Drug & supplement interaction

Fennel + Ethinyl Estradiol, Norgestimate

Ethinyl Estradiol, Norgestimate brand names: Ortho Tri-Cyclen 28, Ortho Tri-Cyclen Lo, Ortho-Cyclen, Mononessa, Previfem, and others.

Moderate Interaction
The bottom line Moderate

Ethinyl Estradiol, Norgestimate 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, Norgestimate

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, Norgestimate 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

1 of 3

Why this applies to Ethinyl Estradiol, Norgestimate

Ethinyl Estradiol, Norgestimate 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 thinking on this one. Your birth control pill, Ortho Tri-Cyclen and similar brands, contains an estrogen (ethinyl estradiol) plus a progestin. Fennel happens to carry plant compounds that act a little like estrogen in the body. The concern is that in large, concentrated amounts, fennel's estrogen-like compounds could compete at estrogen receptors and possibly nudge down how well your pill prevents pregnancy.

I want to be honest about how soft this is: it's a theoretical idea based on how these compounds behave in the lab, not from real-world reports of pill failures. Enjoying fennel as food or spice is very unlikely to matter. If you're thinking about a concentrated fennel supplement or the essential oil, 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.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Ethinyl Estradiol, Norgestimate 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

Here's the gist if you're on a birth control pill like Ortho Tri-Cyclen or Sprintec. The hormones in it, ethinyl estradiol and norgestimate, are partly broken down by a liver enzyme called CYP3A4. Lab studies suggest fennel might slow that enzyme down a touch, which could let a little more hormone build up in your system. In theory that might mean slightly more of the usual estrogen-type effects, like nausea, breast tenderness, bloating, or mood changes.

The honest part: this has only been seen in test-tube research, never in actual people, so it's very theoretical. Cooking and seasoning with fennel is not a concern at all. If you plan to take concentrated fennel supplements or fennel essential oil regularly, just run it by 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

3 of 3

Ethinyl Estradiol, Norgestimate 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 simple version: your birth control pill (Ortho Tri-Cyclen, Sprintec, and similar) works by delivering steady, controlled hormone levels to prevent pregnancy. Fennel contains a few plant compounds that act a little bit like estrogen in the body. The concern on file is purely theoretical, based on how these compounds behave in lab studies, not on real-world reports of people having problems.

The worry is that very large amounts of concentrated fennel (think supplements or essential oil, not the fennel in your cooking or tea) could compete with your pill's hormones at estrogen receptors. In plain terms, that might nudge how your pill works, but we have no solid proof it actually weakens protection. Food-amount fennel is not a concern. If you're using strong fennel supplements, 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, Norgestimate 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, Norgestimate

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, Norgestimate, 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, Norgestimate

This page covers Fennel only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Norgestimate 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.

Open the Ethinyl Estradiol, Norgestimate 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, Norgestimate 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, Norgestimate 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%

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

29 days ago today
Medication Ethinyl Estradiol, Norgestimate
Steady interest

#1,626 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, Norgestimate Together: Common Questions

Can you take Fennel with Ethinyl Estradiol, Norgestimate?
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, Norgestimate?
Ethinyl Estradiol, Norgestimate 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, Norgestimate 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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