Drug & supplement interaction

Aletris + Estradiol, Norethindrone Acetate

Estradiol, Norethindrone Acetate brand name: Activella.

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

Aletris has a moderate interaction with Estradiol, Norethindrone Acetate. Aletris might have estrogenic effects. Theoretically, use of aletris with estrogens might increase the risk for additive adverse effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Aletris and Estradiol, Norethindrone Acetate

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

Moderate

ESTROGENS

Why this applies to Estradiol, Norethindrone Acetate

Estradiol, Norethindrone Acetate falls under ESTROGENS — the group Aletris interacts with.

Aletris might have estrogenic effects. Theoretically, use of aletris with estrogens might increase the risk for additive adverse effects.
Severity Moderate 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

Your Activella already gives you estrogen (estradiol) plus a progestin (norethindrone). Aletris is an old folk herb that, in lab studies, seems to act a little like estrogen itself. So the worry here is simple: if you layer a mild estrogen-like herb on top of your prescribed estrogen, you could in theory be stacking estrogen effects. That might mean more of the usual estrogen-related complaints, like breast tenderness, bloating, nausea, headaches, or spotting.

I want to be honest about how soft this concern is. It is based only on test-tube chemistry, not real human studies, and we do not even have solid proof Aletris works for anything. Still, since safety data is thin, please run it past your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.

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

Aletris Also Interacts With Other Medications

Aletris has 40 moderate, 36 minor known drug interactions in our database — the Estradiol, Norethindrone Acetate one above is one of them. If you take anything else, check it against the full list below.

Moderate 40 Minor 36 No known interaction 2,754 (incl. Estradiol, Norethindrone Acetate)
Taking anything else?

Check Another of Your Medications Against Aletris

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

Everything else you take

See Every Supplement That Interacts With Estradiol, Norethindrone Acetate

This page covers Aletris only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Estradiol, Norethindrone Acetate page lists 212 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), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 171 moderate · 38 minor.

From our pharmacist’s overview on the Estradiol, Norethindrone Acetate page

“Activella pairs estradiol with norethindrone as hormone therapy, and because the treatment depends on steady hormone levels in the blood, supplements that raise or lower those levels warrant real scrutiny. Three of the 212 interacting ingredients rate major, and all three hit that weak point: St.”

Reviewed by 2 · Jul 18, 2026

Open the Estradiol, Norethindrone Acetate interaction page

One more smart check

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

We hold 2 real supplement products containing Aletris, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Aletris. Your product may carry other ingredients that interact with Estradiol, Norethindrone Acetate too, on top of Aletris — 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 Aletris and Estradiol, Norethindrone Acetate 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 Aletris
Top half

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

29 days ago today
Medication Estradiol, Norethindrone Acetate
Steady interest

#2,232 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 Aletris

What is Aletris?

Aletris
  • Menstrual complaints
  • Digestive upset and colic
  • Loss of appetite
  • Female reproductive tonic
  • Rheumatic discomfort

Aletris (true unicorn root or colic root) is a North American herb traditionally used for menstrual problems and digestive complaints, but there is little to no modern human research to show it works. Because safety is poorly studied, it should be avoided during pregnancy and breastfeeding, and anyone considering it should first talk with a pharmacist or doctor.

Read the full Aletris monograph & all interactions
Keep checking

Other Drugs & Aletris

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

0Major
40Moderate
36Minor
2,753No known interaction
40 Moderate 36 Minor 2,753 No interaction
Moderate

40 interactions

Minor

36 interactions

No interaction 2,753 drugs checked — show the list

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

Showing the 60 most looked-up of 2,753 medications checked with no known interaction — see the full Aletris list.

See the full Aletris interactions page
See every supplement checked against Estradiol, Norethindrone Acetate, 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
Aletris monograph › Uses, safety, and every drug interaction in one place Estradiol, Norethindrone Acetate supplement interactions › Every supplement checked against Estradiol, Norethindrone Acetate, 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 Aletris and Estradiol, Norethindrone Acetate Together: Common Questions

Can you take Aletris with Estradiol, Norethindrone Acetate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Aletris and Estradiol, Norethindrone Acetate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Estradiol, Norethindrone Acetate and Aletris?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.