Drug & supplement interaction

Caffeine + Ethinyl Estradiol, Norethindrone, Ferrous Fumarate

Ethinyl Estradiol, Norethindrone, Ferrous Fumarate brand names: Estrostep Fe, Loestrin Fe, Microgestin FE, Junel Fe 1.5/30, Loestrin Fe 1.5/30, and others.

Moderate Interaction
The bottom line Moderate

Ethinyl Estradiol, Norethindrone, Ferrous Fumarate falls into 3 drug categories that Caffeine can interact with; the most serious is rated moderate. Theoretically, estrogens might increase the levels and adverse effects of caffeine.

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

Caffeine and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate

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

Why Are There 3 Interactions?

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

Moderate

ESTROGENS

1 of 3

Why this applies to Ethinyl Estradiol, Norethindrone, Ferrous Fumarate

Ethinyl Estradiol, Norethindrone, Ferrous Fumarate falls under ESTROGENS — the group Caffeine interacts with.

Theoretically, estrogens might increase the levels and adverse effects of 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 a little twist worth knowing about your birth control pill. The estrogen in this combination (ethinyl estradiol) can slow down how your body breaks down caffeine. That means the coffee, tea, or energy drinks you have may stick around longer and hit a bit harder than they would otherwise.

In real life, this can show up as feeling more jittery, a racing or pounding heartbeat, trouble sleeping, or just feeling wired after your usual cup. Your pill itself works the same either way, so this is really about the caffeine building up, not your contraception failing. If you notice these effects, simply easing back on caffeine usually does the trick. Chat with your pharmacist if you're unsure how much is right for you.

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. Balogh, A., Klinger, G., Henschel, L., Borner, A., Vollanth, R., and Kuhnz, W. Influence of ethinylestradiol-containing combination oral contraceptives with gestodene or levonorgestrel on caffeine elimination. Eur.J.Clin.Pharmacol. 1995;48(2):161-166. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

2 of 3

Ethinyl Estradiol, Norethindrone, Ferrous Fumarate also falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS.

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Caffeine is metabolized by CYP1A2. Theoretically, drugs that inhibit CYP1A2 may decrease the rate of caffeine clearance and increase caffeine levels.
Severity Minor 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 something a lot of people don't realize about birth control pills like your Loestrin or Microgestin Fe. The estrogen part (ethinyl estradiol) can gently slow down the liver enzyme called CYP1A2, which is the same enzyme that clears caffeine out of your body. So when you're on the pill, caffeine may hang around a bit longer than usual.

In plain terms, your morning coffee or energy drink might hit a little harder, and you could feel more jittery, wired, anxious, or have trouble sleeping. The good news is this is rated minor, and it's only based on theory and lab work, not strong real-world evidence. You don't need to give up your coffee. Just pay attention to how you feel, and if caffeine seems stronger than before, ease back a cup or chat with your pharmacist.

References
  1. 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
  2. Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. PubMed
Minor

CONTRACEPTIVE DRUGS

3 of 3

Ethinyl Estradiol, Norethindrone, Ferrous Fumarate also falls under CONTRACEPTIVE DRUGS.

Theoretically, contraceptive drugs might increase the levels and adverse effects of caffeine.
Oral contraceptives decrease the rate of caffeine clearance by 40-65%.
Severity Minor Likelihood Possible Evidence B

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 gist with your birth control pill (the Loestrin/Microgestin Fe type combos): it doesn't affect how the pill works, but it can change how your body handles caffeine. The estrogen in these pills slows down the liver enzyme that clears caffeine, by roughly 40 to 65 percent. That means a cup of coffee may stick around longer and hit a little harder than it used to.

In real life this usually just means more of the familiar caffeine stuff: feeling jittery, a racing or pounding heart, or trouble falling asleep if you have coffee, tea, or energy drinks later in the day. It's rated minor, so most people simply notice they're more sensitive and ease back on caffeine. If your heart races or sleep suffers, chat with your pharmacist or doctor.

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

Caffeine Also Interacts With Other Medications

Caffeine has 8 major, 482 moderate, 164 minor known drug interactions in our database — the Ethinyl Estradiol, Norethindrone, Ferrous Fumarate one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Caffeine

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

From our Q&A

Questions About Caffeine or Ethinyl Estradiol, Norethindrone, Ferrous Fumarate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Caffeine or Ethinyl Estradiol, Norethindrone, Ferrous Fumarate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ethinyl Estradiol, Norethindrone, Ferrous Fumarate

This page covers Caffeine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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, Ferrous Fumarate page

“If you take a birth control pill that combines ethinyl estradiol, norethindrone, and iron (Loestrin Fe, Estrostep Fe, Microgestin Fe), a few supplements can genuinely undermine it, and I want you to know which ones first. Six of the 240 ingredients on file carry a major rating.”

Reviewed by 2 · Jul 18, 2026

Open the Ethinyl Estradiol, Norethindrone, Ferrous Fumarate interaction page

One more smart check

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

We hold 6,775 real supplement products containing Caffeine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Caffeine. Your product may carry other ingredients that interact with Ethinyl Estradiol, Norethindrone, Ferrous Fumarate too, on top of Caffeine — 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 Caffeine and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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 Caffeine
Top 5%

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

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

#389 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 Caffeine

What is Caffeine?

  • Mental alertness and reducing fatigue
  • Improving athletic performance
  • Headache and migraine relief
  • Boosting focus and concentration
  • Weight loss aid

Caffeine is a natural stimulant found in coffee, tea, and many other plants and products. In moderate amounts it can boost alertness and reduce tiredness for most healthy adults, but too much can cause jitteriness, a racing heart, and sleep problems. Pregnant women and people with heart conditions or anxiety should be especially careful and check with a doctor or pharmacist.

Read the full Caffeine monograph & all interactions
Keep checking

Other Drugs & Caffeine

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

8Major
482Moderate
164Minor
2,175No known interaction
Major

8 interactions

Moderate

482 interactions

Showing 60 of 482 moderate interactions — see all 482 on the Caffeine page.

Minor

164 interactions

Showing 60 of 164 minor interactions — see all 164 on the Caffeine page.

No interaction 2,175 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

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Pharmacist Counseling Corner

Taking Caffeine and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate Together: Common Questions

Can you take Caffeine with Ethinyl Estradiol, Norethindrone, Ferrous Fumarate?
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 Caffeine and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate?
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate belongs to more than one drug category, and Caffeine 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 Caffeine and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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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