Fo-ti + Ethinyl Estradiol, Desogestrel
Ethinyl Estradiol, Desogestrel brand names: Linessa, Apri, Reclipsen, Solia, Kariva, and others.
Ethinyl Estradiol, Desogestrel falls into 6 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full interaction reportFo-ti and Ethinyl Estradiol, Desogestrel
These two interact in 6 distinct ways. Each one is explained separately below.
Why Are There 6 Interactions?
Fo-ti interacts with whole categories of medication. Ethinyl Estradiol, Desogestrel falls into 6 of those categories, so it can interact with Fo-ti in 6 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 6Why this applies to Ethinyl Estradiol, Desogestrel
Ethinyl Estradiol, Desogestrel falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Fo-ti interacts with.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti 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.
Here's the honest picture with your birth control pill (the ethinyl estradiol plus desogestrel combo) and Fo-ti. Fo-ti has shown some effect on a liver enzyme called CYP1A2 in lab dishes and animals, and your pill's estrogen partly relies on that enzyme. In theory, if Fo-ti slows that enzyme down, estrogen levels could nudge up, which might mean more spotting, nausea, breast tenderness, or headaches.
But notice how soft all of that is. This is only test-tube and animal data, and the studies don't even agree on the direction. Nothing has been confirmed in real people. Because reliable contraception matters, and because Fo-ti has been tied to liver concerns, I'd loop in your pharmacist or doctor before combining them.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
HEPATOTOXIC DRUGS
2 of 6Ethinyl Estradiol, Desogestrel also falls under HEPATOTOXIC DRUGS.
Fo-ti has been linked to liver damage in many reports.
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 simple version. Your birth control pill (the ethinyl estradiol and desogestrel combo found in Apri, Kariva, and similar brands) is processed by your liver, and estrogen-containing pills can occasionally put a little stress on it. Fo-ti has been tied to reports of liver injury in some people, so the worry is that pairing the two could add up and make liver problems a bit more likely.
To be honest, this is a theoretical concern based on scattered case reports, not strong proof. Still, it's worth watching. Tell your doctor or pharmacist if you notice yellowing of your skin or eyes, dark urine, belly pain on the right side, unusual tiredness, or nausea. Don't change anything on your own, just check in first.
- Park GJ, Mann SP, Ngu MC. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol 2001;16:115-7.
- But PP, Tomlinson B, Lee KL. Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from Polygonum multiflorum. Vet Hum Toxicol 1996;38:280-2.
- UK Medicines and Healthcare Products Regulatory Agency. Polygonum multiflorum and liver reactions. April 2006. Available at: www.mhra.gov.uk/home/idcplg?IdcService= SS_GET_PAGE&useSecondary=true&ssDocName= CON2023590&ssTargetNodeId= 833 (Accessed 10 May 2
- Panis B, Wong DR, Hooymans PM, De Smet PA, Rosias PP. Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. J Pediatr Gastroenterol Nutr 2005;41:256-8. PubMed
- Mazzanti G, Battinelli L, Daniele C, et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from Polygonum multiflorum. Ann Intern Med 2004;140:E589-90.
- Cardenas A, Restrepo JC, Sierra F, Correa G. Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum. J Clin Gastroenterol 2006;40:629-32. PubMed
- Laird AR, Ramchandani N, deGoma EM, et al. Acute hepatitis associated with the use of an herbal supplement (Polygonum multiflorum) mimicking iron-overload syndrome. J Clin Gastroenterol 2008;42:861-2. PubMed
- Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. PubMed
- Yuen, M. F., Tam, S., Fung, J., Wong, D. K., Wong, B. C., and Lai, C. L. Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study. Aliment.Pharmacol.Ther 10-15-2006;24(8):1179-1186. PubMed
- Bae, S. H., Kim, D. H., Bae, Y. S., Lee, K. J., Kim, D. W., Yoon, J. B., Hong, J. H., and Kim, S. H. [Toxic hepatitis associated with Polygoni multiflori]. Korean J.Hepatol. 2010;16(2):182-186. PubMed
- Furukawa, M., Kasajima, S., Nakamura, Y., Shouzushima, M., Nagatani, N., Takinishi, A., Taguchi, A., Fujita, M., Niimi, A., Misaka, R., and Nagahara, H. Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation. Intern.Med. 2010;49(15):1537-1 PubMed
- Dong H, Slain D, Cheng J, Ma W, Liang W. Eighteen cases of liver injury following ingestion of Polygonum multiflorum. Complement Ther Med 2014;22(1):70-4. PubMed
- Lei X, Chen J, Ren J, et al. Liver damage associated with Polygonum multiflorum Thunb.: a systematic review of case reports and case series. Evid Based Complement Alternat Med 2015;2015:459749.
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
3 of 6Ethinyl Estradiol, Desogestrel also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C9. However, this interaction 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.
Your birth control pill (Apri, Reclipsen, Kariva and similar) contains ethinyl estradiol plus desogestrel, hormones that your liver clears using several enzymes, including one called CYP2C9. Lab and animal studies hint that Fo-ti might slow that enzyme down a little. If that happened in people, the estrogen part could linger a bit longer, which in theory might mean slightly more of the usual estrogen-related effects like nausea, breast tenderness, bloating, headaches, or spotting.
Here's the honest part: this is only a theoretical concern from test-tube and animal work, and it has never actually been reported in humans. So I wouldn't lose sleep over it. Still, because Fo-ti has its own liver-safety questions, please run it by your pharmacist or doctor before combining the two.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CONTRACEPTIVE DRUGS
4 of 6Ethinyl Estradiol, Desogestrel also falls under CONTRACEPTIVE DRUGS.
In vitro research suggests that fo-ti extract has estrogenic activity.
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..
Your birth control pill (Apri, Kariva, and the others) works by delivering steady, controlled hormone levels to prevent ovulation. The concern here is that Fo-ti contains plant compounds that can act a little like estrogen in lab dishes. In theory, if you took large, concentrated amounts of Fo-ti, those compounds might compete at estrogen receptors and could subtly nudge how your pill behaves.
I want to be honest about how soft this evidence is. It comes only from test-tube research, not from real people, so we truly don't know if it matters in everyday life. Still, since reliable contraception is on the line, it's worth a quick chat with your pharmacist or doctor before adding a Fo-ti supplement. Don't change your pill on your own.
- Oerter Klein KO, Janfaza M, Wong JA, Chang RJ. Estrogen bioactivity in Fo-Ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. J Clin Endocrinol Metab 2003;88:4077-9.. PubMed
- Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. PubMed
- Kang, S. C., Lee, C. M., Choi, H., Lee, J. H., Oh, J. S., Kwak, J. H., and Zee, O. P. Evaluation of oriental medicinal herbs for estrogenic and antiproliferative activities. Phytother Res 2006;20(11):1017-1019. PubMed
ESTROGENS
5 of 6Ethinyl Estradiol, Desogestrel also falls under ESTROGENS.
In vitro research suggests that fo-ti extract has estrogenic activity.
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..
Your birth control pill combines ethinyl estradiol (an estrogen) with desogestrel (a progestin). The concern here is that Fo-ti contains plant compounds that can act a little like estrogen in the body. In theory, large supplement-sized amounts could compete at estrogen receptors and nudge how your hormonal pill behaves. I want to be upfront though: this idea comes only from lab and animal studies, not from real-world data in people, so the actual risk for your pill is uncertain.
Because this is so theoretical, I wouldn't expect a casual interaction, but Fo-ti also carries a separate worry of liver injury. Since your liver helps process these hormones, that's worth a chat with your pharmacist or doctor before you combine them.
- Oerter Klein KO, Janfaza M, Wong JA, Chang RJ. Estrogen bioactivity in Fo-Ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. J Clin Endocrinol Metab 2003;88:4077-9.. PubMed
- Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. PubMed
- Kang, S. C., Lee, C. M., Choi, H., Lee, J. H., Oh, J. S., Kwak, J. H., and Zee, O. P. Evaluation of oriental medicinal herbs for estrogenic and antiproliferative activities. Phytother Res 2006;20(11):1017-1019. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
6 of 6Ethinyl Estradiol, Desogestrel also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction 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.
Your birth control pill, the combo of ethinyl estradiol and desogestrel, gets broken down in your body partly by a liver enzyme called CYP3A4. Here's the theory: lab studies hint that Fo-ti, especially the raw root, might slow that enzyme down a bit. If that happened, the estrogen in your pill could build up slightly, which could nudge up side effects like nausea, breast tenderness, bloating, or headaches.
I want to be honest with you though, this is very early evidence. It comes only from test-tube and animal studies, the animal data actually disagree, and nothing like it has been seen in real people. So I wouldn't lose sleep over it. Still, since reliable birth control matters and Fo-ti has been linked to liver issues, run it by your pharmacist or doctor first.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. 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.
Fo-ti Also Interacts With Other Medications
Fo-ti has 1,256 moderate known drug interactions in our database — the Ethinyl Estradiol, Desogestrel one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Fo-ti
We haven’t checked that one against Fo-ti yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Fo-ti. Pick one to open its full report.
See Every Supplement That Interacts With Ethinyl Estradiol, Desogestrel
This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Desogestrel page lists 246 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 · 201 moderate · 39 minor.
Taking Fo-ti as Part of a Dietary Supplement Product? Check It for Interactions
We hold 976 real supplement products containing Fo-ti, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fo-ti. Your product may carry other ingredients that interact with Ethinyl Estradiol, Desogestrel too, on top of Fo-ti — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Fo-ti and Ethinyl Estradiol, Desogestrel 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.
#207 of 1,452 supplements looked up here in the last 7 days
#1,670 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 Fo-ti
What is Fo-ti?
- Anti-aging and longevity
- Hair graying and hair loss
- General tonic for vitality
- Constipation
- High cholesterol
Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti has been linked to reports of liver injury, so caution and professional guidance are important.
Other Drugs & Fo-ti
Browse every other medication we’ve checked against Fo-ti — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,256 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Amoxicillin ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Allopurinol ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
Showing 60 of 1,256 moderate interactions — see all 1,256 on the Fo-ti page.
No interaction 1,573 drugs checked — show the list
We also checked Fo-ti against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Lisinopril ›
- Acyclovir ›
- Pregabalin ›
- Lamotrigine ›
- Azithromycin ›
- Gabapentin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Cyclopentolate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Levetiracetam ›
- Pegunigalsidase Alfa-iwxj ›
- Ezetimibe ›
- Daptomycin ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Mitomycin ›
- Hexobarbitone ›
- Thyroid Hormone ›
- Phentermine, Topiramate ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Levodopa ›
- Minoxidil ›
- Hethylphenidate Hcl ›
- Cefaclor ›
- Azelaic Acid ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Dirithromycin ›
- Vancomycin ›
- Triptorelin ›
- Pizotifen ›
- Bentoquatam ›
- Pentobarbitone ›
- Ribavirin Aerosol ›
- Procainamide ›
- Dextrothyroxine ›
- Tocainide ›
- Rocuronium ›
- Telmisartan ›
- Mitomycin C ›
- Lomustine ›
- Digitoxin ›
- Lorazepam ›
- Salbutamol Sulfate ›
- Chenodiol ›
- Caspofungin ›
- Desflurane ›
Showing the 60 most looked-up of 1,573 medications checked with no known interaction — see the full Fo-ti 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, Desogestrel Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Ethinyl Estradiol, Desogestrel as a medicine that can lower these. This is not an interaction with Fo-ti — 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, Desogestrel 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 Fo-ti and Ethinyl Estradiol, Desogestrel Together: Common Questions
Can you take Fo-ti with Ethinyl Estradiol, Desogestrel?
Why are there 6 interactions listed for Fo-ti and Ethinyl Estradiol, Desogestrel?
How serious is the Fo-ti and Ethinyl Estradiol, Desogestrel interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Ethinyl Estradiol, Desogestrel and Fo-ti?
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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.