Fo-ti + Ethinyl Estradiol, Norgestrel
Ethinyl Estradiol, Norgestrel brand names: Ovral, Lo/Ovral, Cryselle, Low-Ogestrel, Ogestrel 0.5/50.
Ethinyl Estradiol, Norgestrel falls into 5 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, Norgestrel
These two interact in 5 distinct ways. Each one is explained separately below.
Why Are There 5 Interactions?
Fo-ti interacts with whole categories of medication. Ethinyl Estradiol, Norgestrel falls into 5 of those categories, so it can interact with Fo-ti in 5 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 5Why this applies to Ethinyl Estradiol, Norgestrel
Ethinyl Estradiol, Norgestrel 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 (Ovral and similar) and Fo-ti. Part of the estrogen in your pill is handled by a liver enzyme called CYP1A2. Lab and animal studies hint that Fo-ti might slow that enzyme down (some forms) or speed it up (others). If it slows it, estrogen could build up a bit, which can mean more nausea, breast tenderness, or headaches. If it speeds it up, your pill could clear faster, and in theory that's a concern for reliable pregnancy prevention.
The key thing: this has only been seen in test tubes and animals, never confirmed in people, so it's theoretical. I wouldn't panic, but since this protects you from pregnancy, please run it by 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 5Ethinyl Estradiol, Norgestrel 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 thing to know about pairing Fo-ti with your birth control pill (the ethinyl estradiol and norgestrel combo). This isn't about Fo-ti changing how the pill works or how well it prevents pregnancy. The concern is the liver. Fo-ti, especially the processed root in concentrated supplements, has been linked in several case reports to liver injury. Estrogen-containing birth control can also be a little tough on the liver in some people.
So the worry is that two liver stressors together might add up. I'll be honest, this is mostly theoretical and based on scattered reports, not strong studies, so don't panic. Just watch for yellowing skin or eyes, dark urine, belly pain, or unusual tiredness, and check with your pharmacist or doctor before combining them.
- 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.
CONTRACEPTIVE DRUGS
3 of 5Ethinyl Estradiol, Norgestrel 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..
Here's the gist with your birth control pill (the ethinyl estradiol and norgestrel combo found in Lo/Ovral and Low-Ogestrel). Some lab studies hint that fo-ti has mild estrogen-like activity, meaning its plant compounds may bump up against the same estrogen receptors your pill works on. In theory, large supplement doses could nudge how your hormones behave, which is why this is flagged as a possible concern.
I want to be honest about the strength of this: it comes from test tube and animal research only, not real patients, so we don't truly know if it matters in people. I wouldn't lose sleep over it, but since pregnancy prevention is too important to gamble with, please run it by your pharmacist or doctor before pairing fo-ti with your pill.
- 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
4 of 5Ethinyl Estradiol, Norgestrel 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..
Here's the thing to know if you're on a combined birth control pill like Lo/Ovral, which blends ethinyl estradiol (an estrogen) with norgestrel (a progestin). Lab studies suggest Fo-ti's plant compounds can act a little like estrogen and may bump up against the same estrogen receptors your pill works through. In theory, large supplement doses of Fo-ti could compete with your medication's estrogen signal.
I want to be honest about how soft this evidence is. This concern comes only from test-tube research, not from real people, so we can't say it actually weakens your pill or affects pregnancy protection. Still, since reliable contraception matters, and Fo-ti has also been linked to liver issues, it's worth running it by your pharmacist or doctor before adding it.
- 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
5 of 5Ethinyl Estradiol, Norgestrel 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, which combines ethinyl estradiol and norgestrel, is partly cleared from the body by a liver enzyme called CYP3A4. Some lab studies hint that fo-ti might slow this enzyme down. If that happened in real life, your hormone levels could drift a little higher, which can mean more of the usual estrogen-type complaints like nausea, breast tenderness, headaches, or breakthrough spotting.
Here's the honest part: this is only a theoretical concern from test-tube work, and animal studies didn't agree. It has never been reported in actual people, so I wouldn't lose sleep over it. Still, because of separate reports linking fo-ti to liver injury, 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
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, Norgestrel 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, Norgestrel
This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Norgestrel 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, Norgestrel page
“With a birth control pill like ethinyl estradiol and norgestrel (Ovral, Lo/Ovral, Cryselle, Low-Ogestrel), a supplement interaction can mean an unplanned pregnancy rather than just a side effect, so the six major-rated entries among the 239 on this page deserve real attention before the rest. St.”
Reviewed by 2 · Jul 18, 2026
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, Norgestrel 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, Norgestrel 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.
#209 of 1,452 supplements looked up here in the last 7 days
#637 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 ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Minoxidil ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Phentermine, Topiramate ›
- Cefaclor ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Bentoquatam ›
- Pentobarbitone ›
- Procainamide ›
- Hydroxychloroquine ›
- Azelaic Acid ›
- Triptorelin ›
- Dextrothyroxine ›
- Lomustine ›
- Tocainide ›
- Pizotifen ›
- Rocuronium ›
- Telmisartan ›
- Succimer ›
- Mitomycin C ›
- Lorazepam ›
- Desflurane ›
- Chenodiol ›
- Metronidazole ›
- Cabergoline ›
- Lithium Carbonate (prescription Drug) ›
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, Norgestrel Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Ethinyl Estradiol, Norgestrel 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, Norgestrel 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, Norgestrel Together: Common Questions
Can you take Fo-ti with Ethinyl Estradiol, Norgestrel?
Why are there 5 interactions listed for Fo-ti and Ethinyl Estradiol, Norgestrel?
How serious is the Fo-ti and Ethinyl Estradiol, Norgestrel interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Ethinyl Estradiol, Norgestrel 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.