Drug & supplement interaction

Black Tea + Ethinyl Estradiol, Levonorgestrel

Ethinyl Estradiol, Levonorgestrel brand names: Levlite 28, Tri-Levlen 21, Tri-Levlen 28, Levlite, Trivora-28, and others.

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

Ethinyl Estradiol, Levonorgestrel falls into 3 drug categories that Black Tea can interact with; the most serious is rated moderate. Theoretically, concomitant use might increase the levels and adverse effects of caffeine.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Black Tea and Ethinyl Estradiol, Levonorgestrel

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Black Tea interacts with whole categories of medication. Ethinyl Estradiol, Levonorgestrel falls into 3 of those categories, so it can interact with Black Tea in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

1 of 3

Why this applies to Ethinyl Estradiol, Levonorgestrel

Ethinyl Estradiol, Levonorgestrel falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS — the group Black Tea interacts with.

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Black tea contains caffeine. Caffeine is metabolized by CYP1A2,. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from black tea and increase caffeine levels.
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 a twist with this pairing: it's actually the caffeine in your black tea that gets affected, not your birth control pill. The estrogen in combination pills like these can mildly slow down CYP1A2, the liver enzyme that clears caffeine. So in theory, caffeine may stick around a little longer and feel a bit stronger.

In real life that might mean feeling more jittery, a racing heart, trouble sleeping, or a slightly upset stomach if you drink several cups. This is a theoretical interaction based on how the body works, not strong human studies, so most people do fine. A cup or two is usually no big deal. If caffeine bothers you more than it used to, just ease back and mention it to your pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Weisburger JH. Tea and health: the underlying mechanisms. Proc Soc Exp Biol Med 1999;220:271-5. PubMed
  2. Hagg S, Spigset O, Mjorndal T, Dahlqvist R. Effect of caffeine on clozapine pharmacokinetics in healthy volunteers. Br J Clin Pharmacol 2000;49:59-63. PubMed
  3. Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. PubMed
  4. Kot, M. and Daniel, W. A. Effect of diethyldithiocarbamate (DDC) and ticlopidine on CYP1A2 activity and caffeine metabolism: an in vitro comparative study with human cDNA-expressed CYP1A2 and liver microsomes. Pharmacol Rep. 2009;61(6):1216-1220. PubMed
  5. Wojcikowski, J. and Daniel, W. A. Perazine at therapeutic drug concentrations inhibits human cytochrome P450 isoenzyme 1A2 (CYP1A2) and caffeine metabolism--an in vitro study. Pharmacol Rep. 2009;61(5):851-858. PubMed
  6. Wang, X. and Yeung, J. H. Effects of the aqueous extract from Salvia miltiorrhiza Bunge on caffeine pharmacokinetics and liver microsomal CYP1A2 activity in humans and rats. J Pharm Pharmacol 2010;62(8):1077-1083.
  7. Kot M, Daniel WA. Caffeine as a marker substrate for testing cytochrome P450 activity in human and rat. Pharmacol Rep 2008;60:789-97.
  8. Kjaerstad MB, Nielsen F, Nohr-Jensen L, et al. Systemic uptake of miconazole during vaginal suppository use and effect on CYP1A2 and CYP3A4 associated enzyme activities in women. Eur J Clin Pharmacol 2010;66:1189-97. PubMed
  9. Goh BC, Reddy NJ, Dandamudi UB, et al. An evaluation of the drug interaction potential of pazopanib, an oral vascular endothelial growth factor receptor tyrosine kinase inhibitor, using a modified Cooperstown 5+1 cocktail in patients with advanced solid t
  10. Chen Y, Kang Z, Yan J, et al. Liu wei di huang wan, a well-known traditional Chinese medicine induces CYP1A2 while suppressing CYP2A6 and N-acetyltransferase 2 acivities in man. J Ethnopharmacol 2010;132:213-8.
  11. Suzuki S, Murayama Y, Sugiyama E, et al. Estimating pediatric doses of drugs metabolized by cytochrome P450 (CYP) isozymes, based on physiological liver development and serum protein levels. Yakugaku Zasshi 2010;130:613-20. PubMed
  12. Chien CF, Wu YT, Lee WC, et al. Herb-drug interaction of Andrographis paniculata extract and andrographolide on the pharmacokinetics of theophylline in rats. Chem Biol Interact 2010;184:458-65. PubMed
  13. Mills BM, Zaya MJ, Walters RR, et al. Current cytochrome P450 phenotyping methods applied to metabolic drug -drug interaction prediction in dogs. Drug Metab Dispos 2010;38:396-404. PubMed
  14. Turpault S, Brian W, Van Horn R, et al. Pharmacokinetic assessment of a five-probe cocktail for CYPs 1A2, 2C9, 2C19, 2D6, and 3A. Br J Clin Pharmacol 2009;68:928-35. PubMed
  15. Filimonova AA, Ziganshina LE, Ziganshin AU, Chichirov AA. On the possibility of patient phenotyping on the basis of cytochrome p-450 1A2 isoenzyme activity using caffeine as the test substrate. Eksp Klin Farmakol 2009;72:61-5.
  16. Jenkins J, Williams D, Deng Y, et al. Eltrombopag, an oral thrombopoietin receptor agonist, has no impact on the pharmacokinetic profile of probe drugs for cytochrome P450 isoenzymes CYP3A4, CYP1A2, CYP2C9 and CYP2C19 in healthy men: a cocktail analysis.
  17. Perera, V., Gross, A. S., and McLachlan, A. J. Caffeine and paraxanthine HPLC assay for CYP1A2 phenotype assessment using saliva and plasma. Biomed.Chromatogr. 2010;24(10):1136-1144. PubMed
  18. Izzo, A. A. and Ernst, E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 2009;69(13):1777-1798. PubMed
Moderate

ESTROGENS

2 of 3

Ethinyl Estradiol, Levonorgestrel also falls under ESTROGENS.

Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Black tea contains caffeine. Estrogen inhibits caffeine metabolism.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

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

Here's the twist with this one: it's not your birth control pill that gets affected, it's the caffeine in your black tea. The estrogen part of your pill (ethinyl estradiol) can slow down how your liver clears caffeine, so the caffeine tends to hang around longer and build up a bit.

In plain terms, your usual cup or two of tea may hit you harder than expected. You might notice things like jitteriness, a faster heartbeat, trouble sleeping, or feeling wired. This won't make your pill less effective at preventing pregnancy, and modest tea drinking is fine for most people. If you feel extra sensitive to caffeine, just ease back on tea and coffee, and chat with your pharmacist if you have questions.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. PubMed
Moderate

CONTRACEPTIVE DRUGS

3 of 3

Ethinyl Estradiol, Levonorgestrel also falls under CONTRACEPTIVE DRUGS.

Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in black tea.
Black tea contains caffeine. Oral contraceptive drugs can decrease caffeine clearance by 40% to 65%.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

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

Here's the simple version: your birth control pill (the combination of ethinyl estradiol and levonorgestrel) can slow down how fast your body clears caffeine, by roughly 40% to 65%. So the caffeine in your black tea sticks around longer than it normally would. The pill's effectiveness isn't reduced here, this works the other way: it's about caffeine building up in you.

In practical terms, the same cup or two of tea might hit a little harder. You may notice more jitteriness, a racing or pounding heart, trouble sleeping, or feeling on edge. Most people who drink moderate amounts are fine, but if you're sensitive to caffeine or feel wired lately, cutting back or switching to decaf in the afternoon can help. Chat with your pharmacist if you have questions.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. PubMed
  2. Abernethy DR, Todd EL. Impairment of caffeine clearance by chronic use of low-dose oestrogen-containing oral contraceptives. Eur J Clin Pharmacol 1985;28:425-8. 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 Tea Also Interacts With Other Medications

Black Tea has 8 major, 571 moderate, 114 minor known drug interactions in our database — the Ethinyl Estradiol, Levonorgestrel one above is among them. If you take anything else, check it against the full list below.

Major 8 Moderate 571 Minor 114 No known interaction 2,137 (incl. Ethinyl Estradiol, Levonorgestrel)
Taking anything else?

Check Another of Your Medications Against Black Tea

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

Everything else you take

See Every Supplement That Interacts With Ethinyl Estradiol, Levonorgestrel

This page covers Black Tea only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Levonorgestrel page lists 239 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 · 195 moderate · 38 minor.

Open the Ethinyl Estradiol, Levonorgestrel interaction page

One more smart check

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

We hold 271 real supplement products containing Black Tea, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Black Tea. Your product may carry other ingredients that interact with Ethinyl Estradiol, Levonorgestrel too, on top of Black Tea — 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 Tea and Ethinyl Estradiol, Levonorgestrel 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 Tea
Top 25%

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

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

#504 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 Tea

What is Black Tea?

  • Mental alertness and energy
  • Heart health support
  • Blood pressure and cholesterol
  • Digestive complaints
  • Weight management
  • Antioxidant support

Black tea is a popular caffeinated drink made from the fully oxidized leaves of the Camellia sinensis plant, and it contains caffeine and antioxidant plant compounds. Moderate tea drinking is generally safe for most adults and may modestly support heart health and alertness, but it is not a proven treatment for any disease. If you are pregnant, breastfeeding, sensitive to caffeine, or taking medicines, talk to your pharmacist or doctor.

Read the full Black Tea monograph & all interactions
Keep checking

Other Drugs & Black Tea

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

8Major
571Moderate
114Minor
2,136No known interaction
8 Major 571 Moderate 114 Minor 2,136 No interaction
Major

8 interactions

Moderate

571 interactions

Showing 60 of 571 moderate interactions — see all 571 on the Black Tea page.

Minor

114 interactions

Showing 60 of 114 minor interactions — see all 114 on the Black Tea page.

No interaction 2,136 drugs checked — show the list

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

Showing the 60 most looked-up of 2,136 medications checked with no known interaction — see the full Black Tea list.

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

Can you take Black Tea with Ethinyl Estradiol, Levonorgestrel?
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 3 interactions listed for Black Tea and Ethinyl Estradiol, Levonorgestrel?
Ethinyl Estradiol, Levonorgestrel belongs to more than one drug category, and Black Tea 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 Black Tea and Ethinyl Estradiol, Levonorgestrel 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.