Drug & supplement interaction

Bitter Melon + Ethinyl Estradiol, Norethindrone

Ethinyl Estradiol, Norethindrone brand names: Femhrt, Loestrin 21, Ovcon 35 21, Ovcon 50 28, Necon 0.5 35 21, and others.

Moderate Interaction
The bottom line Moderate

Bitter Melon has a moderate interaction with Ethinyl Estradiol, Norethindrone. Theoretically, bitter melon might increase levels of P-glycoprotein substrates.

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

Bitter Melon and Ethinyl Estradiol, Norethindrone

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

Moderate

P-GLYCOPROTEIN SUBSTRATES

Why this applies to Ethinyl Estradiol, Norethindrone

Ethinyl Estradiol, Norethindrone falls under P-GLYCOPROTEIN SUBSTRATES — the group Bitter Melon interacts with.

Theoretically, bitter melon might increase levels of P-glycoprotein substrates.
Bitter melon might inhibit the p-glycoprotein (P-gp) intestinal pump and increase intracellular levels of P-gp substrates. In vitro research in intestinal cells shows that 1-monopalmitin, a constituent of bitter melon, increases levels of daunomycin, a P-gp substrate. Additionally, drinking bitter melon juice has been associated with a case of acute pancreatitis in a patient who had been taking pazopanib, a P-gp substrate, for 8 years. Researchers theorize that inhibition of P-gp led to increased levels of pazopanib, resulting in pazopanib-induced pancreatitis.
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: your birth control pill (ethinyl estradiol with norethindrone) is moved around the body partly by a transporter called P-glycoprotein. Bitter melon may gently block that pump, and in theory that could let a little more of the hormone hang around in your system. If that happened, you might notice more of the usual estrogen-related effects, things like nausea, breast tenderness, bloating, or headaches.

I want to be honest about the strength of this, though. It comes only from lab and test-tube research, not from real-world studies in people taking these pills, so it's very much a 'theoretical' concern. Eating bitter melon as an occasional food is unlikely to cause trouble. If you're using concentrated bitter melon supplements regularly, just mention it to your pharmacist or doctor so they can keep an eye on things.

References
  1. Konishi T, Satsu H, Hatsugai Y, et al. Inhibitory effect of a bitter melon extract on the P-glycoprotein activity in intestinal Caco-2 cells. Br J Pharmacol. 2004;143(3):379-87. PubMed
  2. Unsal O, Sütcüoglu O, Yazici O. Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: a case of acute pancreatitis. J Oncol Pharm Pract 2022;28(2):486-8.

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

Bitter Melon Also Interacts With Other Medications

Bitter Melon has 281 moderate known drug interactions in our database — the Ethinyl Estradiol, Norethindrone one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Bitter Melon

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

Everything else you take

See Every Supplement That Interacts With Ethinyl Estradiol, Norethindrone

This page covers Bitter Melon only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Norethindrone page lists 240 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 · 196 moderate · 38 minor.

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

“If you take a birth control pill or hormone therapy containing ethinyl estradiol and norethindrone (Loestrin, Femhrt, and others), a few supplements can genuinely undermine it, so read this page with care. Six of the 240 ingredients on file are rated major, and those six come first.”

Reviewed by 2 · Jul 18, 2026

Open the Ethinyl Estradiol, Norethindrone interaction page

One more smart check

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

We hold 736 real supplement products containing Bitter Melon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bitter Melon. Your product may carry other ingredients that interact with Ethinyl Estradiol, Norethindrone too, on top of Bitter Melon — 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 Bitter Melon and Ethinyl Estradiol, Norethindrone 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 Bitter Melon
Top 25%

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

29 days ago today
Medication Ethinyl Estradiol, Norethindrone
Top 25%

#418 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 Bitter Melon

What is Bitter Melon?

Bitter Melon
  • Blood sugar support
  • Diabetes
  • Digestive complaints
  • Antioxidant source
  • Skin conditions

Bitter melon is a tropical fruit eaten as food and used in traditional medicine, most often for blood sugar control. While some small studies hint it may modestly lower blood sugar, the evidence is limited and inconsistent, so it should not replace proven diabetes treatment. Talk with your pharmacist or doctor before using it, especially if you take diabetes medicines or are pregnant.

Read the full Bitter Melon monograph & all interactions
Keep checking

Other Drugs & Bitter Melon

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

0Major
281Moderate
0Minor
2,548No known interaction
Moderate

281 interactions

Showing 60 of 281 moderate interactions — see all 281 on the Bitter Melon page.

No interaction 2,548 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 Bitter Melon and Ethinyl Estradiol, Norethindrone Together: Common Questions

Can you take Bitter Melon with Ethinyl Estradiol, Norethindrone?
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 Bitter Melon and Ethinyl Estradiol, Norethindrone 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 Ethinyl Estradiol, Norethindrone and Bitter Melon?

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.