Drug & supplement interaction

Anise + Drospirenone, Estetrol

Drospirenone, Estetrol brand name: Nextstellis.

Moderate Interaction
The bottom line Moderate

Drospirenone, Estetrol falls into 2 drug categories that Anise can interact with; the most serious is rated moderate. Theoretically, anise might interfere with estrogen-based hormone replacement therapy.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Anise and Drospirenone, Estetrol

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Anise interacts with whole categories of medication. Drospirenone, Estetrol falls into 2 of those categories, so it can interact with Anise in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ESTROGENS

1 of 2

Why this applies to Drospirenone, Estetrol

Drospirenone, Estetrol falls under ESTROGENS — the group Anise interacts with.

Theoretically, anise might interfere with estrogen-based hormone replacement therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic 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

Nextstellis combines two hormones, drospirenone and estetrol, and is used both as birth control and to manage hormone-related symptoms. The concern here is purely theoretical. In test-tube studies, anise has shown mixed signals, sometimes acting a little like estrogen and other times blocking it. We honestly don't know which way it would tip things in a real person, and there's no solid human data showing it changes how well this pill works.

The practical takeaway: the small amount of anise in food or a cup of tea is very unlikely to matter. I'd be a bit more cautious with concentrated anise oil or high-dose supplements. If you rely on Nextstellis to prevent pregnancy, it's worth a quick chat with your pharmacist before adding anise pills.

References
  1. Kassi E, Papoutsi Z, Fokialakis N, et al. Greek plant extracts exhibit selective estrogen receptor modulator (SERM)-like properties. J Agric Food Chem 2004;52:6956-61. PubMed
  2. Tabanca N, Khan SI, Bedir E, et al. Estrogenic activity of isolated compounds and essential oils of Pimpinella species from Turkey, evaluated using a recombinant yeast screen. Planta Med 2004;70:728-35.
Moderate

CONTRACEPTIVE DRUGS

2 of 2

Drospirenone, Estetrol also falls under CONTRACEPTIVE DRUGS.

Theoretically, anise might interfere with contraceptive drug therapy.
Some in vitro research suggests that anise has estrogenic effects, while other in vitro research suggests that anise has antiestrogenic 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

You asked about pairing anise with Nextstellis, your birth control pill that combines drospirenone and estetrol. Here's the honest picture: the concern is purely theoretical. In test tube studies, anise has shown mixed hormone-like activity, sometimes acting a little like estrogen and other times working against it. Because nobody knows which direction it leans in a real person, scientists worry it could nudge how your contraceptive behaves.

The practical takeaway is reassuring. Normal food and tea amounts of anise are very unlikely to affect your pill or its ability to prevent pregnancy. There's no solid human evidence here at all. Still, if you're thinking about concentrated anise oil or capsules, it's worth a quick chat with your pharmacist or doctor first.

References
  1. Kassi E, Papoutsi Z, Fokialakis N, et al. Greek plant extracts exhibit selective estrogen receptor modulator (SERM)-like properties. J Agric Food Chem 2004;52:6956-61. PubMed
  2. Tabanca N, Khan SI, Bedir E, et al. Estrogenic activity of isolated compounds and essential oils of Pimpinella species from Turkey, evaluated using a recombinant yeast screen. Planta Med 2004;70:728-35.

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

Anise Also Interacts With Other Medications

Anise has 192 moderate, 52 minor known drug interactions in our database — the Drospirenone, Estetrol one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Anise

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

Everything else you take

See Every Supplement That Interacts With Drospirenone, Estetrol

This page covers Anise only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Drospirenone, Estetrol page lists 245 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 200 moderate · 39 minor.

From our pharmacist’s overview on the Drospirenone, Estetrol page

“The stakes with Nextstellis (drospirenone and estetrol) are the ones that come with any birth control pill, because an interaction that lowers its hormone levels can mean an unplanned pregnancy, and I would treat this list with genuine seriousness. Most of what is here changes how the body handles the hormones.”

Reviewed by 2 · Jul 18, 2026

Open the Drospirenone, Estetrol interaction page

One more smart check

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

We hold 465 real supplement products containing Anise, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Anise. Your product may carry other ingredients that interact with Drospirenone, Estetrol too, on top of Anise — 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 Anise and Drospirenone, Estetrol 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 Anise
Top half

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

29 days ago today
Medication Drospirenone, Estetrol
Top half

#1,133 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 Anise

What is Anise?

Anise
  • Digestive upset and bloating
  • Cough and respiratory complaints
  • Sore throat
  • Menstrual discomfort
  • Flavoring agent

Anise is a fragrant, licorice-flavored seed used for centuries to ease digestion and soothe coughs. Most of its health claims are based on tradition and small or laboratory studies rather than strong human research, so evidence is limited. It is generally safe as a food and tea for most adults, but the concentrated essential oil should be used carefully and avoided in pregnancy.

Read the full Anise monograph & all interactions
Keep checking

Other Drugs & Anise

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

0Major
192Moderate
52Minor
2,585No known interaction
Moderate

192 interactions

Showing 60 of 192 moderate interactions — see all 192 on the Anise page.

Minor

52 interactions

No interaction 2,585 drugs checked — show the list
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
Pharmacist Counseling Corner

Taking Anise and Drospirenone, Estetrol Together: Common Questions

Can you take Anise with Drospirenone, Estetrol?
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.
Why are there 2 interactions listed for Anise and Drospirenone, Estetrol?
Drospirenone, Estetrol belongs to more than one drug category, and Anise interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Anise and Drospirenone, Estetrol 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 Drospirenone, Estetrol and Anise?

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.