Drug & supplement interaction

Guggul + Ethinyl Estradiol, Drospirenone

Ethinyl Estradiol, Drospirenone brand name: Yaz.

Moderate Interaction
The bottom line Moderate

Ethinyl Estradiol, Drospirenone falls into 3 drug categories that Guggul can interact with; the most serious is rated moderate. Theoretically, guggul might reduce the effects of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Guggul and Ethinyl Estradiol, Drospirenone

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Guggul interacts with whole categories of medication. Ethinyl Estradiol, Drospirenone falls into 3 of those categories, so it can interact with Guggul in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

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Why this applies to Ethinyl Estradiol, Drospirenone

Ethinyl Estradiol, Drospirenone falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Guggul interacts with.

Theoretically, guggul might reduce the effects of CYP3A4 substrates.
In vitro research shows that guggul constituents known as guggulsterones can induce CYP3A4.
Severity Moderate Likelihood Probable Evidence D

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..

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

Here's the gist if you take Yaz (the combination of ethinyl estradiol and drospirenone) and you're thinking about guggul. Your birth control hormones are cleared from your body by a liver enzyme called CYP3A4. Lab studies hint that guggul may speed up that enzyme, which in theory could lower your hormone levels a bit. For a birth control pill, the worry with lower levels is reduced reliability, meaning a higher chance of breakthrough bleeding or, in the worst case, less protection against pregnancy.

I'll be honest: this is based only on test-tube research, not real people, so it's far from certain. Still, since an unplanned pregnancy is a big deal, I'd run it by your pharmacist or doctor before combining them rather than guessing.

References
  1. Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35. PubMed
Moderate

CONTRACEPTIVE DRUGS

2 of 3

Ethinyl Estradiol, Drospirenone also falls under CONTRACEPTIVE DRUGS.

Theoretically, guggul might increase the risk of adverse effects when taken with contraceptive drugs.
In vitro research shows that guggul has estrogen-alpha receptor agonist activity.
Severity Moderate 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

Yaz combines two hormones, an estrogen (ethinyl estradiol) and a progestin (drospirenone), to prevent pregnancy. Here's the thing about guggul: in test-tube studies, its active compounds appear to act a bit like estrogen on certain receptors. The concern is that adding that estrogen-like activity on top of your pill could, in theory, nudge up the risk of estrogen-related side effects.

What might that look like? Things like breast tenderness, nausea, bloating, headaches, or mood changes. Honestly, this is a theoretical worry based only on lab research, not real-world cases, so I wouldn't lose sleep over it. Still, since you're on a hormone pill, it's worth a quick chat with your pharmacist or doctor before starting concentrated guggul supplements.

References
  1. Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35. PubMed
Moderate

ESTROGENS

3 of 3

Ethinyl Estradiol, Drospirenone also falls under ESTROGENS.

Theoretically, guggul might increase the risk of adverse effects when taken with estrogens.
In vitro research shows that guggul constituents known as guggulsterones have estrogen-alpha receptor agonist activity.
Severity Moderate 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

Yaz combines two hormones, ethinyl estradiol (an estrogen) and drospirenone, to prevent pregnancy. The concern here is pretty mild and mostly theoretical. In lab dishes, the active compounds in guggul (guggulsterones) act a little like estrogen by switching on estrogen receptors. So in theory, stacking guggul on top of your birth control could add to your overall estrogen-like activity.

If that effect were real in people, you might notice more estrogen-type symptoms such as breast tenderness, nausea, bloating, or headaches. But to be honest, this is only based on cell studies, not human research, so we really don't know if it matters in real life. I wouldn't lose sleep over it, but do mention guggul to your pharmacist or doctor before starting it.

References
  1. Brobst DE, Ding X, Creech KL, et al. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 2004;310:528-35. 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

Guggul Also Interacts With Other Medications

Guggul has 756 moderate known drug interactions in our database — the Ethinyl Estradiol, Drospirenone 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 Guggul

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

Everything else you take

See Every Supplement That Interacts With Ethinyl Estradiol, Drospirenone

This page covers Guggul only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Drospirenone page lists 245 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 · 200 moderate · 39 minor.

Open the Ethinyl Estradiol, Drospirenone interaction page

One more smart check

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

We hold 955 real supplement products containing Guggul, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guggul. Your product may carry other ingredients that interact with Ethinyl Estradiol, Drospirenone too, on top of Guggul — 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 Guggul and Ethinyl Estradiol, Drospirenone 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 Guggul
Top 25%

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

29 days ago today
Medication Ethinyl Estradiol, Drospirenone
Top 25%

#702 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 Guggul

What is Guggul?

Guggul
  • High cholesterol
  • Joint pain and arthritis
  • Weight management
  • Acne
  • Skin conditions

Guggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are mixed and often low-quality, and it can cause stomach upset and skin rashes. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Guggul monograph & all interactions
Keep checking

Other Drugs & Guggul

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

0Major
756Moderate
0Minor
2,073No known interaction
Moderate

756 interactions

Showing 60 of 756 moderate interactions — see all 756 on the Guggul page.

No interaction 2,073 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 Guggul and Ethinyl Estradiol, Drospirenone Together: Common Questions

Can you take Guggul with Ethinyl Estradiol, Drospirenone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Guggul and Ethinyl Estradiol, Drospirenone?
Ethinyl Estradiol, Drospirenone belongs to more than one drug category, and Guggul 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 Guggul and Ethinyl Estradiol, Drospirenone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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.