Drug & supplement interaction

Hemp + Etonogestrel, Ethinyl Estradiol

Etonogestrel, Ethinyl Estradiol brand name: NuvaRing.

Moderate Interaction
The bottom line Moderate

Etonogestrel, Ethinyl Estradiol falls into 3 drug categories that Hemp can interact with; the most serious is rated moderate. Theoretically, hemp might interfere with hormone therapy due to its estrogenic effects.

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

Hemp and Etonogestrel, Ethinyl Estradiol

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

Why Are There 3 Interactions?

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

Moderate

ESTROGENS

1 of 3

Why this applies to Etonogestrel, Ethinyl Estradiol

Etonogestrel, Ethinyl Estradiol falls under ESTROGENS — the group Hemp interacts with.

Theoretically, hemp might interfere with hormone therapy due to its estrogenic effects.
In an ovariectomized animal model, a diet containing hemp seed 1%, 2%, or 10% resulted in normalized plasma levels of 17-beta-estradiol. The mechanism of action for this effect is unclear.
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

Here's the honest picture with your NuvaRing, which delivers the hormones etonogestrel and ethinyl estradiol. The concern on file is that hemp might have mild estrogen-like activity and could, in theory, nudge your hormone balance. But this idea comes only from an animal study where hemp seed in the diet helped normalize estrogen levels. The actual mechanism wasn't clear, and there's no solid human evidence that hemp weakens or strengthens birth control.

In plain terms, eating hemp seeds or hemp oil as food is very unlikely to affect how well your ring works. If you're considering concentrated hemp supplements, it's worth a quick chat with your pharmacist or doctor first, just to be safe. Don't change anything about your NuvaRing on your own.

References
  1. Saberivand A, Karimi I, Becker LA, et al. The effects of Cannabis sativa L. seed (hempseed) in the ovariectomized rat model of menopause. Methods Find Exp Clin Pharmacol. 2010;32(7):467-73. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

Etonogestrel, Ethinyl Estradiol also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, hemp might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that hemp induces CYP1A2 enzymes.
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 with the NuvaRing (which releases etonogestrel and ethinyl estradiol) and hemp. Lab studies suggest hemp may speed up an enzyme called CYP1A2, which is one pathway the body uses to break down estrogen. In theory, faster breakdown could lower hormone levels a bit. With birth control, even small dips in hormone levels are worth thinking about, since the concern would be slightly weaker protection against pregnancy or some breakthrough spotting.

That said, this is very weak evidence, based only on test-tube research, not real people. Eating hemp seeds or hemp oil as food almost certainly won't cause trouble. If you're using concentrated hemp supplements, just mention it to your pharmacist or doctor so they can reassure you.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Etonogestrel, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, hemp might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that hemp induces CYP3A4 enzymes.
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 for your NuvaRing (etonogestrel and ethinyl estradiol). Both hormones in the ring are processed by a liver enzyme called CYP3A4. Lab studies hint that hemp might speed up that enzyme, which could lower hormone levels a bit. For a birth control product, the worry would be slightly weaker protection or some breakthrough spotting if levels dipped too low.

The good news: this is only a theoretical, test-tube finding, not something seen in real people, and eating hemp seeds or hemp oil as food is very unlikely to matter. Concentrated hemp supplements are less studied. Since reliable birth control is important, it's worth a quick chat with your pharmacist or doctor before adding any hemp product.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. 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

Hemp Also Interacts With Other Medications

Hemp has 40 moderate, 897 minor known drug interactions in our database — the Etonogestrel, Ethinyl Estradiol 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 Hemp

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

Everything else you take

See Every Supplement That Interacts With Etonogestrel, Ethinyl Estradiol

This page covers Hemp only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etonogestrel, 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 Etonogestrel, Ethinyl Estradiol page

“St. John's wort belongs at the top of any conversation about NuvaRing (etonogestrel and ethinyl estradiol) and supplements.”

Reviewed by 2 · Jul 18, 2026

Open the Etonogestrel, Ethinyl Estradiol interaction page

One more smart check

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

We hold 720 real supplement products containing Hemp, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hemp. Your product may carry other ingredients that interact with Etonogestrel, Ethinyl Estradiol too, on top of Hemp — 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 Hemp and Etonogestrel, 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.

Supplement Hemp
Top 25%

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

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

#457 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 Hemp

What is Hemp?

Hemp
  • Plant-based protein source
  • Heart health support
  • Skin and hair health
  • Reducing inflammation
  • General nutrition (omega fatty acids)

Hemp seeds and hemp seed oil are nutritious foods rich in protein, fiber, and healthy omega-3 and omega-6 fatty acids, and they are generally safe for most people as part of the diet. While the nutrition is real, strong human evidence that hemp supplements treat specific medical conditions is limited. Talk with your pharmacist or doctor before using hemp products for a health concern, especially if you are pregnant or breastfeeding.

Read the full Hemp monograph & all interactions
Keep checking

Other Drugs & Hemp

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

0Major
40Moderate
897Minor
1,892No known interaction
Moderate

40 interactions

Minor

897 interactions

Showing 60 of 897 minor interactions — see all 897 on the Hemp page.

No interaction 1,892 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 Hemp and Etonogestrel, Ethinyl Estradiol Together: Common Questions

Can you take Hemp with Etonogestrel, Ethinyl Estradiol?
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 Hemp and Etonogestrel, Ethinyl Estradiol?
Etonogestrel, Ethinyl Estradiol belongs to more than one drug category, and Hemp 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 Hemp and Etonogestrel, Ethinyl Estradiol 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.