Drug & supplement interaction

Ashwagandha + Cyproterone Acetate, Ethinyl Estradiol

Cyproterone Acetate, Ethinyl Estradiol brand names: Diane-35, Dianette.

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

Cyproterone Acetate, Ethinyl Estradiol falls into 2 drug categories that Ashwagandha can interact with; the most serious is rated minor. Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ashwagandha and Cyproterone Acetate, Ethinyl Estradiol

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

Why Are There 2 Interactions?

Ashwagandha interacts with whole categories of medication. Cyproterone Acetate, Ethinyl Estradiol falls into 2 of those categories, so it can interact with Ashwagandha in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Cyproterone Acetate, Ethinyl Estradiol

Cyproterone Acetate, Ethinyl Estradiol falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Ashwagandha interacts with.

Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that ashwagandha extract induces CYP1A2 enzymes.
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 short version. Diane-35 combines an estrogen (ethinyl estradiol) with cyproterone acetate, and it's often used for acne, excess hair growth, and birth control. The estrogen part is partly handled by a liver enzyme called CYP1A2. In lab dish studies only, ashwagandha appeared to speed up that enzyme, which could in theory clear the estrogen a bit faster and slightly lower its level in your body.

If that happened, you might notice things like breakthrough spotting or a return of acne. But I want to be honest about the strength here: this is theoretical and based only on test-tube work, not real people, and it's rated minor. For most folks it's unlikely to cause a real problem. Still, since this pill can be relied on for contraception, please run it past your pharmacist or doctor before adding ashwagandha.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Cyproterone Acetate, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that ashwagandha extract induces CYP3A4 enzymes.
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 for Diane-35 (the combo of cyproterone acetate and ethinyl estradiol). Your body uses an enzyme called CYP3A4 to break down both of these hormones. Lab studies hint that ashwagandha might gently speed that enzyme up, which in theory could clear the hormones a little faster and lower their levels in your blood.

For a pill that's often used for birth control as well as acne and hormonal symptoms, even a small dip in hormone levels could mean breakthrough spotting or, in the worst case, less reliable protection. That said, this is a minor, theoretical concern based only on test-tube data, not real people. I wouldn't panic, but since pregnancy prevention may be on the line, do run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. 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

Ashwagandha Also Interacts With Other Medications

Ashwagandha has 918 moderate, 454 minor known drug interactions in our database — the Cyproterone Acetate, Ethinyl Estradiol one above is among them. If you take anything else, check it against the full list below.

Moderate 918 Minor 454 No known interaction 1,458 (incl. Cyproterone Acetate, Ethinyl Estradiol)
Taking anything else?

Check Another of Your Medications Against Ashwagandha

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

From our Q&A

Questions About Ashwagandha or Cyproterone Acetate, Ethinyl Estradiol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ashwagandha or Cyproterone Acetate, Ethinyl Estradiol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Cyproterone Acetate, Ethinyl Estradiol

This page covers Ashwagandha only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cyproterone Acetate, Ethinyl Estradiol page lists 211 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 · 170 moderate · 38 minor.

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

“Diane-35 (cyproterone acetate with ethinyl estradiol) is a hormone pill, often used for birth control and acne, so a supplement that weakens it can mean breakthrough bleeding or an unplanned pregnancy. That is why the 211 entries here warrant real care, and the three major ones come first.”

Reviewed by 2 · Jul 18, 2026

Open the Cyproterone Acetate, Ethinyl Estradiol interaction page

One more smart check

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

We hold 4,964 real supplement products containing Ashwagandha, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ashwagandha. Your product may carry other ingredients that interact with Cyproterone Acetate, Ethinyl Estradiol too, on top of Ashwagandha — 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 Ashwagandha and Cyproterone Acetate, Ethinyl Estradiol 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 Ashwagandha
Top 5%

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

29 days ago today
Medication Cyproterone Acetate, Ethinyl Estradiol
Top 25%

#335 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 Ashwagandha

What is Ashwagandha?

Ashwagandha
  • Stress and anxiety
  • Sleep problems
  • Fatigue and low energy
  • Athletic performance
  • General well-being (adaptogen)

Ashwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evidence is still limited. It is generally well tolerated for short-term use in healthy adults, but it should be avoided in pregnancy and used cautiously by people with thyroid or liver problems. Talk with your pharmacist or doctor before starting it.

Read the full Ashwagandha monograph & all interactions
Keep checking

Other Drugs & Ashwagandha

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

0Major
918Moderate
454Minor
1,457No known interaction
918 Moderate 454 Minor 1,457 No interaction
Moderate

918 interactions

Showing 60 of 918 moderate interactions — see all 918 on the Ashwagandha page.

Minor

454 interactions

Showing 60 of 454 minor interactions — see all 454 on the Ashwagandha page.

No interaction 1,457 drugs checked — show the list

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

Showing the 60 most looked-up of 1,457 medications checked with no known interaction — see the full Ashwagandha list.

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

Can you take Ashwagandha with Cyproterone Acetate, Ethinyl Estradiol?
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.
Why are there 2 interactions listed for Ashwagandha and Cyproterone Acetate, Ethinyl Estradiol?
Cyproterone Acetate, Ethinyl Estradiol belongs to more than one drug category, and Ashwagandha 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 Ashwagandha and Cyproterone Acetate, Ethinyl Estradiol 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

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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.