Drug & supplement interaction

Evening Primrose + Tamoxifen Citrate

Tamoxifen Citrate brand names: Nolvadex, Soltamox.

Minor Interaction
The bottom line Minor

Evening Primrose has a minor interaction with Tamoxifen Citrate. Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.

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

Evening Primrose and Tamoxifen Citrate

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

Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

Why this applies to Tamoxifen Citrate

Tamoxifen Citrate falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Evening Primrose interacts with.

Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.
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 the gist for tamoxifen and evening primrose oil. Your body uses an enzyme called CYP2C9 to help process tamoxifen. Lab (test tube) studies suggest a fatty acid in evening primrose oil might gently slow that enzyme. In theory, that could let a bit more tamoxifen build up in your system, which might mean slightly stronger effects or side effects like hot flashes, leg swelling, or nausea.

I want to be honest with you though: this is a theoretical concern based only on lab data, and it's rated as minor. We have no real-world reports of trouble. Tamoxifen is far too important a medicine to second-guess on your own, so don't start or stop anything. Just let your oncologist or pharmacist know before adding evening primrose.

References
  1. Zou L, Harkey MR, and Henderson GL. Effects of herbal components on cDNA-expressed cytochrome P450 enzyme catalytic activity. Life Sci 8-16-2002;71(13):1579-1589. 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

Evening Primrose Also Interacts With Other Medications

Evening Primrose has 148 moderate, 84 minor known drug interactions in our database — the Tamoxifen Citrate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Evening Primrose

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

From our Q&A

Questions About Evening Primrose or Tamoxifen Citrate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Evening Primrose or Tamoxifen Citrate, 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 Tamoxifen Citrate

This page covers Evening Primrose only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tamoxifen Citrate page lists 210 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 11 major · 166 moderate · 33 minor.

From our pharmacist’s overview on the Tamoxifen Citrate page

“Tamoxifen (Nolvadex, Soltamox) often stands between a breast cancer patient and a recurrence, so the stakes on this page run higher than usual. Eleven of the 210 supplements and herbs on file carry a major rating, and those eleven deserve your attention ahead of everything else.”

Reviewed by 2 · Jul 18, 2026

Open the Tamoxifen Citrate interaction page

One more smart check

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

We hold 98 real supplement products containing Evening Primrose, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Evening Primrose. Your product may carry other ingredients that interact with Tamoxifen Citrate too, on top of Evening Primrose — 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 Evening Primrose and Tamoxifen Citrate 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 Evening Primrose
Top half

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

29 days ago today
Medication Tamoxifen Citrate
Top 10%

#282 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 Evening Primrose

What is Evening Primrose?

Evening Primrose
  • Eczema and skin health
  • PMS symptoms
  • Breast pain (mastalgia)
  • Menopause symptoms
  • Inflammation
  • Diabetic nerve pain

Evening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and breast pain. The evidence behind most of these uses is mixed or weak, and it is not proven to be a reliable treatment for any condition. It is generally well tolerated for short-term use, but talk to your pharmacist or doctor before starting it, especially if you are pregnant or have a bleeding disorder.

Read the full Evening Primrose monograph & all interactions
Medication

About Tamoxifen

What Is Tamoxifen Used For?

Brand names: Nolvadex, Soltamox

Tamoxifen is used to treat estrogen receptor-positive metastatic breast cancer in both women and men, and as follow-up (adjuvant) therapy after surgery for early-stage breast cancer in women. It also reduces the occurrence of cancer in the opposite breast when used as adjuvant therapy.

In women with ductal carcinoma in situ (DCIS — an early, non-invasive breast change) following surgery and radiation, tamoxifen lowers the risk of developing invasive breast cancer. It is also approved to reduce the risk of breast cancer in women who are at high risk but have not yet been diagnosed. Both Tamoxifen Citrate tablets and Soltamox oral solution share these indications.

See full Tamoxifen drug information
Keep checking

Other Drugs & Evening Primrose

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

0Major
148Moderate
84Minor
2,597No known interaction
Moderate

148 interactions

Showing 60 of 148 moderate interactions — see all 148 on the Evening Primrose page.

Minor

84 interactions

Showing 60 of 84 minor interactions — see all 84 on the Evening Primrose page.

No interaction 2,597 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 Evening Primrose and Tamoxifen Citrate Together: Common Questions

Can you take Evening Primrose with Tamoxifen Citrate?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Evening Primrose and Tamoxifen Citrate interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tamoxifen Citrate and Evening Primrose?

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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.