Drug & supplement interaction

Fennel + Ethinyl estradiol, Levonogestrel

Ethinyl estradiol, Levonogestrel brand name: Lybrel.

Moderate Interaction
The bottom line Moderate

Ethinyl estradiol, Levonogestrel falls into 3 drug categories that Fennel can interact with; the most serious is rated moderate. Theoretically, taking large amounts of fennel might decrease the effects of contraceptive drugs due to competition for estrogen receptors.

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

Fennel and Ethinyl estradiol, Levonogestrel

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

Why Are There 3 Interactions?

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

Moderate

CONTRACEPTIVE DRUGS

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Why this applies to Ethinyl estradiol, Levonogestrel

Ethinyl estradiol, Levonogestrel falls under CONTRACEPTIVE DRUGS — the group Fennel interacts with.

Theoretically, taking large amounts of fennel might decrease the effects of contraceptive drugs due to competition for estrogen receptors.

Some constituents of fennel have estrogenic activity.
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 gist with your birth control pill (Lybrel, which combines ethinyl estradiol and levonorgestrel). Fennel contains plant compounds that act a little like estrogen in the body. The concern on file is purely theoretical: in very large, concentrated amounts, fennel might compete at estrogen receptors and, in theory, nudge down how well your pill prevents pregnancy.

I want to be honest, this is based on lab pharmacology, not on real cases of pill failure, so it's a low-level worry. Using fennel as a food or spice is very unlikely to matter. Concentrated fennel supplements or the essential oil are where I'd pause. If you're relying on this pill for contraception and want to take fennel pills regularly, run it past your pharmacist or doctor first.

References
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

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Ethinyl estradiol, Levonogestrel also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.

In vitro research suggests that fennel inhibits CYP3A4 enzyme activity. 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

Lybrel combines two active hormones, ethinyl estradiol and levonorgestrel, and both are cleared from your body partly by a liver enzyme called CYP3A4. In a test-tube study, fennel slowed that enzyme down. If that happened in real life, your body might clear these hormones a little more slowly, leaving slightly higher levels around. In practice that could mean more of the usual hormone side effects, like nausea, breast tenderness, bloating, or spotting.

Here's the reassuring part: this was only seen in the lab, never in actual people, so it stays theoretical. Everyday food and cooking amounts of fennel are very unlikely to matter. If you're using concentrated fennel capsules or the essential oil regularly, just mention it to your pharmacist or doctor first.

References
  1. Subehan, Usia, T., Iwata, H., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of CYP3A4 and CYP2D6 by Indonesian medicinal plants. J Ethnopharmacol. 5-24-2006;105(3):449-455. PubMed
  2. Subehan, Zaidi, S. F., Kadota, S., and Tezuka, Y. Inhibition on human liver cytochrome P450 3A4 by constituents of fennel (Foeniculum vulgare): identification and characterization of a mechanism-based inactivator. J Agric.Food Chem. 12-12-2007;55(25):101 PubMed
Moderate

ESTROGENS

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Ethinyl estradiol, Levonogestrel also falls under ESTROGENS.

Theoretically, taking large amounts of fennel might interfere with hormone replacement therapy due to competition for estrogen receptors.

Some constituents of fennel have estrogenic activity.
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 gist with Lybrel (your ethinyl estradiol and levonorgestrel birth control pill) and fennel. Some plant compounds in fennel can act a little like estrogen and may bump up against estrogen receptors in your body. In theory, large amounts of concentrated fennel could compete with the estrogen in your pill and slightly muddy how it works.

I want to be honest, this concern is theoretical and based on lab pharmacology, not real-world reports of people getting pregnant or having problems. The fennel you cook with or sprinkle on food is very unlikely to matter. Where I'd pause is with concentrated fennel supplements or the essential oil. If you're using those regularly, just run it by your pharmacist or doctor first.

References
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.

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

Fennel Also Interacts With Other Medications

Fennel has 739 moderate known drug interactions in our database — the Ethinyl estradiol, Levonogestrel 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 Fennel

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

From our Q&A

Questions About Fennel or Ethinyl estradiol, Levonogestrel

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Fennel or Ethinyl estradiol, Levonogestrel, 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, Levonogestrel

This page covers Fennel only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl estradiol, Levonogestrel page lists 239 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 · 195 moderate · 38 minor.

From our pharmacist’s overview on the Ethinyl estradiol, Levonogestrel page

“A daily birth control pill like Lybrel (ethinyl estradiol with levonorgestrel) only works when enough hormone stays in the bloodstream, and that is exactly what several supplements on this page can undermine. This list deserves genuine care, starting with the six major-rated entries.”

Reviewed by 2 · Jul 18, 2026

Open the Ethinyl estradiol, Levonogestrel interaction page

One more smart check

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

We hold 2,219 real supplement products containing Fennel, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fennel. Your product may carry other ingredients that interact with Ethinyl estradiol, Levonogestrel too, on top of Fennel — 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 Fennel and Ethinyl estradiol, Levonogestrel 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 Fennel
Top 10%

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

29 days ago today
Medication Ethinyl estradiol, Levonogestrel
Top 25%

#526 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 Fennel

What is Fennel?

Fennel
  • Digestive upset and bloating
  • Infant colic
  • Menstrual cramps
  • Cough and respiratory complaints
  • Breast milk support (traditional)

Fennel is a Mediterranean herb widely used as a food and spice, and traditionally taken for digestive complaints, colic, and menstrual cramps. Some small studies suggest possible benefit for certain stomach and menstrual symptoms, but the evidence is limited. It is generally well tolerated in food amounts, but concentrated supplements and the essential oil should be used with caution and after checking with your pharmacist or doctor.

Read the full Fennel monograph & all interactions
Keep checking

Other Drugs & Fennel

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

0Major
739Moderate
0Minor
2,090No known interaction
Moderate

739 interactions

Showing 60 of 739 moderate interactions — see all 739 on the Fennel page.

No interaction 2,090 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 Fennel and Ethinyl estradiol, Levonogestrel Together: Common Questions

Can you take Fennel with Ethinyl estradiol, Levonogestrel?
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 Fennel and Ethinyl estradiol, Levonogestrel?
Ethinyl estradiol, Levonogestrel belongs to more than one drug category, and Fennel 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 Fennel and Ethinyl estradiol, Levonogestrel 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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