Fo-ti + Norelgestromin, Ethinyl Estradiol
Norelgestromin, Ethinyl Estradiol brand names: Ortho Evra, Evra.
Norelgestromin, 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 Norelgestromin, 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. Norelgestromin, 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 Norelgestromin, Ethinyl Estradiol
Norelgestromin, 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.
Your Ortho Evra patch delivers two hormones, norelgestromin and ethinyl estradiol, and one of the pathways your body uses to break down the estrogen portion is a liver enzyme called CYP1A2. The concern here is purely theoretical. In lab dishes, Fo-ti seemed to slow this enzyme down, but in animal tests one type of extract slowed it while another sped it up. Nothing has been shown to happen in real people, so this is a weak, mixed signal rather than a proven problem.
If Fo-ti did slow estrogen breakdown, you might notice more estrogen-type effects like nausea, breast tenderness, or spotting. I wouldn't lose sleep over it, but since Fo-ti has also been tied to liver injury, 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
CONTRACEPTIVE DRUGS
2 of 4Norelgestromin, 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 patch (Ortho Evra) delivers two hormones, a progestin and an estrogen, to prevent pregnancy. The concern with Fo-ti here is different from the usual liver-enzyme story. In lab dish studies, Fo-ti showed weak estrogen-like activity, meaning some of its plant compounds may bump up against the same estrogen receptors your birth control uses. The worry is that, in theory, large amounts of Fo-ti could compete at those receptors and throw off how reliably the patch works.
Keep this in perspective. This is based only on test-tube research, not on real people, so it's a maybe, not a proven problem. Still, because an unintended pregnancy is a big deal, I'd flag it. If you want to use Fo-ti, check with your pharmacist or doctor first, and don't change your patch 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
3 of 4Norelgestromin, 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..
The patch you're using (Ortho Evra) delivers two hormones, an estrogen and a progestin, that work partly by acting on estrogen receptors in your body. Here's the thing about Fo-ti: lab studies in test tubes suggest it has its own mild estrogen-like activity. The concern on file is that, in theory, large amounts of Fo-ti could compete at those same receptors and nudge how your hormone therapy behaves.
I want to be honest with you: this is theoretical, based only on cell studies, not real people. We don't have evidence it actually weakens birth control or causes problems like breakthrough bleeding. Still, since the patch matters and Fo-ti has also been linked to liver issues, please run it by 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
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
4 of 4Norelgestromin, 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.
The hormones in your Ortho Evra patch (norelgestromin and ethinyl estradiol) are cleared from your body partly by a liver enzyme called CYP3A4. Some lab studies hint that fo-ti might slow that enzyme down. If that happened, your estrogen levels could nudge a bit higher, which in theory might mean more of the usual estrogen-type side effects like nausea, breast tenderness, headaches, or bloating.
Here's the honest part: this is only seen in test-tube research, and even animal studies disagree. It has never actually been reported in a person, so I wouldn't lose sleep over it. Still, because fo-ti has been tied to liver injury in some reports, it's worth running it past your pharmacist or doctor before pairing 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 Norelgestromin, 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 Norelgestromin, Ethinyl Estradiol
This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Norelgestromin, 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 Norelgestromin, Ethinyl Estradiol page
“St. John's wort is the first entry to check if you wear the Ortho Evra patch (norelgestromin and ethinyl estradiol).”
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 Norelgestromin, 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 Norelgestromin, 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.
#213 of 1,452 supplements looked up here in the last 7 days
#2,593 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 ›
- Pregabalin ›
- Azithromycin ›
- Gabapentin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Cyclopentolate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Levetiracetam ›
- Pegunigalsidase Alfa-iwxj ›
- Ezetimibe ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Daptomycin ›
- Phentermine, Topiramate ›
- Mitomycin ›
- Thyroid Hormone ›
- Hexobarbitone ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Hethylphenidate Hcl ›
- Levodopa ›
- Minoxidil ›
- Cefaclor ›
- Azelaic Acid ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Pizotifen ›
- Bentoquatam ›
- Vancomycin ›
- Dirithromycin ›
- Ribavirin Aerosol ›
- Triptorelin ›
- Alglucosidase Alpha ›
- Pentobarbitone ›
- Telmisartan ›
- Dextrothyroxine ›
- Tocainide ›
- Rocuronium ›
- Procainamide ›
- Salbutamol Sulfate ›
- Mitomycin C ›
- Flutemetamol F-18 ›
- Chenodiol ›
- Digitoxin ›
- Caspofungin ›
- Lomustine ›
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
Norelgestromin, Ethinyl Estradiol Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Norelgestromin, 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 Norelgestromin, 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 Norelgestromin, Ethinyl Estradiol Together: Common Questions
Can you take Fo-ti with Norelgestromin, Ethinyl Estradiol?
Why are there 4 interactions listed for Fo-ti and Norelgestromin, Ethinyl Estradiol?
How serious is the Fo-ti and Norelgestromin, Ethinyl Estradiol interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Norelgestromin, 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.