplement interactions › Every supplement checked against Tibolone, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Acerola and Tibolone Together: Common Questions

Can you take Acerola with Tibolone?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Acerola and Tibolone interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Tibolone and Acerola?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.