Drug & supplement interaction

Baikal Skullcap + Bazedoxifene Acetate, Conjugated Estrogens

Bazedoxifene Acetate, Conjugated Estrogens brand name: Duavee.

Moderate Interaction
The bottom line Moderate

Bazedoxifene Acetate, Conjugated Estrogens falls into 2 drug categories that Baikal Skullcap can interact with; the most serious is rated moderate. Theoretically, concomitant use of large amounts of Baikal skullcap might interfere with hormone replacement therapy, due to competition for estrogen receptors.

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

Baikal Skullcap and Bazedoxifene Acetate, Conjugated Estrogens

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

Why Are There 2 Interactions?

Baikal Skullcap interacts with whole categories of medication. Bazedoxifene Acetate, Conjugated Estrogens falls into 2 of those categories, so it can interact with Baikal Skullcap 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 Bazedoxifene Acetate, Conjugated Estrogens

Bazedoxifene Acetate, Conjugated Estrogens falls under ESTROGENS — the group Baikal Skullcap interacts with.

Theoretically, concomitant use of large amounts of Baikal skullcap might interfere with hormone replacement therapy, due to competition for estrogen receptors.
In vitro evidence suggests that Baikal skullcap has estrogenic activity.
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

Here's the short version on pairing Baikal skullcap with Duavee (your conjugated estrogens plus bazedoxifene combo). In lab dishes, the plant compounds in skullcap act a little like estrogen and may bump into the same receptors your medication is designed to work on. The concern is that large, concentrated supplement doses could theoretically compete at those receptors and make your hormone therapy work less predictably, so your hot flashes might creep back or your bone protection could be blunted.

Keep in mind this is only test-tube evidence, not proven in people, so it's a maybe rather than a sure thing. Still, since you're taking this for real symptoms and bone strength, it's worth a quick chat with your pharmacist or doctor before starting skullcap.

References
  1. Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. PubMed
Minor

P-GLYCOPROTEIN SUBSTRATES

2 of 2

Bazedoxifene Acetate, Conjugated Estrogens also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, Baikal skullcap might increase levels of drugs transported by P-glycoprotein.
In vitro and animal research suggests that baicalein, oroxylin A, and wogonin, constituents of Baikal skullcap, can inhibit P-glycoprotein. This effect has not been reported in humans.
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: a few compounds in Baikal skullcap (like baicalein and wogonin) have slowed down a transporter called P-glycoprotein in lab and animal studies. P-glycoprotein helps move certain drugs, including Duavee (bazedoxifene with conjugated estrogens), in and out of your body. If that pump is blocked, in theory a bit more of the medicine could hang around, which might nudge up estrogen-type effects such as breast tenderness, bloating, nausea, or spotting.

I want to be honest, though: this has only been seen in test tubes and animals, never in people, and it's rated as a minor, possible interaction. So I wouldn't lose sleep over it. Still, before adding this herb, run it past your pharmacist or doctor so they can weigh it with your full picture.

References
  1. Lee, Y., Yeo, H., Liu, S. H., Jiang, Z., Savizky, R. M., Austin, D. J., and Cheng, Y. C. Increased anti-P-glycoprotein activity of baicalein by alkylation on the A ring. J Med Chem 10-21-2004;47(22):5555-5566. PubMed
  2. Lee, E., Enomoto, R., Suzuki, C., Ohno, M., Ohashi, T., Miyauchi, A., Tanimoto, E., Maeda, K., Hirano, H., Yokoi, T., and Sugahara, C. Wogonin, a plant flavone, potentiates etoposide-induced apoptosis in cancer cells. Ann N Y Acad Sci 2007;1095:521-526. PubMed
  3. Go, W. J., Ryu, J. H., Qiang, F., and Han, H. K. Evaluation of the flavonoid oroxylin A as an inhibitor of P-glycoprotein-mediated cellular efflux. J Nat Prod 2009;72(9):1616-1619. PubMed
  4. Enomoto, R., Koshiba, C., Suzuki, C., and Lee, E. Wogonin potentiates the antitumor action of etoposide and ameliorates its adverse effects. Cancer Chemother.Pharmacol 2011;67(5):1063-1072. 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

Baikal Skullcap Also Interacts With Other Medications

Baikal Skullcap has 593 moderate, 352 minor known drug interactions in our database — the Bazedoxifene Acetate, Conjugated Estrogens 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 Baikal Skullcap

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

Everything else you take

See Every Supplement That Interacts With Bazedoxifene Acetate, Conjugated Estrogens

This page covers Baikal Skullcap only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bazedoxifene Acetate, Conjugated Estrogens page lists 187 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 · 152 moderate · 32 minor.

From our pharmacist’s overview on the Bazedoxifene Acetate, Conjugated Estrogens page

“If you take Duavee (bazedoxifene with conjugated estrogens) for hot flashes or bone protection after menopause, give this list genuine care, because three of its 187 supplement interactions rate major. Grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Bazedoxifene Acetate, Conjugated Estrogens interaction page

One more smart check

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

We hold 737 real supplement products containing Baikal Skullcap, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Baikal Skullcap. Your product may carry other ingredients that interact with Bazedoxifene Acetate, Conjugated Estrogens too, on top of Baikal Skullcap — 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 Baikal Skullcap and Bazedoxifene Acetate, 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 Baikal Skullcap
Top 25%

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

29 days ago today
Medication Bazedoxifene Acetate, Conjugated Estrogens
Top 10%

#185 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 Baikal Skullcap

What is Baikal Skullcap?

Baikal Skullcap
  • Inflammation
  • Allergies
  • Anxiety and sleep
  • Immune support
  • Respiratory infections

Baikal skullcap is a traditional Chinese herb (Huang Qin) used for inflammation, allergies, and infections, with active compounds like baicalin and baicalein studied mostly in the lab. Human evidence remains limited, so it should not replace proven treatments. Talk to your pharmacist or doctor before using it, and avoid it in pregnancy and breastfeeding.

Read the full Baikal Skullcap monograph & all interactions
Medication

About Estrogen and Bazedoxifene

What Is Estrogen and Bazedoxifene Used For?

Brand name: Duavee

  • Estrogen and bazedoxifene tablets are used to treat hot flashes (sudden feelings of warmth, especially in the face, neck, and chest) in women who are experiencing menopause (stage of life when menstrual periods become less frequent and stop and women may experience other symptoms and body changes). Estrogen and bazedoxifene tablets are also used to prevent osteoporosis (condition in which the bones become thin and weak and break easily) in women who have undergone menopause. Estrogen is in a class of medications called hormones and bazedoxifene is in a class of medications called estrogen agonist–antagonists. Estrogen works by replacing estrogen that is normally produced by the body. Bazedoxifene is used to block the action of estrogen on the lining of the uterus, decreasing the risk of overgrowth that may lead to cancer.

See full Estrogen and Bazedoxifene drug information
Keep checking

Other Drugs & Baikal Skullcap

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

0Major
593Moderate
352Minor
1,884No known interaction
Moderate

593 interactions

Showing 60 of 593 moderate interactions — see all 593 on the Baikal Skullcap page.

Minor

352 interactions

Showing 60 of 352 minor interactions — see all 352 on the Baikal Skullcap page.

No interaction 1,884 drugs checked — show the list

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

Showing the 60 most looked-up of 1,884 medications checked with no known interaction — see the full Baikal Skullcap 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

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Pharmacist Counseling Corner

Taking Baikal Skullcap and Bazedoxifene Acetate, Conjugated Estrogens Together: Common Questions

Can you take Baikal Skullcap with Bazedoxifene Acetate, Conjugated Estrogens?
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 Baikal Skullcap and Bazedoxifene Acetate, Conjugated Estrogens?
Bazedoxifene Acetate, Conjugated Estrogens belongs to more than one drug category, and Baikal Skullcap 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 Baikal Skullcap and Bazedoxifene Acetate, Conjugated Estrogens 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

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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.