Cannabidiol (cbd) + Norelgestromin, Ethinyl Estradiol
Norelgestromin, Ethinyl Estradiol brand names: Ortho Evra, Evra.
Norelgestromin, Ethinyl Estradiol falls into 3 drug categories that Cannabidiol (cbd) can interact with; the most serious is rated moderate. Cannabidiol may increase levels of drugs metabolized by CYP1A2.
Read the full interaction reportCannabidiol (cbd) and Norelgestromin, Ethinyl Estradiol
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Cannabidiol (cbd) interacts with whole categories of medication. Norelgestromin, Ethinyl Estradiol falls into 3 of those categories, so it can interact with Cannabidiol (cbd) in 3 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 3Why this applies to Norelgestromin, Ethinyl Estradiol
Norelgestromin, Ethinyl Estradiol falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Cannabidiol (cbd) interacts with.
In vitro research shows that cannabidiol inhibits CYP1A2. Furthermore, clinical studies show that cannabidiol may inhibit the metabolism of caffeine, a CYP1A2 substrate. Two pharmacokinetic studies in healthy adults show that taking cannabidiol dosed 640 mg once up to 750 twice daily increases the area under the curve of caffeine. However, results are mixed over whether cannabidiol impacts peak serum levels of caffeine.
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..
Here's the honest picture with your Ortho Evra patch and CBD. The interaction on file is about CBD slowing down an enzyme called CYP1A2. The thing is, your patch (norelgestromin plus ethinyl estradiol) is mainly broken down by other liver pathways, not CYP1A2, so this particular concern is more of a loose category match than a strong, drug-specific worry. The clinical proof we have is really about caffeine, not birth control.
That said, CBD can nudge several liver enzymes, and high supplement doses behave differently than a little hemp product. If estrogen levels did creep up, you might notice nausea, breast tenderness, or headaches. I wouldn't change anything on your own. Just run your CBD product past your pharmacist or doctor so they can check the dose and brand.
- Yamaori S, Kushihara M, Yamamoto I, Watanabe K. Characterization of major phytocannabinoids, cannabidiol and cannabinol, as isoform-selective potent inhibitors of human CYP1 enzymes. Biochem Pharmacol 2010;79(11):1691-8.
- Thai C, Tayo B, Critchley D. A Phase 1 Open-Label, Fixed-Sequence Pharmacokinetic Drug Interaction Trial to Investigate the Effect of Cannabidiol on the CYP1A2 Probe Caffeine in Healthy Subjects. Clin Pharmacol Drug Dev. 2021. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS
2 of 3Norelgestromin, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.
Cannabidiol is a substrate of CYP3A4 enzymes. Theoretically, drugs that inhibit CYP3A4 enzymes might increase levels of cannabidiol, increasing its effects and adverse effects.
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 thing to keep straight with your Ortho Evra patch (norelgestromin and ethinyl estradiol) and CBD: in this case, it's the birth control side that may gently slow down the CBD, not the other way around. The hormones in your patch can act as a mild brake (CYP3A4 inhibitor) on the enzyme that clears CBD, so CBD could build up a bit and you might notice more of its usual effects, like drowsiness, dry mouth, loose stools, or feeling more tired than expected.
This is a theoretical concern based on how the two are processed, not something proven in real patients, so I wouldn't lose sleep over it. Your patch should still work fine for preventing pregnancy. If you start CBD, just mention it to your pharmacist so we can watch how you feel.
- Product information for Marinol. AbbVie. North Chicago, IL 60064. August 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Norelgestromin, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro and animal research shows that cannabidiol inhibits CYP3A4. In human studies and case reports, cannabidiol has been associated with an increase in plasma levels of the CYP3A4 substrates zonisamide, tacrolimus, everolimus, citalopram, midazolam, and methadone.
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..
Your Ortho Evra patch delivers two active hormones (norelgestromin and ethinyl estradiol), and your liver clears the estrogen part using an enzyme called CYP3A4. CBD can gently block that enzyme. In theory, that could let a bit more estrogen build up in your system, which might mean more of the usual estrogen-type side effects like nausea, breast tenderness, headaches, bloating, or mood changes.
The good news: this isn't a prodrug situation, so your birth control should still work to prevent pregnancy. The effect here is usually mild, and high-quality studies mostly looked at other CYP3A4 drugs, not this exact patch. Still, if you're using CBD regularly (not just once in a while), mention it to your pharmacist or doctor so they can keep an eye on how you feel.
- Yamaori S, Ebisawa J, Okushima Y, et al. Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety. Life Sci 2011;88(15-16):730-6. PubMed
- Harvey DJ. Absorption, distribution, and biotransformation of the cannabinoids. Marijuana and Medicine. 1999;91-103. DOI
- Bornheim LM, Everhart ET, Li J, Correia MA. Characterization of cannabidiol-mediated cytochrome P450 inactivation. Biochem Pharmacol 1993;45(6):1323-31. PubMed
- Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP; UAB CBD Program. Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia. 2017 Sep;58(9):1586-92. PubMed
- Leino AD, Emoto C, Fukuda T, Privitera M, Vinks AA, Alloway RR. Evidence of a clinically significant drug-drug interaction between cannabidiol and tacrolimus. Am J Transplant. 2019;19(10):2944-2948. PubMed
- Wiemer-Kruel A, Stiller B, Bast T. Cannabidiol Interacts Significantly with Everolimus-Report of a Patient with Tuberous Sclerosis Complex. Neuropediatrics. 2019. PubMed
- Madden K, Tanco K, Bruera E. Clinically Significant Drug-Drug Interaction Between Methadone and Cannabidiol. Pediatrics. 2020;e20193256. PubMed
- Anderson LL, Doohan PT, Oldfield L, et al. Citalopram and Cannabidiol: In Vitro and In Vivo Evidence of Pharmacokinetic Interactions Relevant to the Treatment of Anxiety Disorders in Young People. J Clin Psychopharmacol. 2021. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Treyer A, Reinhardt JK, Eigenmann DE, Oufir M, Hamburger M. Phytochemical comparison of medicinal cannabis extracts and study of their CYP-mediated interactions with coumarinic oral anticoagulants. Med Cannabis Cannabinoids. 2023;6(1):21-31. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
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.
Cannabidiol (cbd) Also Interacts With Other Medications
Cannabidiol (cbd) has 1,050 moderate known drug interactions in our database — the Norelgestromin, 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 Cannabidiol (cbd)
We haven’t checked that one against Cannabidiol (cbd) yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Cannabidiol (cbd). Pick one to open its full report.
See Every Supplement That Interacts With Norelgestromin, Ethinyl Estradiol
This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Norelgestromin, 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 Norelgestromin, Ethinyl Estradiol page
“St. John's wort is the first entry to check if you wear the Ortho Evra patch (norelgestromin and ethinyl estradiol).”
Reviewed by 2 · Jul 18, 2026
Where Cannabidiol (cbd) and Norelgestromin, 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.
#406 of 1,452 supplements looked up here in the last 7 days
#1,082 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 Cannabidiol (cbd)
What is Cannabidiol (cbd)?
- Anxiety and stress
- Sleep problems
- Chronic pain
- Certain seizure disorders
- Inflammation
CBD is a compound from the cannabis (hemp) plant that does not cause a 'high.' It has strong evidence only for certain rare seizure disorders (as a prescription drug), while most other popular uses are still backed by limited or early research. Product quality varies a lot, so talk with your pharmacist or doctor before using it, especially if you take other medicines.
Other Drugs & Cannabidiol (cbd)
Browse every other medication we’ve checked against Cannabidiol (cbd) — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,050 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Diphenhydramine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Griseofulvin ›
- Ivabradine ›
Showing 60 of 1,050 moderate interactions — see all 1,050 on the Cannabidiol (cbd) page.
No interaction 1,779 drugs checked — show the list
We also checked Cannabidiol (cbd) against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Tirzepatide ›
- Docusate ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Semaglutide ›
- Metformin ›
- Methotrexate ›
- Lisinopril ›
- Amoxicillin ›
- Doxycycline ›
- Acyclovir ›
- Azithromycin ›
- Levothyroxine, Liothyronine ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Cephalexin ›
- Cyclopentolate ›
- Acetylsalicylic Acid ›
- Ezetimibe ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Mannitol ›
- Spironolactone ›
- Levodopa ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Mitomycin ›
- Atenolol ›
- Insulin Degludec, Liraglutide ›
- Canagliflozin, Metformin ›
- Minoxidil ›
- Daptomycin ›
- Cefaclor ›
- Magnesium Hydroxide (otc Drug) ›
- Acenocoumarol ›
- Acarbose ›
- Hydroxychloroquine ›
- Alginic Acid, Aluminum Hydroxide ›
- Hydrochlorothiazide ›
- Pegunigalsidase Alfa-iwxj ›
- Factor 7a ›
- Hexobarbitone ›
- Bentoquatam ›
- Pizotifen ›
- Insulin Human, Sodium Chloride ›
- Flutemetamol F-18 ›
- Casanthranol, Docusate ›
- Birth Control Pills ›
- Succinylcholine ›
- Triptorelin ›
- Vancomycin ›
- Acetohexamide ›
- Alglucosidase Alpha ›
Showing the 60 most looked-up of 1,779 medications checked with no known interaction — see the full Cannabidiol (cbd) 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
Norelgestromin, Ethinyl Estradiol Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Norelgestromin, Ethinyl Estradiol as a medicine that can lower these. This is not an interaction with Cannabidiol (cbd) — 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 Norelgestromin, 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 Cannabidiol (cbd) and Norelgestromin, Ethinyl Estradiol Together: Common Questions
Can you take Cannabidiol (cbd) with Norelgestromin, Ethinyl Estradiol?
Why are there 3 interactions listed for Cannabidiol (cbd) and Norelgestromin, Ethinyl Estradiol?
How serious is the Cannabidiol (cbd) and Norelgestromin, Ethinyl Estradiol interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Norelgestromin, Ethinyl Estradiol and Cannabidiol (cbd)?
Our pharmacists answer your medication & supplement questions — free.
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.