Drug & supplement interaction

Folic Acid + Ethinyl Estradiol, Norethindrone

Ethinyl Estradiol, Norethindrone brand names: Femhrt, Loestrin 21, Ovcon 35 21, Ovcon 50 28, Necon 0.5 35 21, and others.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Folic Acid and Ethinyl Estradiol, Norethindrone in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Ethinyl Estradiol, Norethindrone states a food rule worth keeping to.

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Interaction report

Folic Acid and Ethinyl Estradiol, Norethindrone

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Ethinyl Estradiol, Norethindrone and Folic Acid in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Folic Acid safety at a glance

Folic Acid overall Generally safe Generally safe at recommended doses for most adults.
Pregnancy Likely Safe When used orally and appropriately. Folic acid 300-400 mcg is commonly used during pregnancy for prevention of neural tube defects. Miscarriage rates and negati... Read the full pregnancy detail
Breastfeeding Likely Safe When used orally and appropriately. Folic acid 300-400 mcg is commonly used during pregnancy for prevention of neural tube defects. Miscarriage rates and negati... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ethinyl Estradiol, Norethindrone and Folic Acid? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ethinyl Estradiol, Norethindrone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ethinyl Estradiol, Norethindrone is filed under 13 classifications — including progestin, contraceptive drugs, estrogens. Folic Acid has documented interactions with 7 drug classes — the most serious being 5-fluorouracil (moderate), capecitabine (xeloda) (moderate) and methotrexate (trexall, others) (moderate) — and none of Ethinyl Estradiol, Norethindrone’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Folic Acid Does Interact With Other Medications

Folic Acid has 40 moderate known drug interactions in our database — Ethinyl Estradiol, Norethindrone isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Folic Acid

Covers the 2,830 medications we’ve checked against Folic Acid. Pick one to open its full report.

What to actually watch for

What Folic Acid Itself Has Been Linked To

This is not an interaction — nothing below involves Ethinyl Estradiol, Norethindrone. It is the side-effect record for Folic Acid on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Folic Acid, this list is the first place to look. 7 entries are worth acting on rather than waiting out — marked below.

  • Yellowing of the skin or eyes Worth acting on Additional detail

    “Liver dysfunction, with jaundice and very high liver enzymes, occurred in a 30-year-old pregnant patient with severe nausea and vomiting taking a folic acid supplement (Folic acid, Nature Made) 400 mcg daily.”

    Folic Acid · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 91309. Matsubara S, Imai K, Murayama K, Higashizawa T. Severe liver dysfunction during nausea and vomiting of pregnancy: folic acid supplement as a suggested culprit. J Obstet Gynaecol. 2012;32(7):701-2. PubMed
  • Wheezing Worth acting on Additional detail

    “Folic acid use in late pregnancy has been associated with an increased risk of persistent and childhood asthma at 3.5 years in population research. When taken pre-pregnancy or early in pregnancy, population research has not found an association with increased risk of asthma or allergies in childhood.”

    Folic Acid · Natural Medicines adverse-effect record, reported in allergic rhinitis (hay fever).

    4 sources cited
    1. 50380. Whitrow, M. J., Moore, V. M., Rumbold, A. R., and Davies, M. J. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. Am J Epidemiol. 12-15-2009;170(12):1486-1493. PubMed
    2. 90799. Crider KS, Cordero AM, Qi YP, Mulinare J, Dowling NF, Berry RJ. Prenatal folic acid and risk of asthma in children: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98(5):1272-81. PubMed
    3. 103979. Liu J, Li Z, Ye R, Liu J, Ren A. Periconceptional folic acid supplementation and risk of parent-reported asthma in children at 4-6 years of age. ERJ Open Res. 2020;6(1):00250-2019. PubMed
    4. 50328. Haberg, S. E., London, S. J., Stigum, H., Nafstad, P., and Nystad, W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis.Child 2009;94(3):180-184. PubMed
  • Confusion Worth acting on Additional detail

    “Orally, folic acid 15 mg daily can sometimes cause altered sleep patterns, vivid dreaming, irritability, excitability, hyperactivity, confusion, and impaired judgment (15). Large doses of folic acid can also precipitate or exacerbate neuropathy in people deficient in vitamin B12.”

    Folic Acid · Natural Medicines adverse-effect record, reported in anemia.

    3 sources cited
    1. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    2. 6243. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
    3. 13068. Morris MC, Evans DA, Bienias JL, et al. Dietary folate and vitamin B12 intake and cognitive decline among community-dwelling older persons. Arch Neurol 2005;62:641-5. PubMed
  • Seizures Worth acting on Additional detail

    “Orally, folic acid 15 mg daily can sometimes cause exacerbation of seizure frequency and psychotic behavior (15).”

    Folic Acid · Natural Medicines adverse-effect record, reported in epilepsy.

    1 source cited
    1. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  • Anemia Worth acting on Additional detail

    Recorded for Folic Acid in the same Natural Medicines adverse-effect record shown under Confusion above.

  • A severe allergic reaction / Liver problems / An allergic reaction Worth acting on Additional detail

    Recorded for Folic Acid in the same Natural Medicines adverse-effect record shown under Wheezing above.

  • A higher chance of infection Worth acting on Additional detail

    Recorded for Folic Acid in the same Natural Medicines adverse-effect record shown under Wheezing above.

  • A change in taste Additional detail

    “Orally, folic acid 5 mg daily can cause abdominal cramps and diarrhea. Folic acid 15 mg daily can sometimes cause nausea, abdominal distention, flatulence, and bitter taste in the mouth (15). In children aged 6-30 months at risk of malnourishment, taking a nutritional supplement (Nutriset Ltd) enriched in folic acid 75-150 mcg daily, with or without vitamin B 12 0.9-1.8 mcg daily, for 6 months increases the likelihoo…”

    Folic Acid · Natural Medicines adverse-effect record, reported in diarrhea.

    3 sources cited
    1. 7225. Sandoval M, Charbonnet RM, Okuhama NN, et al. Cat's claw inhibits TNFalpha production and scavenges free radicals: role in cytoprotection. Free Radic Biol Med 2000;29:71-78.
    2. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    3. 90391. Taneja S, Strand TA, Kumar T, et al. Folic acid and vitamin B-12 supplementation and common infections in 6-30-mo-old children in India: a randomized placebo-controlled trial. Am J Clin Nutr 2013;98(3):731-7. PubMed

Showing the 10 most notable of 18 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Folic Acid — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Ethinyl Estradiol, Norethindrone’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Ethinyl Estradiol, Norethindrone column appears here.

Special populations

Folic Acid in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When used orally and appropriately. Folic acid 300-400 mcg is commonly used during pregnancy for prevention of neural tube defects. Miscarriage rates and negative impacts on fetal growth have not been shown to increase with peri-conception supplemental folic acid intakes of 4 mg per day. However, other research shows that taking more than 5 mg per day during pregnancy may reduce development of cognitive, emotional, and motor skills in infants. Also, the tolerable upper intake level (UL) of folic acid for pregnant or lactating women is 800 mcg daily for those 14-18 years of age and 1000 mcg daily for those 19 years and older.

Pregnancy And Lactation Possibly Safe

When L-5-methyltetrahydrofolate (L-5-MTHF), the reduced form of folate, is used orally and appropriately, short-term. L-5-MTHF has been used with apparent safety at a dose of 416 mcg daily for 16 weeks during lactation. Compared to folic acid, this form seems to further increase the folate concentration of red blood cells, but not breast milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Worth knowing

No Interaction — But Ethinyl Estradiol, Norethindrone May Lower Your Folic Acid Levels

These two do not interact. The relationship runs the other way: the licensed record lists Ethinyl Estradiol, Norethindrone as associated with lower Folic Acid levels — rated “Moderate Depletion”.

Estrogens might reduce serum folate levels and increase the risk of folate deficiency. Reduced serum and red blood cell folate levels can occur with the use of conjugated estrogens (Premarin) or oral contraceptives, although this is unlikely with adequate dietary folate intake. There are rare reports of megaloblastic anemia associated with oral contraceptive use, usually in patients with other conditions contributing to folate deficiency. Possible mechanisms by which estrogens contribute to folate deficiency include reduced absorption of dietary folate, increased excretion, induction of liver enzymes, and increased protein binding of folate in serum. There is some evidence that oral contraceptives can increase the rate of progression of cervical dysplasia to cervical cancer, and that folic acid can slow or reverse this dysplasia. Advise patients taking oral contraceptives or other estrogens to maintain a good dietary intake of folate. Recommend supplements only for those with inadequate dietary intake or other conditions that contribute to folate deficiency, and for those diagnosed with, or at increased risk for, cervical dysplasia. For information on foods that are rich in folate, see our chart.

FOLIC ACID — Moderate Depletion

See every medication linked to lower Folic Acid levels · See the full Ethinyl Estradiol, Norethindrone nutrient report

Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center

How to take them

Some Ethinyl Estradiol, Norethindrone Products Have a Food Rule — Folic Acid Should Not Break It

At least one FDA label for a product containing Ethinyl Estradiol, Norethindrone says to take it with food. If you take Folic Acid on an empty stomach out of habit, keep them separate — and take Ethinyl Estradiol, Norethindrone with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Ethinyl Estradiol, Norethindrone products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Tablets should be taken regularly with a meal or at bedtime.

From the Dosage and Administration section of the FDA label we read for Ethinyl Estradiol, Norethindrone — where that label names a specific product, the instruction is that product's.

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Folic Acid or Ethinyl Estradiol, Norethindrone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Folic Acid or Ethinyl Estradiol, Norethindrone, 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, Norethindrone

This page covers Folic Acid only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Norethindrone page lists 240 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 · 196 moderate · 38 minor.

From our pharmacist’s overview on the Ethinyl Estradiol, Norethindrone page

“If you take a birth control pill or hormone therapy containing ethinyl estradiol and norethindrone (Loestrin, Femhrt, and others), a few supplements can genuinely undermine it, so read this page with care. Six of the 240 ingredients on file are rated major, and those six come first.”

Reviewed by 2 · Jul 18, 2026

Open the Ethinyl Estradiol, Norethindrone interaction page

One more smart check

Taking Folic Acid as Part of a Dietary Supplement Product? Check It for Interactions

We hold 92 real supplement products containing Folic Acid, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Folic Acid. Even though Folic Acid itself has no known interaction with Ethinyl Estradiol, Norethindrone, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Folic Acid and Ethinyl Estradiol, Norethindrone 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 Folic Acid
Top 25%

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

29 days ago today
Medication Ethinyl Estradiol, Norethindrone
Top 10%

#258 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Folic Acid reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Folic Acid and Ethinyl Estradiol, Norethindrone records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Folic Acid

What is Folic Acid?

  • Preventing neural tube birth defects
  • Treating or preventing folate deficiency
  • Supporting pregnancy health
  • Certain types of anemia
  • Heart and blood vessel health

Folic acid is the man-made form of vitamin B9 and is one of the most well-studied supplements, especially for preventing serious birth defects when taken before and during early pregnancy. It is widely available, inexpensive, and generally safe at recommended doses, but you should still check with your pharmacist or doctor about the right amount for you.

Synthetic vitamin (not a plant part); natural folate is found in many foods · Tablets, capsules, softgels, multivitamins, prenatal vitamins, fortified foods

An interaction check asks whether these two react with each other — it does not ask whether Folic Acid is a good idea for someone in your situation. Here is what our Folic Acid record says about it on its own.

Folic Acid: dosing

People being treated for a deficiency may need higher amounts under medical supervision. Do not guess at high doses on your own — check with a healthcare professional, especially if you have anemia or are over 50.

From our Folic Acid monograph — the full record covers uses, side effects and every documented interaction.

Read the full Folic Acid monograph & all interactions
Keep checking

Other Drugs & Folic Acid

Browse every other medication we’ve checked against Folic Acid — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
40Moderate
0Minor
2,789No known interaction
Moderate

40 interactions

No interaction 2,789 drugs checked — show the list
Evidence & sources

Folic Acid References

The 56 references that drive our Folic Acid monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Duhra P. Treatment of gastrointestinal symptoms associated with methotrexate therapy for psoriasis. J Am Acad Dermatol 1993;28:466-9. PubMed
  3. Morgan SL, Baggott JE, Vaughn WH, et al. Supplementation with folic acid during methotrexate therapy for rheumatoid arthritis. A double-blind, placebo-controlled trial. Ann Intern Med 1994;121:833-41. PubMed
  4. Froscher W, Maier V, Laage M, et al. Folate deficiency, anticonvulsant drugs, and psychiatric morbidity. Clin Neuropharmacol 1995;18:165-82. PubMed
  5. Lewis DP, Van Dyke DC, Willhite LA, et al. Phenytoin-folic acid interaction. Ann Pharmacother 1995;29:726-35. PubMed
  6. Berg MJ, Stumbo PJ, Chenard CA, et al. Folic acid improves phenytoin pharmacokinetics. J Am Diet Assoc 1995;95:352-6. PubMed
  7. Berg MJ, Fincham RW, Ebert BE, et al. Phenytoin pharmacokinetics: Before and after folic acid administration. Epilepsia 1992;33:712-20. PubMed
  8. Shafer RB, Nuttall FQ. Calcium and folic acid absorption in patients taking anticonvulsant drugs. J Clin Endocrinol Metab 1975;41:1125-9. PubMed
  9. Leeb BF, Witzmann G, Ogris E, et al. Folic acid and cyanocobalamin levels in serum and erythrocytes during low-dose methotrexate therapy of rheumatoid arthritis and psoriatic arthritis patients. Clin Exp Rheumatol 1995;13:459-63.
  10. Morgan SL, Baggott JE, Lee JY, Alarcón GS. Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease preventi
  11. Dijkmans BA. Folate supplementation and methotrexate. Br J Rheumatol 1995;34:1172-4. PubMed
  12. Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
  13. Lambie DG, Johnson RH. Drugs and folate metabolism. Drugs 1985;30:145-55. PubMed
  14. Amer College of Rheumatology ad hoc committee on clinical guidelines. Guidelines for monitoring drug therapy in rheumatoid arthritis. Arthritis Rheum 1996;39:723-31. DOI
  15. Suitor CW, Bailey LB. Dietary folate equivalents: interpretation and application. J Am Diet Assoc 2000;100:88-94. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Folic Acid and Ethinyl Estradiol, Norethindrone Together: Common Questions

Is it safe to take Folic Acid with Ethinyl Estradiol, Norethindrone?
We do not list a known interaction between Folic Acid and Ethinyl Estradiol, Norethindrone. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Should I take Folic Acid and Ethinyl Estradiol, Norethindrone at the same time of day?
At least one FDA label for a product containing Ethinyl Estradiol, Norethindrone says to take it with food. If you take Folic Acid on an empty stomach out of habit, keep them separate and take Ethinyl Estradiol, Norethindrone with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ethinyl Estradiol, Norethindrone products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Can Ethinyl Estradiol, Norethindrone lower my Folic Acid levels?
Natural Medicines records Ethinyl Estradiol, Norethindrone as a medicine that can deplete Folic Acid. That is the opposite direction to an interaction — it is a reason some people are told to take a supplement, not a reason to avoid one. Do not start one on the strength of this page; ask your pharmacist or doctor whether it applies to you.
How was the Folic Acid and Ethinyl Estradiol, Norethindrone combination checked?
Interactions in our licensed database are recorded against drug classes. Ethinyl Estradiol, Norethindrone is filed under 13 classifications, and Folic Acid has documented interactions with 7 drug classes — none of Ethinyl Estradiol, Norethindrone's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Folic Acid interact with any other medications?
Yes. Folic Acid has 40 documented drug interactions in our database — Ethinyl Estradiol, Norethindrone is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Ethinyl Estradiol, Norethindrone interact with any supplements?
Yes. Ethinyl Estradiol, Norethindrone has documented interactions with 240 supplements in our database — Folic Acid is not one of them. The Ethinyl Estradiol, Norethindrone interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Ethinyl Estradiol, Norethindrone and Folic Acid?

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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.