Drug & supplement interaction

Black Psyllium + Etonogestrel, Ethinyl Estradiol

Etonogestrel, Ethinyl Estradiol brand name: NuvaRing.

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

Black Psyllium has a minor interaction with Etonogestrel, Ethinyl Estradiol. Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.

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

Black Psyllium and Etonogestrel, Ethinyl Estradiol

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

Minor

ETHINYL ESTRADIOL

Why this applies to Etonogestrel, Ethinyl Estradiol

Etonogestrel, Ethinyl Estradiol falls under ETHINYL ESTRADIOL — the group Black Psyllium interacts with.

Theoretically, taking black psyllium at the same time as ethinyl estradiol might alter levels of estradiol.
Concurrent use of blond psyllium with ethinyl estradiol results in a slight increase in the extent of ethinyl estradiol absorption and a slower rate of absorption. This is unlikely to be clinically significant.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the good news: with the NuvaRing, this is a very low concern. The ring slowly releases its hormones (etonogestrel and ethinyl estradiol) directly through the vaginal wall into your bloodstream, so it mostly skips the digestive tract where psyllium fiber does its work. The interaction on file comes from oral estradiol studies, where psyllium's fiber gel slightly changed how much got absorbed through the gut.

Even with pills, the effect was tiny and considered unlikely to matter. With the ring, it's essentially a non-issue. To keep things simple, just take psyllium with plenty of water as directed. If you ever have questions about your birth control's reliability, your pharmacist or doctor is happy to reassure you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. 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

Black Psyllium Also Interacts With Other Medications

Black Psyllium has 23 moderate, 2,001 minor known drug interactions in our database — the Etonogestrel, Ethinyl Estradiol one above is one of them. If you take anything else, check it against the full list below.

Moderate 23 Minor 2,001 No known interaction 806 (incl. Etonogestrel, Ethinyl Estradiol)
Taking anything else?

Check Another of Your Medications Against Black Psyllium

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

Everything else you take

See Every Supplement That Interacts With Etonogestrel, Ethinyl Estradiol

This page covers Black Psyllium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etonogestrel, Ethinyl Estradiol page lists 203 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate), Activated Charcoal (moderate) and Adrafinil (moderate).

By severity: 2 major · 168 moderate · 33 minor.

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

“St. John's wort belongs at the top of any conversation about NuvaRing (etonogestrel and ethinyl estradiol) and supplements.”

Reviewed by 2 · Jul 18, 2026

Open the Etonogestrel, Ethinyl Estradiol interaction page

One more smart check

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

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

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

29 days ago today
Medication Etonogestrel, Ethinyl Estradiol
Top half

#750 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 Black Psyllium

What is Black Psyllium?

Black Psyllium
  • Constipation
  • Diarrhea
  • High cholesterol
  • Digestive health
  • Blood sugar support
  • Weight management

Black psyllium is a soluble-fiber supplement made from the seeds of a Plantago plant, used mostly to ease constipation and support digestive health. It is best known and most studied for relieving constipation and may modestly help lower cholesterol, but it must always be taken with plenty of water. Talk with your pharmacist or doctor before starting, especially if you have swallowing problems or bowel disorders.

Read the full Black Psyllium monograph & all interactions
Keep checking

Other Drugs & Black Psyllium

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

0Major
23Moderate
2,001Minor
805No known interaction
23 Moderate 2,001 Minor 805 No interaction
Moderate

23 interactions

Minor

2,001 interactions

Showing 60 of 2,001 minor interactions — see all 2,001 on the Black Psyllium page.

No interaction 805 drugs checked — show the list

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

Showing the 60 most looked-up of 805 medications checked with no known interaction — see the full Black Psyllium list.

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

Can you take Black Psyllium with Etonogestrel, 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.
How serious is the Black Psyllium and Etonogestrel, 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

Still Have a Question About Etonogestrel, Ethinyl Estradiol and Black Psyllium?

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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.