Drug & supplement interaction

Bugleweed + Ospemifene

Ospemifene brand name: Osphena.

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

Bugleweed has a moderate interaction with Ospemifene. Theoretically, bugleweed may alter thyroid function.

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

Bugleweed and Ospemifene

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

Moderate

THYROID HORMONE

Why this applies to Ospemifene

Ospemifene falls under THYROID HORMONE — the group Bugleweed interacts with.

Theoretically, bugleweed may alter thyroid function.
Concomitant use of bugleweed may reduce the effects of thyroid hormones by blocking peripheral conversion of thyroxine (T4) to triiodothyronine (T3).
Severity Moderate Likelihood Probable Evidence D

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 thing worth clearing up: the interaction on file was built for thyroid hormone medications (like levothyroxine), where bugleweed could theoretically blunt their effect by slowing the body's conversion of T4 to the active T3. Ospemifene (Osphena) isn't a thyroid hormone at all. It's a selective estrogen receptor modulator used for painful intercourse and vaginal dryness after menopause, and it works on estrogen receptors, not on your thyroid.

So this particular bugleweed concern doesn't really map onto Ospemifene, and I wouldn't expect bugleweed to change how well it relieves your vaginal symptoms. That said, bugleweed can affect thyroid function on its own and shouldn't be used without supervision. Please run both past your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

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

Bugleweed Also Interacts With Other Medications

Bugleweed has 15 moderate known drug interactions in our database — the Ospemifene one above is one of them. If you take anything else, check it against the full list below.

Moderate 15 No known interaction 2,815 (incl. Ospemifene)
Taking anything else?

Check Another of Your Medications Against Bugleweed

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

Everything else you take

See Every Supplement That Interacts With Ospemifene

This page covers Bugleweed only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ospemifene page lists 155 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), Tiratricol (major) and Acacia Rigidula (moderate).

By severity: 4 major · 112 moderate · 39 minor.

From our pharmacist’s overview on the Ospemifene page

“Women prescribed ospemifene (Osphena) for painful intercourse after menopause are often the same women reaching for St. John's wort for mood or grapefruit juice at breakfast, and both sit among the four major-rated interactions on this page, so the list deserves genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Ospemifene interaction page

One more smart check

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

We hold 29 real supplement products containing Bugleweed, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bugleweed. Your product may carry other ingredients that interact with Ospemifene too, on top of Bugleweed — 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 Bugleweed and Ospemifene 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 Bugleweed
Steady interest

#1,159 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ospemifene
Steady interest

#2,542 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 Bugleweed

What is Bugleweed?

Bugleweed
  • Mild overactive thyroid symptoms
  • Heart palpitations and rapid heartbeat
  • Anxiety and restlessness
  • Breast pain (mastalgia)
  • Premenstrual symptoms

Bugleweed is a traditional herb most often used for mild overactive thyroid symptoms and the rapid heartbeat that can come with it, but high-quality human evidence is very limited. Because it may affect thyroid hormones, it should not be used without medical supervision, and it must be avoided in pregnancy and breastfeeding.

Read the full Bugleweed monograph & all interactions
Medication

About Ospemifene

What Is Ospemifene Used For?

Brand name: Osphena

Osphena (ospemifene) is used to treat two specific symptoms of vulvar and vaginal atrophy — the thinning and drying of vaginal tissues that can happen after menopause. The first is moderate to severe dyspareunia (painful intercourse), and the second is moderate to severe vaginal dryness.

Both of these uses are for postmenopausal women only. Osphena is not used in children or in women who are pregnant or may become pregnant.

See full Ospemifene drug information
Keep checking

Other Drugs & Bugleweed

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

0Major
15Moderate
0Minor
2,814No known interaction
15 Moderate 2,814 No interaction
Moderate

15 interactions

No interaction 2,814 drugs checked — show the list

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

Showing the 60 most looked-up of 2,814 medications checked with no known interaction — see the full Bugleweed list.

See the full Bugleweed interactions page
See every supplement checked against Ospemifene, 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
Bugleweed monograph › Uses, safety, and every drug interaction in one place Ospemifene supplement interactions › Every supplement checked against Ospemifene, ranked by severity Ospemifene drug information › The full plain-English guide to this medication 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 Bugleweed and Ospemifene Together: Common Questions

Can you take Bugleweed with Ospemifene?
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 Bugleweed and Ospemifene 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 Ospemifene and Bugleweed?

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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.