Drug & supplement interaction

Alchemilla + Conjugated Estrogens

Conjugated Estrogens brand names: Premarin, Cenestin, Enjuvia, Premarin Vaginal Cream.

Minor Interaction
Medically reviewed by · Updated January 2024
The bottom line Minor

Alchemilla has a minor interaction with Conjugated Estrogens. While no side effects have been reported from orally using Alchemilla, a clinical study titled "Treatment of Aphthous Stomatitis with Topical Alchemilla vulgaris in Glycerine," published in Clinical Drug Investigation (https://pubmed.ncbi.nlm.nih.gov/17163290/), found that local mouth irritation occ...

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

Alchemilla and Conjugated Estrogens

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

Minor

Topical Drugs

Why this applies to Conjugated Estrogens

Conjugated Estrogens falls under Topical Drugs — the group Alchemilla interacts with.

While no side effects have been reported from orally using Alchemilla, a clinical study titled "Treatment of Aphthous Stomatitis with Topical Alchemilla vulgaris in Glycerine," published in Clinical Drug Investigation (https://pubmed.ncbi.nlm.nih.gov/17163290/), found that local mouth irritation occurred after applying a commercial product containing 3% alchemilla extract and glycerol (Aphtarine, Laboratoires Biosphere). Aphtarine was non-irritating in 68.2% of cases within 2-3 days, in 18.8% of cases within 4-7 days, and in 13.6% of cases with moderate irritation. Theoretically, combining Alchemilla with other potentially irritating topical products could increase the risk of local irritation and discomfort. The drug in this drug interaction monograph is available in a topical dosage form. There is no interaction expected from the oral dosage form of the drug.
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 good news: this isn't a deep chemistry interaction. It has nothing to do with how your body absorbs or breaks down estrogen. If you take conjugated estrogens as a pill, Alchemilla isn't expected to interfere at all.

The only real concern is with the topical forms, like Premarin Vaginal Cream. Alchemilla is rich in tannins, which are astringent and can dry or irritate skin and delicate tissues. Applying it on or near the same area as your estrogen cream could, in theory, add up to some local redness, stinging, or discomfort. This is a minor, possible effect based on limited evidence, not a dangerous one. If you'd like to use both, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction

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

Alchemilla Also Interacts With Other Medications

Alchemilla has 197 minor known drug interactions in our database — the Conjugated Estrogens one above is one of them. If you take anything else, check it against the full list below.

Minor 197 No known interaction 2,633 (incl. Conjugated Estrogens)
Taking anything else?

Check Another of Your Medications Against Alchemilla

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

Everything else you take

See Every Supplement That Interacts With Conjugated Estrogens

This page covers Alchemilla only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Conjugated Estrogens page lists 207 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Tiratricol (major) and Acacia Rigidula (moderate).

By severity: 4 major · 172 moderate · 31 minor.

From our pharmacist’s overview on the Conjugated Estrogens page

“Conjugated estrogens (Premarin, Cenestin) are hormone replacement, most often for menopause symptoms, and the 207 supplements here warrant real care before adding any of them. Most of the risk runs through drug processing: 121 entries involve the CYP3A4 enzyme that clears estrogen, which is how St.”

Reviewed by 2 · Jul 18, 2026

Open the Conjugated Estrogens interaction page

One more smart check

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

We hold 19 real supplement products containing Alchemilla, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Alchemilla. Your product may carry other ingredients that interact with Conjugated Estrogens too, on top of Alchemilla — 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 Alchemilla and Conjugated Estrogens 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 Alchemilla
Top half

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

29 days ago today
Medication Conjugated Estrogens
Steady interest

#1,499 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 Alchemilla

What is Alchemilla?

Alchemilla
  • Menstrual and women's health complaints
  • Diarrhea and digestive upset
  • Wound healing (topical)
  • Skin moisturizing (topical)
  • Mild inflammation

Alchemilla (lady's mantle) is a European herb traditionally used for digestive complaints, women's health issues, and as an astringent for skin and wounds. Solid human research is very limited, so its benefits remain largely unproven, and it should be avoided in pregnancy and breastfeeding due to a lack of safety data.

Read the full Alchemilla monograph & all interactions
Keep checking

Other Drugs & Alchemilla

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

0Major
0Moderate
197Minor
2,632No known interaction
197 Minor 2,632 No interaction
Minor

197 interactions

Showing 60 of 197 minor interactions — see all 197 on the Alchemilla page.

No interaction 2,632 drugs checked — show the list

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

Showing the 60 most looked-up of 2,632 medications checked with no known interaction — see the full Alchemilla list.

See the full Alchemilla interactions page
See every supplement checked against Conjugated Estrogens, 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
Alchemilla monograph › Uses, safety, and every drug interaction in one place Conjugated Estrogens supplement interactions › Every supplement checked against Conjugated Estrogens, 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 Alchemilla and Conjugated Estrogens Together: Common Questions

Can you take Alchemilla with Conjugated Estrogens?
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 Alchemilla and Conjugated Estrogens 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 Conjugated Estrogens and Alchemilla?

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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.