Fo-ti + Etonogestrel, Ethinyl Estradiol
Etonogestrel, Ethinyl Estradiol brand name: NuvaRing.
Etonogestrel, Ethinyl Estradiol falls into 4 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 Etonogestrel, Ethinyl Estradiol
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Fo-ti interacts with whole categories of medication. Etonogestrel, Ethinyl Estradiol falls into 4 of those categories, so it can interact with Fo-ti 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 Etonogestrel, Ethinyl Estradiol
Etonogestrel, Ethinyl Estradiol 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.
If you're using the NuvaRing, here's the honest picture on Fo-ti. The hormones in your ring (etonogestrel and ethinyl estradiol) are handled by several liver enzymes, and one of them, CYP1A2, is the one Fo-ti seems to affect. The catch is that the lab and animal data point in both directions: some forms of Fo-ti slow this enzyme down, while others speed it up. None of this has actually been confirmed in people.
Practically, that means we can't say for sure whether your hormone levels would drift up (more spotting, nausea, breast tenderness) or down (less reliable protection from pregnancy). Because birth control failure is a real concern, it's worth a quick chat with 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
2 of 4Etonogestrel, Ethinyl Estradiol 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 NuvaRing releases two hormones, etonogestrel (a progestin) and ethinyl estradiol (an estrogen), that work together to prevent pregnancy. The concern with Fo-ti here is fairly mild and mostly theoretical. In lab dish studies, Fo-ti extract showed some estrogen-like activity, which means its plant compounds could in theory compete at the same estrogen receptors your ring's hormones use. If that happened, it might slightly nudge how well the birth control works or add to estrogen-related effects.
To be clear, this comes only from test-tube research, not real patients, so we don't have proof it matters in people. Still, since reliable contraception is important, it's worth running a Fo-ti supplement past your pharmacist or doctor before combining 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
ESTROGENS
3 of 4Etonogestrel, Ethinyl Estradiol 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 NuvaRing releases two hormones, etonogestrel (a progestin) and ethinyl estradiol (an estrogen). The concern here is that Fo-ti may have mild estrogen-like activity, meaning its plant compounds could bump into the same estrogen receptors your ring's hormones use. In theory, large supplement doses might slightly nudge how your body's estrogen signaling behaves.
I want to be honest about the strength of this: it comes only from lab and test-tube studies, not from real people, so it's mostly theoretical. There's no good evidence it would weaken your birth control or cause clear side effects. Still, because reliable contraception matters and processed Fo-ti has been tied to liver concerns, I'd check with your pharmacist or doctor before using it regularly.
- 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
4 of 4Etonogestrel, Ethinyl Estradiol 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 NuvaRing releases two active hormones, etonogestrel and ethinyl estradiol, and your liver clears them partly through an enzyme called CYP3A4. On paper, fo-ti might slow that enzyme down a bit, which could let estrogen levels run slightly higher than usual. If that happened, you might notice more of the typical estrogen-related effects, such as nausea, breast tenderness, headaches, or bloating.
Here's the honest part: this is only a theoretical concern from lab studies, and even those results disagree with each other. It has never actually been reported in people, so I wouldn't lose sleep over it. Still, since fo-ti has been tied to liver problems, it's worth a quick chat with 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 Etonogestrel, Ethinyl Estradiol 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 Etonogestrel, Ethinyl Estradiol
This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etonogestrel, Ethinyl Estradiol page lists 203 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate), Activated Charcoal (moderate) and Adrafinil (moderate).
By severity: 2 major · 168 moderate · 33 minor.
From our pharmacist’s overview on the Etonogestrel, Ethinyl Estradiol page
“St. John's wort belongs at the top of any conversation about NuvaRing (etonogestrel and ethinyl estradiol) and supplements.”
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 Etonogestrel, Ethinyl Estradiol 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 Etonogestrel, Ethinyl Estradiol 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.
#210 of 1,452 supplements looked up here in the last 7 days
#760 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 ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Lisinopril ›
- Acyclovir ›
- Lamotrigine ›
- Pregabalin ›
- Azithromycin ›
- Gabapentin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Cyclopentolate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Levetiracetam ›
- Pegunigalsidase Alfa-iwxj ›
- Ezetimibe ›
- Daptomycin ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Hexobarbitone ›
- Phentermine, Topiramate ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Levodopa ›
- Hethylphenidate Hcl ›
- Mitomycin ›
- Minoxidil ›
- Cefaclor ›
- Azelaic Acid ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Dirithromycin ›
- Pizotifen ›
- Vancomycin ›
- Triptorelin ›
- Bentoquatam ›
- Pentobarbitone ›
- Dextrothyroxine ›
- Procainamide ›
- Tocainide ›
- Rocuronium ›
- Telmisartan ›
- Mitomycin C ›
- Lomustine ›
- Digitoxin ›
- Ribavirin Aerosol ›
- Chenodiol ›
- Lorazepam ›
- Salbutamol Sulfate ›
- Desflurane ›
- Caspofungin ›
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
Etonogestrel, Ethinyl Estradiol Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Etonogestrel, Ethinyl Estradiol 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 Etonogestrel, Ethinyl Estradiol 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 Etonogestrel, Ethinyl Estradiol Together: Common Questions
Can you take Fo-ti with Etonogestrel, Ethinyl Estradiol?
Why are there 4 interactions listed for Fo-ti and Etonogestrel, Ethinyl Estradiol?
How serious is the Fo-ti and Etonogestrel, Ethinyl Estradiol interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Etonogestrel, Ethinyl Estradiol 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.