Drug & supplement interaction

Gamma-hydroxybutyrate (ghb) + Ospemifene

Ospemifene brand name: Osphena.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 20, 2026

The bottom line No known interaction

We found no known interaction between Gamma-hydroxybutyrate (ghb) and Ospemifene 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 Ospemifene states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Gamma-hydroxybutyrate (ghb) and Ospemifene

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 Ospemifene and Gamma-hydroxybutyrate (ghb) 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.

Gamma-hydroxybutyrate (ghb) safety at a glance

Gamma-hydroxybutyr... overall Avoid GHB is a controlled substance with a high risk of overdose, coma, and death; it is not a safe supplement.

Pregnancy Unsafe When used orally. GHB has been associated with life-threatening toxicities. Read the full pregnancy detail

Breastfeeding Unsafe When used orally. GHB has been associated with life-threatening toxicities. 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 Ospemifene and Gamma-hydroxybutyrate (ghb)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Ospemifene

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ospemifene is filed under 3 classifications — thyroid hormone, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Gamma-hydroxybutyrate (ghb) has documented interactions with 10 drug classes — the most serious being alcohol (ethanol) (major), cns depressants (major) and divalprox sodium (depakote) (major) — and none of Ospemifene’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

Gamma-hydroxybutyrate (ghb) Does Interact With Other Medications

Gamma-hydroxybutyrate (ghb) has 249 major, 21 moderate, 5 minor known drug interactions in our database — Ospemifene isn’t one of them. If you take anything else, check it against the full list below.

Major 249 Moderate 21 Minor 5 No known interaction 2,555 (incl. Ospemifene)

Taking anything else?

Check Another of Your Medications Against Gamma-hydroxybutyrate (ghb)

Covers the 2,830 medications we’ve checked against Gamma-hydroxybutyrate (ghb). Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Gamma-hydroxybutyrate (ghb) and Ospemifene May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

Muscle pain / Headache reported in 8.0% of FDA reports for Ospemifene Additional detail
Gamma-hydroxybutyrate (ghb)
“Orally, GHB can cause headache, hallucinations, dizziness, confusion, amnesia, drowsiness, somnolence, tremor, and agitation. It can also cause ataxia, eosinophilia-myalgia syndrome, memory loss, reduced or altered levels of consciousness, seizures, and coma.”

Gamma-hydroxybutyrate (ghb) · Natural Medicines adverse-effect record, reported in anxiety.
6 sources cited

6016. Timby N, Eriksson A. Gamma-Hydroxybutyrate-Associated Deaths. Am J Med 2000;108:518. PubMed

10658. Mason P, Kerns II W. Gamma Hydroxybutyric Acid (GHB) Intoxication. Acad Emerg Med 2002;9:730-39.. DOI

93823. Kuiper MA, Peikert N, Boerma EC. Gamma-hydroxybutyrate withdrawal syndrome: a case report. Cases J. 2009 Mar 25;2:6530. DOI

93824. Leone MA, Vigna-Taglianti F, Avanzi G, Brambilla R, Faggiano F. Gamma-hydroxybutyrate (GHB) for treatment of alcohol withdrawal and prevention of relapses. Cochrane Database Syst Rev. 2010 Feb 17;(2):CD006266. PubMed

93827. Nimmerrichter AA, Walter H, Gutierrez-Lobos KE, Lesch OM. Double-blind controlled trial of gamma-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol Alcohol. 2002 Jan-Feb;37(1):67-73. PubMed

93830. Stomberg MW, Knudsen K, Stomberg H, Skärsäter I. Symptoms and signs in interpreting gamma-hydroxybutyrate (GHB) intoxication - an explorative study. Scand J Trauma Resusc Emerg Med. 2014 Apr 23;22:27. PubMed
Ospemifene

Listed in the ADVERSE REACTIONS section of the FDA label for Ospemifene, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›
Sweating Additional detail

Gamma-hydroxybutyrate (ghb)

Recorded for Gamma-hydroxybutyrate (ghb) in the same Natural Medicines adverse-effect record shown under Muscle pain / Headache above.

Ospemifene

Listed in the ADVERSE REACTIONS section of the FDA label for Ospemifene. Read the label on DailyMed ›

Reported for Gamma-hydroxybutyrate (ghb) but not commonly for Ospemifene: hallucinations, reduced appetite, chest pain and severe muscle breakdown.

Effects for Ospemifene come from the ADVERSE REACTIONS section of its FDA label; effects for Gamma-hydroxybutyrate (ghb) come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 2,601 voluntary FDA FAERS reports for Ospemifene that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Gamma-hydroxybutyrate (ghb) in Pregnancy & Breastfeeding

Pregnancy And Lactation Unsafe

When used orally. GHB has been associated with life-threatening toxicities.

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

How to take them

Some Ospemifene Products Have a Food Rule — Gamma-hydroxybutyrate (ghb) Should Not Break It

At least one FDA label for a product containing Ospemifene says to take it with food. If you take Gamma-hydroxybutyrate (ghb) on an empty stomach out of habit, keep them separate — and take Ospemifene 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 Ospemifene 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.

One tablet taken orally once daily with food.

From the Dosage and Administration section of the FDA label we read for Ospemifene — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

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.

Everything else you take

See Every Supplement That Interacts With Ospemifene

This page covers Gamma-hydroxybutyrate (ghb) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ospemifene page lists 155 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Tiratricol (major) and Acacia Rigidula (moderate).

By severity: 4 major · 112 moderate · 39 minor.

From our pharmacist’s overview on the Ospemifene page

“Women prescribed ospemifene (Osphena) for painful intercourse after menopause are often the same women reaching for St. John's wort for mood or grapefruit juice at breakfast, and both sit among the four major-rated interactions on this page, so the list deserves genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Ospemifene interaction page

How much people look this up

Where Gamma-hydroxybutyrate (ghb) and Ospemifene 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 Gamma-hydroxybutyrate (ghb)

Steady interest

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

29 days ago today

Medication Ospemifene

Steady interest

#2,474 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 Gamma-hydroxybutyrate (ghb) reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Gamma-hydroxybutyrate (ghb) and Ospemifene 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Gamma-hydroxybutyrate (ghb)

What is Gamma-hydroxybutyrate (ghb)?

Narcolepsy (cataplexy and excessive daytime sleepiness)
Sleep aid
Misused as a recreational 'party drug'
Bodybuilding/muscle building (unproven)
Alcohol withdrawal (in some countries)

GHB (gamma-hydroxybutyrate) is a powerful central nervous system depressant that is NOT a safe dietary supplement. In the U.S. it is a controlled substance, and only a tightly regulated prescription form (sodium oxybate) is legal for narcolepsy. Non-prescription GHB can cause coma, breathing failure, and death, and it is also a known 'date-rape' drug — it should not be taken outside of medical supervision.

Liquid solution, powder, prescription oral solution (sodium oxybate)

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

Gamma-hydroxybutyrate (ghb): dosing

There is no safe over-the-counter or supplement dose of GHB. Because illicit products are not standardized, there is no reliable way to measure a safe amount, and small differences can cause overdose.The only legitimate use is the prescription medication sodium oxybate, which is dosed and monitored by a doctor through a special safety program. Do not attempt to use GHB on your own.

From our Gamma-hydroxybutyrate (ghb) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Gamma-hydroxybutyrate (ghb) monograph & all interactions

Medication

About Ospemifene

What Is Ospemifene Used For?

Brand name: Osphena

Osphena (ospemifene) is used to treat two specific symptoms of vulvar and vaginal atrophy — the thinning and drying of vaginal tissues that can happen after menopause. The first is moderate to severe dyspareunia (painful intercourse), and the second is moderate to severe vaginal dryness.

Both of these uses are for postmenopausal women only. Osphena is not used in children or in women who are pregnant or may become pregnant.

Most-Reported Side Effects for Ospemifene

From FAERS, the FDA’s public side-effect reporting system (2,601 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Hot flush 372 reports

Headache 209 reports

Muscle spasms 194 reports

Vaginal haemorrhage 150 reports

Vaginal discharge 134 reports

See full Ospemifene drug information

Keep checking

Other Drugs & Gamma-hydroxybutyrate (ghb)

Browse every other medication we’ve checked against Gamma-hydroxybutyrate (ghb) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

249Major

21Moderate

5Minor

2,554No known interaction

249 Major 21 Moderate 5 Minor 2,554 No interaction

Major

249 interactions

Showing 60 of 249 major interactions — see all 249 on the Gamma-hydroxybutyrate (ghb) page.

Moderate

21 interactions

Minor

5 interactions

No interaction 2,554 drugs checked — show the list

We also checked Gamma-hydroxybutyrate (ghb) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,554 medications checked with no known interaction — see the full Gamma-hydroxybutyrate (ghb) list.

See the full Gamma-hydroxybutyrate (ghb) interactions page

See every supplement checked against Ospemifene, ranked by severity

Evidence & sources

Gamma-hydroxybutyrate (ghb) References

The 31 references that drive our Gamma-hydroxybutyrate (ghb) 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.

Harrington RD, Woodward JA, Hooton TM, et al. Life-threatening interactions between HIV-1 protease inhibitors and the illicit drugs MDMA and gamma-hydroxybutyrate. Arch Intern Med 1999;159:2221-4.
Anon. FDA alert on misuse of consumer products containing GHB, GBL and BD. Food and Drug Administration, Rockville, MD. June 15, 1999.
Anon. Important message for health professionals: Report serious adverse events associated with dietary supplements containing GBL, GHB or BD. Food and Drug Administration, Rockville, MD. August 25, 1999. Available at: http://vm.cfsan.fda.gov/~dms/mwg
Otto A. Acquaintance rape drug may one day help instead of hurt (news). Pharmacy Today. American Pharmaceutical Association, Washington, DC. April 2000:17.
Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8. DOI
Dyer JE. Gamma-Hydroxybutyrate: a health-food product producing coma and seizure-like activity (abstract). Am J Emerg Med 1991;9:321-4.
FDA Talk Paper. FDA Warns About GBL-Related Products. 1999. Available at: vm.cfsan.fda.gov/~lrd/tpgbl2.html
Timby N, Eriksson A. Gamma-Hydroxybutyrate-Associated Deaths. Am J Med 2000;108:518. PubMed
Galloway GP, Frederick SL, Staggers FE Jr, et al. Gamma-hydroxybutyrate: an emerging drug of abuse that causes physical dependence. Addiction 1997;92:89-96. DOI
Price G. In-patient detoxification after GHB dependence. Br J Psychiatry 2000;177:181. PubMed
Dyer J, Roth B, Hyma B. Gamma-Hydroxybutyrate withdrawal syndrome. Ann Emerg Med 2001;37:147-53.. PubMed
Ingels M, Rangan C, Bellezzo J, Clark R. Coma and respiratory depression following the ingestion of GHB and its precursors: Three cases. J Emerg Med 2000;19:47-50.. PubMed
Mason P, Kerns II W. Gamma Hydroxybutyric Acid (GHB) Intoxication. Acad Emerg Med 2002;9:730-39.. DOI
Abanades S, Farré M, Segura M, et al. Gamma-hydroxybutyrate (GHB) in humans: pharmacodynamics and pharmacokinetics. Ann N Y Acad Sci. 2006 Aug;1074:559-76. PubMed
Boscolo-Berto R, Viel G, Montagnese S, Raduazzo DI, Ferrara SD, Dauvilliers Y. Narcolepsy and effectiveness of gamma-hydroxybutyrate (GHB): a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2012 Oct;16(5):431-43. PubMed
Kuiper MA, Peikert N, Boerma EC. Gamma-hydroxybutyrate withdrawal syndrome: a case report. Cases J. 2009 Mar 25;2:6530. DOI
Leone MA, Vigna-Taglianti F, Avanzi G, Brambilla R, Faggiano F. Gamma-hydroxybutyrate (GHB) for treatment of alcohol withdrawal and prevention of relapses. Cochrane Database Syst Rev. 2010 Feb 17;(2):CD006266. PubMed
Nimmerrichter AA, Walter H, Gutierrez-Lobos KE, Lesch OM. Double-blind controlled trial of gamma-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol Alcohol. 2002 Jan-Feb;37(1):67-73. PubMed
Stomberg MW, Knudsen K, Stomberg H, Skärsäter I. Symptoms and signs in interpreting gamma-hydroxybutyrate (GHB) intoxication - an explorative study. Scand J Trauma Resusc Emerg Med. 2014 Apr 23;22:27. PubMed
Thai D, Dyer JE, Benowitz NL, Haller CA. Gamma-hydroxybutyrate and ethanol effects and interactions in humans. J Clin Psychopharmacol. 2006 Oct;26(5):524-9. PubMed
Weiss T, Müller D, Marti I, Happold C, Russmann S. Gamma-hydroxybutyrate (GHB) and topiramate--clinically relevant drug interaction suggested by a case of coma and increased plasma GHB concentration. Eur J Clin Pharmacol. 2013 May;69(5):1193-4. PubMed
Liakoni E, Dempsey DA, Meyers M, et al. Effect of ?-hydroxybutyrate (GHB) on driving as measured by a driving simulator. Psychopharmacology (Berl) 2018;235(11):3223-32. doi: 10.1007/s00213-018-5025-2. PubMed
Xu XM, Wei YD, Liu Y, Li ZX. Gamma-hydroxybutyrate (GHB) for narcolepsy in adults: an updated systematic review and meta-analysis. Sleep Med 2019;64:62-70. doi: 10.1016/j.sleep.2019.06.017. PubMed
Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
Aronsen AC, Brekke M, Vallersnes OM. Acute poisoning with gamma-hydroxybutyrate. Tidsskr Nor Laegeforen 2020;140(10). PubMed
Lee S, Boyce SL, Southwell J. Case of gamma-hydroxybutyrate poisoning in an infant. J Paediatr Child Health 2022;58(5):909-910. PubMed
Abid M, Kietzerow J, Iwersen-Bergmann S, Schnitgerhans T, Andresen-Streichert H. Characteristics and dose-effect relationship of clinical gamma-hydroxybutyrate intoxication: A case series. J Forensic Sci 2022;67(1):416-427. PubMed
Rodriguez-Cruz V, Ren T, Morris ME. Drug-drug interaction between diclofenac and gamma-hydroxybutyric acid. Biopharm Drug Dispos 2021;42(8):351-358. PubMed
Wolf CJH, Beurmanjer H, Dijkstra BAG, et al. Characterization of the GHB Withdrawal Syndrome. J Clin Med 2021;10(11):2333. PubMed
Chien-Po H, An-Yi W. Amphetamine toxicity masked by concomitant ?-hydroxybutyrate (GHB) ingestion. Am J Emerg Med 2022;58:338-339. PubMed
Siefried KJ, Freeman G, Roberts DM, et al. Inpatient GHB withdrawal management in an inner-city hospital in Sydney, Australia: a retrospective medical record review. Psychopharmacology (Berl) 2022. 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 Gamma-hydroxybutyrate (ghb) and Ospemifene Together: Common Questions

Is it safe to take Gamma-hydroxybutyrate (ghb) with Ospemifene?

We do not list a known interaction between Gamma-hydroxybutyrate (ghb) and Ospemifene. 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.

Do Gamma-hydroxybutyrate (ghb) and Ospemifene have any of the same side effects?

Yes — our sources link each of them separately to 3 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.

Should I take Gamma-hydroxybutyrate (ghb) and Ospemifene at the same time of day?

At least one FDA label for a product containing Ospemifene says to take it with food. If you take Gamma-hydroxybutyrate (ghb) on an empty stomach out of habit, keep them separate and take Ospemifene with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ospemifene products can differ — so check the directions on your own box. This is about absorption, not an interaction.

How was the Gamma-hydroxybutyrate (ghb) and Ospemifene combination checked?

Interactions in our licensed database are recorded against drug classes. Ospemifene is filed under 3 classifications, and Gamma-hydroxybutyrate (ghb) has documented interactions with 10 drug classes — none of Ospemifene'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 Gamma-hydroxybutyrate (ghb) interact with any other medications?

Yes. Gamma-hydroxybutyrate (ghb) has 275 documented drug interactions in our database — Ospemifene 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 Ospemifene interact with any supplements?

Yes. Ospemifene has documented interactions with 155 supplements in our database — Gamma-hydroxybutyrate (ghb) is not one of them. The Ospemifene interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Gamma-hydroxybutyrate (ghb) monograph Uses, safety profile, and every drug interaction in one place Ospemifene drug information The full plain-English guide to this medication Ospemifene supplement interactions Every supplement checked against Ospemifene, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 31 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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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.