Evodia + 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.
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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 reportEvodia and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
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. Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 4Why this applies to Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Evodia interacts with.
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.
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 gist with your birth control pill (Estrostep Fe, Loestrin Fe, and similar combos). Evodia appears to speed up a liver enzyme called CYP1A2, and it may rev up other clearance pathways too. In theory, that could make your body break down the estrogen in your pill a bit faster, lowering its levels. If hormone levels drop enough, you might see breakthrough bleeding or spotting, and there's a concern, at least on paper, that protection against pregnancy could weaken.
That said, this is based on lab and animal research, not real-world studies in people taking the pill, so the actual risk in humans isn't clear. Because pregnancy prevention is the stakes here, I'd run it past your pharmacist or doctor before pairing Evodia with your birth control. Don't change anything on your own.
- 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.
- 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
- 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.
- 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
CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS
2 of 4Ethinyl Estradiol, Norethindrone, Ferrous Fumarate also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.
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.
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 in mind: your birth control pill (the ethinyl estradiol and norethindrone part) is itself a mild blocker of the liver enzyme CYP3A4. The interaction on file says that drugs which slow down CYP3A4 can cause evodia to build up in your body. So in this pairing, your pill may push evodia levels a little higher, which could make any of evodia's effects or side effects more noticeable. It does not work the other way, your contraceptive protection isn't being reduced here.
I'll be honest, this is only a theoretical concern based on animal studies, so I wouldn't lose sleep over it. Still, since human data is thin and evodia isn't well studied, it's worth a quick chat with your pharmacist or doctor before adding it.
- 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
CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS
3 of 4Ethinyl Estradiol, Norethindrone, Ferrous Fumarate also falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS.
The evodia constituent rutaecarpine is metabolized by CYP1A2.
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 about this particular pairing: the concern runs in the opposite direction from what you might expect. Your birth control pill (the ethinyl estradiol and norethindrone part) can gently slow down a liver enzyme called CYP1A2. Since Evodia's compound rutaecarpine is broken down by that same enzyme, your pill could theoretically let Evodia build up a bit higher than usual. So it's Evodia that may hang around longer, not your contraceptive.
Keep in mind this is based only on lab and animal research, not real-world patient cases, so it's mostly theoretical. Your pill should still work as intended. Still, since Evodia is poorly studied in people, I'd run it by your pharmacist or doctor before combining the two.
- 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
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
4 of 4Ethinyl Estradiol, Norethindrone, Ferrous Fumarate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that evodia extract inhibits hepatic CYP3A4. This effect has not been reported 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.
This is your birth control pill, where the ethinyl estradiol and norethindrone hormones are cleared from your body partly by a liver enzyme called CYP3A4. In the lab, evodia appears to slow that enzyme down. If that happened in real life, your body might hold onto a little more of the hormones, which could mean more estrogen-type side effects like nausea, breast tenderness, headaches, or bloating.
Here's the important context: this was only seen in test tubes, never in people, so it's a theoretical concern, not a proven one. It's unlikely to change how well the pill prevents pregnancy. Still, since the right hormone level matters here, I'd run any evodia supplement by your pharmacist or doctor first before combining the two.
- 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.
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.
Evodia Also Interacts With Other Medications
Evodia has 950 moderate 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.
Check Another of Your Medications Against Evodia
We haven’t checked that one against Evodia yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Evodia. Pick one to open its full report.
See Every Supplement That Interacts With Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
This page covers Evodia 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
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 Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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:
Where Evodia 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.
#410 of 1,452 supplements looked up here in the last 7 days
#300 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 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.
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.
No drugs match “”.
950 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Aspirin ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Triazolam ›
- Zopiclone ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Miconazole ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Griseofulvin ›
- Ivabradine ›
- Ketoprofen ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Nortriptyline ›
- Rifampin ›
- Sotalol ›
- Sumatriptan Succinate ›
- Testosterone Undecanoate ›
- Aripiprazole ›
Showing 60 of 950 moderate interactions — see all 950 on the Evodia page.
No interaction 1,879 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.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Rosuvastatin ›
- Metoprolol ›
- Isotretinoin ›
- Tirzepatide ›
- Levothyroxine, Liothyronine ›
- Methamphetamine ›
- Docusate ›
- Metformin ›
- Valacyclovir ›
- Hydroxyurea ›
- Semaglutide ›
- Lisdexamfetamine ›
- Amphetamine ›
- Methotrexate ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Pregabalin ›
- Doxycycline ›
- Gabapentin ›
- Dextroamphetamine ›
- Lamotrigine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Bisoprolol ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Atenolol, Chlorthalidone ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Aminophylline, Amobarbital, Ephedrine ›
- Enalapril Maleate ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Canagliflozin, Metformin ›
- Ezetimibe ›
- Cephalexin ›
- Sacubitril, Valsartan ›
- Cyclopentolate ›
- Levetiracetam ›
- Levodopa ›
- Rosiglitazone Maleate ›
- Daunorubicin, Cytarabine ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Bupivacaine, Meloxicam ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Amobarbital, Ephedrine Sulfate ›
- Alginic Acid, Aluminum Hydroxide ›
- Mannitol ›
- Insulin Aspart, Insulin Degludec ›
- Efgartigimod Alfa-fcab ›
- Valsartan ›
- Sodium Bicarbonate (otc Drug) ›
Showing the 60 most looked-up of 1,879 medications checked with no known interaction — see the full Evodia 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
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Ethinyl Estradiol, Norethindrone, Ferrous Fumarate as a medicine that can lower these. This is not an interaction with Evodia — 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 Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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 Evodia and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate Together: Common Questions
Can you take Evodia with Ethinyl Estradiol, Norethindrone, Ferrous Fumarate?
Why are there 4 interactions listed for Evodia and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate?
How serious is the Evodia and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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.