Drug & supplement interaction

Guarana + Mestranol, Norethynodrel

Mestranol, Norethynodrel brand name: Enovid-E.

Minor Interaction
The bottom line Minor

Mestranol, Norethynodrel falls into 2 drug categories that Guarana can interact with; the most serious is rated minor. Theoretically, concomitant use might increase the levels and adverse effects of caffeine.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Guarana and Mestranol, Norethynodrel

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Guarana interacts with whole categories of medication. Mestranol, Norethynodrel falls into 2 of those categories, so it can interact with Guarana in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

1 of 2

Why this applies to Mestranol, Norethynodrel

Mestranol, Norethynodrel falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS — the group Guarana interacts with.

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Guarana contains caffeine. Caffeine is metabolized by the CYP1A2 enzyme. Theoretically, drugs that inhibit CYP1A2 may decrease the rate of caffeine clearance and increase caffeine levels.
Severity Minor Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: the birth control combo in Enovid-E (mestranol plus norethynodrel) contains estrogen, and estrogen can gently slow down the CYP1A2 enzyme, which is the same enzyme your body uses to clear caffeine. Guarana is basically concentrated caffeine. So the interaction runs in this direction: the medication may make caffeine hang around longer, not the other way around.

In plain terms, a guarana energy product could hit you harder than expected. Think more jitteriness, a faster or pounding heartbeat, trouble sleeping, or feeling wired and anxious. This is rated minor and is mostly theoretical, so a cup of coffee likely won't be a big deal, but stacking strong guarana supplements might. If you notice these effects, check in with your pharmacist or doctor.

References
  1. Hagg S, Spigset O, Mjorndal T, Dahlqvist R. Effect of caffeine on clozapine pharmacokinetics in healthy volunteers. Br J Clin Pharmacol 2000;49:59-63. PubMed
  2. Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. PubMed
Minor

CONTRACEPTIVE DRUGS

2 of 2

Mestranol, Norethynodrel also falls under CONTRACEPTIVE DRUGS.

Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in guarana.
Guarana contains caffeine. Oral contraceptives decrease the rate of caffeine clearance by 40% to 65%.
Severity Minor Likelihood Possible Evidence B

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to know about pairing guarana with an estrogen-progestin pill like Enovid-E (mestranol and norethynodrel): the birth control pill isn't the one that builds up here. Instead, these hormones slow down how fast your body clears caffeine, and guarana is basically a concentrated caffeine source. Studies suggest the pill can cut caffeine clearance by roughly 40 to 65 percent, so the caffeine sticks around longer.

In plain terms, you may feel the guarana hit harder and last longer than usual: more jitteriness, a racing or pounding heart, trouble sleeping, and that wired, anxious feeling. This is a minor, mostly theoretical concern, and a cup of coffee likely won't faze you, but stacked energy supplements could. If you notice it, just ease up on caffeine and check with your pharmacist.

References
  1. Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. PubMed
  2. Abernethy DR, Todd EL. Impairment of caffeine clearance by chronic use of low-dose oestrogen-containing oral contraceptives. Eur J Clin Pharmacol 1985;28:425-8. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Guarana Also Interacts With Other Medications

Guarana has 8 major, 462 moderate, 184 minor known drug interactions in our database — the Mestranol, Norethynodrel one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Guarana

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

Everything else you take

See Every Supplement That Interacts With Mestranol, Norethynodrel

This page covers Guarana only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mestranol, Norethynodrel page lists 188 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 · 140 moderate · 42 minor.

From our pharmacist’s overview on the Mestranol, Norethynodrel page

“The list for Mestranol and Norethynodrel (Enovid-E, a combined birth control pill) deserves genuine care, because several entries can quietly undo the pill itself. St.”

Reviewed by 2 · Jul 18, 2026

Open the Mestranol, Norethynodrel interaction page

One more smart check

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

We hold 1,430 real supplement products containing Guarana, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guarana. Your product may carry other ingredients that interact with Mestranol, Norethynodrel too, on top of Guarana — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Guarana and Mestranol, Norethynodrel 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 Guarana
Top 10%

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

29 days ago today
Medication Mestranol, Norethynodrel
Steady interest

#1,656 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.

Supplement

About Guarana

What is Guarana?

Guarana
  • Energy and alertness
  • Reducing fatigue
  • Weight loss support
  • Athletic performance
  • Mental focus

Guarana is an Amazonian seed that is naturally high in caffeine, which explains most of its stimulant and energy effects. While it may give a short-term boost in alertness and reduce fatigue, strong evidence for weight loss or major performance gains is limited, and it carries the same risks as too much caffeine. Talk to your pharmacist or doctor before using it, especially if you have heart problems, anxiety, or are pregnant.

Read the full Guarana monograph & all interactions
Keep checking

Other Drugs & Guarana

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

8Major
462Moderate
184Minor
2,175No known interaction
Major

8 interactions

Moderate

462 interactions

Showing 60 of 462 moderate interactions — see all 462 on the Guarana page.

Minor

184 interactions

Showing 60 of 184 minor interactions — see all 184 on the Guarana page.

No interaction 2,175 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

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Pharmacist Counseling Corner

Taking Guarana and Mestranol, Norethynodrel Together: Common Questions

Can you take Guarana with Mestranol, Norethynodrel?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Guarana and Mestranol, Norethynodrel?
Mestranol, Norethynodrel belongs to more than one drug category, and Guarana interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Guarana and Mestranol, Norethynodrel interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

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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.