Bulbine Natalensis + Desogestrel, Ethinyl Estradiol
Desogestrel, Ethinyl Estradiol brand names: Ortho-Cept 28, Ortho-Cept 21, Marvelon 21, Marvelon 28, Desogen, and others.
Desogestrel, Ethinyl Estradiol falls into 4 drug categories that Bulbine Natalensis can interact with; the most serious is rated moderate. Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP1A2 substrates.
Read the full interaction reportBulbine Natalensis and Desogestrel, Ethinyl Estradiol
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Bulbine Natalensis interacts with whole categories of medication. Desogestrel, Ethinyl Estradiol falls into 4 of those categories, so it can interact with Bulbine Natalensis in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 4Why this applies to Desogestrel, Ethinyl Estradiol
Desogestrel, Ethinyl Estradiol falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Bulbine Natalensis interacts with.
In vitro research shows that Bulbine natalensis stem extract slightly induces CYP1A2 mRNA expression and enzyme activity. Theoretically, this may increase the metabolism of CYP1A2 substrates; however, this has not been studied in humans.
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.
Here's the gist for your birth control pill (desogestrel plus ethinyl estradiol). In lab dishes, Bulbine natalensis seemed to slightly speed up an enzyme called CYP1A2, which is one of the helpers that breaks down estrogen. If that nudge happened in real people, it could lower the hormone levels a bit. With a contraceptive, even small drops in hormone levels are worth taking seriously, because the worry would be reduced reliability (think breakthrough bleeding or, in theory, less protection against pregnancy).
That said, this is only a test-tube finding, never confirmed in humans, so the real-world risk is unknown. Given the safety questions around this supplement anyway, please check with your pharmacist or doctor before combining the two.
- Husain I, Manda V, Alhusban M, et al. Modulation of CYP3A4 and CYP2C9 activity by Bulbine natalensis and its constituents: An assessment of HDI risk of B. natalensis containing supplements. Phytomedicine 2021;81:153416. PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
2 of 4Desogestrel, Ethinyl Estradiol also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
In vitro research shows that Bulbine natalensis stem extract induces CYP2C9 mRNA expression and enzyme activity. Theoretically, this may increase the metabolism of CYP2C9 substrates; however, this has not been studied in humans.
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.
Here's the gist for your birth control pill (desogestrel with ethinyl estradiol). In lab dishes, Bulbine natalensis seemed to speed up an enzyme called CYP2C9, which is one of the pathways that helps clear hormones from your body. If that sped-up clearance also happened in people, the worry is that your pill's hormone levels could run a little lower than intended. With a contraceptive, that theoretically means a bit less reliable protection against pregnancy, and possibly more breakthrough spotting or irregular bleeding.
I want to be honest, though: this is only a test-tube finding and has never been confirmed in humans, so it's far from proven. Still, since pregnancy prevention is the goal, I'd run this by your pharmacist or doctor before combining the two.
- Husain I, Dale OR, Manda V, et al. Bulbine natalensis (currently Bulbine latifolia) and select bulbine knipholones modulate the activity of AhR, CYP1A2, CYP2B6, and P-gp. Planta Med 2022;88(12):975-984. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Desogestrel, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that Bulbine natalensis stem extract induces CYP3A4 mRNA expression and enzyme activity. Theoretically, this may increase the metabolism of CYP3A4 substrates, but this has not been studied in humans.
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.
Here's the concern with your birth control pill (Desogen, Marvelon, Ortho-Cept). The hormones in it, including the ethinyl estradiol, are partly cleared by a liver enzyme called CYP3A4. In lab studies, Bulbine natalensis appeared to speed up that enzyme. In theory, a faster enzyme could clear the hormones out of your body more quickly, which might lower the pill's reliability and lead to breakthrough bleeding or, in the worst case, an unintended pregnancy.
I want to be honest about how soft this evidence is. This comes only from test-tube and animal work, not from people, so we truly don't know if it matters in real life. Since reduced contraceptive protection is a serious gamble, I'd talk with your pharmacist or doctor before pairing these, and consider a backup method while you do.
- Husain I, Dale OR, Manda V, et al. Bulbine natalensis (currently Bulbine latifolia) and select bulbine knipholones modulate the activity of AhR, CYP1A2, CYP2B6, and P-gp. Planta Med 2022;88(12):975-984. PubMed
P-GLYCOPROTEIN SUBSTRATES
4 of 4Desogestrel, Ethinyl Estradiol also falls under P-GLYCOPROTEIN SUBSTRATES.
In vitro research shows that Bulbine natalensis stem extract induces p-glycoprotein mRNA expression; however, effects on transporter expression were not evaluated.
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.
Here's the situation with your birth control pill (Desogestrel and Ethinyl Estradiol) and Bulbine natalensis. This is very much a theoretical concern. The only evidence comes from lab dish studies, where Bulbine extract seemed to nudge up a transporter called p-glycoprotein. We don't have any human data showing this actually happens in real life.
If anything, ramping up that transporter could push some hormone out a little faster, which in theory might slightly weaken the pill's reliability. With birth control, even a small dip in effectiveness matters, since the whole point is preventing pregnancy. Honestly, the bigger worry with Bulbine is its possible liver and kidney effects in animal studies. Before mixing the two, please check with your pharmacist or doctor first.
- Husain I, Manda V, Alhusban M, et al. Modulation of CYP3A4 and CYP2C9 activity by Bulbine natalensis and its constituents: An assessment of HDI risk of B. natalensis containing supplements. Phytomedicine 2021;81:153416. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Bulbine Natalensis Also Interacts With Other Medications
Bulbine Natalensis has 918 moderate known drug interactions in our database — the Desogestrel, Ethinyl Estradiol one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Bulbine Natalensis
We haven’t checked that one against Bulbine Natalensis yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Bulbine Natalensis. Pick one to open its full report.
See Every Supplement That Interacts With Desogestrel, Ethinyl Estradiol
This page covers Bulbine Natalensis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Desogestrel, Ethinyl Estradiol page lists 246 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 · 201 moderate · 39 minor.
From our pharmacist’s overview on the Desogestrel, Ethinyl Estradiol page
“St. John's Wort is the supplement I would flag first for anyone on desogestrel with ethinyl estradiol (Desogen, Ortho-Cept, Marvelon).”
Reviewed by 2 · Jul 18, 2026
Taking Bulbine Natalensis as Part of a Dietary Supplement Product? Check It for Interactions
We hold 51 real supplement products containing Bulbine Natalensis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bulbine Natalensis. Your product may carry other ingredients that interact with Desogestrel, Ethinyl Estradiol too, on top of Bulbine Natalensis — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Bulbine Natalensis and Desogestrel, 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.
#465 of 1,452 supplements looked up here in the last 7 days
#372 of 2,830 medications looked up here in the last 7 days
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.
About Bulbine Natalensis
What is Bulbine Natalensis?
- Boosting testosterone
- Improving libido
- Muscle building and athletic performance
- General male vitality
Bulbine natalensis is a South African plant marketed mainly as a testosterone-boosting and libido supplement, but the human evidence is essentially absent and most claims come from animal studies. Animal research has also raised concerns about possible liver and kidney harm at higher doses, so caution is warranted. Talk to your pharmacist or doctor before trying it.
Other Drugs & Bulbine Natalensis
Browse every other medication we’ve checked against Bulbine Natalensis — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
918 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ivermectin ›
- Ketoprofen ›
- Lofepramine ›
Showing 60 of 918 moderate interactions — see all 918 on the Bulbine Natalensis page.
No interaction 1,911 drugs checked — show the list
We also checked Bulbine Natalensis against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Rosuvastatin ›
- Escitalopram ›
- Metoprolol ›
- Isotretinoin ›
- Tirzepatide ›
- Methamphetamine ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Metformin ›
- Sumatriptan ›
- Semaglutide ›
- Lisdexamfetamine ›
- Levothyroxine, Liothyronine ›
- Amphetamine ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Bupropion ›
- Azithromycin ›
- Pregabalin ›
- Gabapentin ›
- Dextroamphetamine ›
- Lamotrigine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Bisoprolol ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Insulin Degludec, Liraglutide ›
- Ezetimibe ›
- Cephalexin ›
- Cyclopentolate ›
- Atenolol, Chlorthalidone ›
- Thyroid Hormone ›
- Levetiracetam ›
- Carbidopa, Levodopa ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Mannitol ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Levodopa ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Enalapril Maleate ›
- Canagliflozin, Metformin ›
- Acarbose ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Spironolactone ›
- Ephedrine, Phenobarbital, Theophylline ›
- Alginic Acid, Aluminum Hydroxide ›
- Amobarbital, Ephedrine Sulfate ›
- Venlafaxine ›
- Mitomycin ›
- Roxithromycin ›
- Atenolol ›
- Charcoal (otc Drug) ›
Showing the 60 most looked-up of 1,911 medications checked with no known interaction — see the full Bulbine Natalensis list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Desogestrel, Ethinyl Estradiol Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Desogestrel, Ethinyl Estradiol as a medicine that can lower these. This is not an interaction with Bulbine Natalensis — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Desogestrel, Ethinyl Estradiol nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Bulbine Natalensis and Desogestrel, Ethinyl Estradiol Together: Common Questions
Can you take Bulbine Natalensis with Desogestrel, Ethinyl Estradiol?
Why are there 4 interactions listed for Bulbine Natalensis and Desogestrel, Ethinyl Estradiol?
How serious is the Bulbine Natalensis and Desogestrel, Ethinyl Estradiol interaction?
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.