Drug & supplement interaction

Evodia + Ethiny Estradiol, Levonorgestrel

Ethiny Estradiol, Levonorgestrel brand names: Logynon, Microgynon 30 ED.

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

Ethiny Estradiol, Levonorgestrel falls into 4 drug categories that Evodia can interact with; the most serious is rated moderate. Evodia might reduce the levels and clinical effects of CYP1A2 substrates through induction of CYP1A2.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Evodia and Ethiny Estradiol, Levonorgestrel

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Evodia interacts with whole categories of medication. Ethiny Estradiol, Levonorgestrel falls into 4 of those categories, so it can interact with Evodia in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 4

Why this applies to Ethiny Estradiol, Levonorgestrel

Ethiny Estradiol, Levonorgestrel falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Evodia interacts with.

Evodia might reduce the levels and clinical effects of CYP1A2 substrates through induction of CYP1A2.
Evodia extract and the evodia constituent rutaecarpine induce hepatic CYP1A2 enzyme activity. Evodia decreases levels of theophylline and caffeine, CYP1A2 substrates, by about 70% in animal models.
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 short version: Evodia appears to speed up a liver enzyme called CYP1A2, which is one of the pathways your body uses to clear the estrogen part (ethinyl estradiol) of your birth control pill. If that enzyme runs faster, the hormones could be broken down a bit quicker, which in theory might lower their levels and make the pill less reliable. With a contraceptive, the real worry isn't a side effect so much as reduced protection against pregnancy, plus possible breakthrough spotting or bleeding.

I want to be honest about the evidence here: this is based mostly on lab and animal studies, not solid human data, so it's more of a caution than a proven problem. Still, since an unplanned pregnancy is a big deal, please check with your pharmacist or doctor before combining the two, and don't change your pill on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ueng YF, Tsai TH, Don MJ, et al. Alteration of the pharmacokinetics of theophylline by rutaecarpine, an alkaloid of the medicinal herb Evodia rutaecarpa, in rats. J Pharm Pharmacol 2005;57:227-32.
  2. Ueng YF, Jan WC, Lin LC, et al. The alkaloid rutaecarpine is a selective inhibitor of cytochrome P450 1A in mouse and human liver microsomes. Drug Metab Dispos 2002;30:349-53. PubMed
  3. Tsai TH, Chang CH, Lin LC. Effects of Evodia rutaecarpa and rutaecarpine on the pharmacokinetics of caffeine in rats. Planta Med 2005;71:640-5.
  4. Lee SK, Kim NH, Lee J, et al. Induction of cytochrome P450s by rutaecarpine and metabolism of rutaecarpine by cytochrome P450s. Planta Med 2004;70:753-7. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

2 of 4

Ethiny Estradiol, Levonorgestrel also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of evodia.
Animal research shows that concomitant administration of ketoconazole, a known CYP3A4 inhibitor, with the alkaloid constituents of evodia significantly increases the area under the curve (AUC), maximum concentration (Cmax), and half-life of these constituents.
Severity Moderate 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 is the thing to keep in mind: your birth control pill (the estrogen plus levonorgestrel in Microgynon or Logynon) can gently slow down the same liver pathway, CYP3A4, that helps break down evodia. So in theory, taking them together could let the evodia compounds build up a bit higher and linger longer in your body. This works in the direction of more evodia effect, not less.

Honestly, though, this is based only on lab and animal studies, so it is theoretical and not well proven in people. The bigger practical concern is simply that evodia itself is poorly studied and not recommended in pregnancy or breastfeeding. Before adding it, please run it past your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Zhang W, Guo J, Wang D, et al. Effect of CYP3A inducer/inhibitor on pharmacokinetics of five alkaloids in Evodiae Fructus. Chem Biol Interact 2020;327:109146. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

3 of 4

Ethiny Estradiol, Levonorgestrel also falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS.

Theoretically, drugs that inhibit CYP1A2 might increase the levels and clinical effects of evodia.
The evodia constituent rutaecarpine is metabolized by CYP1A2.
Severity Moderate 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 thing to keep straight with your birth control pill (the ethinyl estradiol and levonorgestrel combo in Logynon or Microgynon): in this interaction, your medicine is actually the player affecting Evodia, not the other way around. Estrogens like ethinyl estradiol can mildly block a liver enzyme called CYP1A2, which is the same enzyme that breaks down one of Evodia's compounds (rutaecarpine).

In plain terms, your pill might cause a bit more Evodia to build up in your body. This is purely theoretical and comes only from lab and animal studies, so I wouldn't lose sleep over it. Your pill itself should keep working normally. Still, since Evodia is poorly studied, it's worth running it by your pharmacist or doctor before combining the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lee SK, Kim NH, Lee J, et al. Induction of cytochrome P450s by rutaecarpine and metabolism of rutaecarpine by cytochrome P450s. Planta Med 2004;70:753-7. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

4 of 4

Ethiny Estradiol, Levonorgestrel also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, evodia might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that evodia extract inhibits hepatic CYP3A4. This effect has not been reported in humans.
Severity Moderate 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

Your birth control pill combines ethinyl estradiol and levonorgestrel, and the liver uses an enzyme called CYP3A4 to help clear these hormones. In lab dish studies, evodia appears to slow that enzyme down. If that held true in people, your body might clear the hormones a little more slowly, so their levels could edge up. In practice, that might mean a bit more of the usual hormone-related effects, like nausea, breast tenderness, bloating, or spotting.

Here's the honest part: this is only seen in test tubes, never confirmed in real people, so it's theoretical. I wouldn't lose sleep over it, but since this pill is important for preventing pregnancy, please run it by your pharmacist or doctor before adding evodia.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Iwata H, Tezuka Y, Kadota S, et al. Mechanism-based inactivation of human liver microsomal CYP3A4 by rutaecarpine and limonin from Evodia fruit extract. Drug Metab Pharmacokinet 2005;20:34-45. 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

Evodia Also Interacts With Other Medications

Evodia has 949 moderate known drug interactions in our database — the Ethiny Estradiol, Levonorgestrel one above is among them. If you take anything else, check it against the full list below.

Moderate 949 No known interaction 1,881 (incl. Ethiny Estradiol, Levonorgestrel)
Taking anything else?

Check Another of Your Medications Against Evodia

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

Everything else you take

See Every Supplement That Interacts With Ethiny Estradiol, Levonorgestrel

This page covers Evodia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethiny Estradiol, Levonorgestrel page lists 214 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), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 171 moderate · 40 minor.

From our pharmacist’s overview on the Ethiny Estradiol, Levonorgestrel page

“A supplement that lowers hormone levels in a birth control pill can mean an unplanned pregnancy, and St. John's wort can do exactly that to ethinyl estradiol and levonorgestrel (Logynon, Microgynon 30 ED) by speeding up how your liver clears the hormones.”

Reviewed by 2 · Jul 18, 2026

Open the Ethiny Estradiol, Levonorgestrel interaction page

One more smart check

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

We hold 182 real supplement products containing Evodia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Evodia. Your product may carry other ingredients that interact with Ethiny Estradiol, Levonorgestrel too, on top of Evodia — 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 Evodia and Ethiny Estradiol, Levonorgestrel 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 Evodia
Top half

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

29 days ago today
Medication Ethiny Estradiol, Levonorgestrel
Top 5%

#124 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 Evodia

What is Evodia?

  • Digestive upset and nausea
  • Headaches
  • Menstrual cramps
  • Abdominal pain
  • Diarrhea

Evodia is a fruit used in traditional Chinese medicine, most often for digestive complaints, headaches, and menstrual pain. Human evidence for these uses is very limited, and it is mostly studied in laboratory and animal research. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Evodia monograph & all interactions
Keep checking

Other Drugs & Evodia

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

0Major
949Moderate
0Minor
1,880No known interaction
949 Moderate 1,880 No interaction
Moderate

949 interactions

Showing 60 of 949 moderate interactions — see all 949 on the Evodia page.

No interaction 1,880 drugs checked — show the list

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

Showing the 60 most looked-up of 1,880 medications checked with no known interaction — see the full Evodia list.

See the full Evodia interactions page
See every supplement checked against Ethiny Estradiol, Levonorgestrel, 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
Evodia monograph › Uses, safety, and every drug interaction in one place Ethiny Estradiol, Levonorgestrel supplement interactions › Every supplement checked against Ethiny Estradiol, Levonorgestrel, ranked by severity 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 Evodia and Ethiny Estradiol, Levonorgestrel Together: Common Questions

Can you take Evodia with Ethiny Estradiol, Levonorgestrel?
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 4 interactions listed for Evodia and Ethiny Estradiol, Levonorgestrel?
Ethiny Estradiol, Levonorgestrel belongs to more than one drug category, and Evodia 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 Evodia and Ethiny Estradiol, Levonorgestrel 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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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.