Drug & supplement interaction

Lentinan + Estradiol, Norethindrone Acetate

Estradiol, Norethindrone Acetate brand name: Activella.

Moderate Interaction
Medically reviewed by · Updated October 2026
The bottom line Moderate

Estradiol, Norethindrone Acetate falls into 2 drug categories that Lentinan can interact with; the most serious is rated moderate. Laboratory evidence suggests that lentinan might increase the activity of cytochrome P450 1A2 (CYP1A2).

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

Lentinan and Estradiol, Norethindrone Acetate

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Estradiol, Norethindrone Acetate

Estradiol, Norethindrone Acetate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Lentinan interacts with.

Laboratory evidence suggests that lentinan might increase the activity of cytochrome P450 1A2 (CYP1A2). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP1A2 in patients taking lentinan.
Some drugs metabolized by CYP1A2 include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others.
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 gist with Activella (estradiol plus norethindrone acetate) and lentinan. In lab studies, lentinan seems to speed up an enzyme called CYP1A2, which is one of the pathways your body uses to break down estrogen. If that enzyme works faster, your body could clear the estradiol a little quicker, which in theory might make this hormone therapy slightly less effective. You might notice things like hot flashes, night sweats, or breakthrough spotting creeping back.

The important part: this is only laboratory and animal data, and it has never been reported in real people. So I wouldn't lose sleep over it. Still, if you plan to use a lentinan supplement, run it by your pharmacist or doctor first so they can keep an eye on how you're doing.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Estradiol, Norethindrone Acetate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 3A4 (CYP3A4). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP3A4 in patients taking lentinan.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others.
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

Your Activella combines estradiol with norethindrone, and your liver uses an enzyme called CYP3A4 to help clear the estrogen part out of your body. Some lab research hints that lentinan might speed up that enzyme. If it does, your body could break down the estrogen a little faster, which in theory might make the medicine work less well. For hormone therapy, that could mean a return of symptoms like hot flashes, night sweats, or breakthrough spotting.

I want to be honest with you though: this is based only on test-tube and animal studies, and it has never been reported in real people. So I wouldn't lose sleep over it. Still, it's worth a quick chat with your pharmacist or doctor before adding lentinan.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.

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

Lentinan Also Interacts With Other Medications

Lentinan has 815 moderate known drug interactions in our database — the Estradiol, Norethindrone Acetate one above is among them. If you take anything else, check it against the full list below.

Moderate 815 No known interaction 2,015 (incl. Estradiol, Norethindrone Acetate)
Taking anything else?

Check Another of Your Medications Against Lentinan

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

Everything else you take

See Every Supplement That Interacts With Estradiol, Norethindrone Acetate

This page covers Lentinan only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Estradiol, Norethindrone Acetate page lists 212 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), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 171 moderate · 38 minor.

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

“Activella pairs estradiol with norethindrone as hormone therapy, and because the treatment depends on steady hormone levels in the blood, supplements that raise or lower those levels warrant real scrutiny. Three of the 212 interacting ingredients rate major, and all three hit that weak point: St.”

Reviewed by 2 · Jul 18, 2026

Open the Estradiol, Norethindrone Acetate interaction page

One more smart check

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

We hold 1 real supplement products containing Lentinan, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lentinan. Your product may carry other ingredients that interact with Estradiol, Norethindrone Acetate too, on top of Lentinan — 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 Lentinan and Estradiol, Norethindrone Acetate 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 Lentinan
Steady interest

#1,062 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Estradiol, Norethindrone Acetate
Top half

#1,373 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 Lentinan

What is Lentinan?

Lentinan
  • Immune support
  • Used alongside cancer treatment
  • Anti-inflammatory
  • General wellness/tonic
  • Antimicrobial support

Lentinan is a beta-glucan polysaccharide from shiitake mushrooms that is studied mainly as an immune-modulating add-on to cancer chemotherapy, where it is given by injection in a few countries. Evidence for oral supplements is limited, and quality varies widely between products. Talk with your pharmacist or doctor before using it, especially if you have a health condition or are pregnant or breastfeeding.

Read the full Lentinan monograph & all interactions
Keep checking

Other Drugs & Lentinan

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

0Major
815Moderate
0Minor
2,014No known interaction
815 Moderate 2,014 No interaction
Moderate

815 interactions

Showing 60 of 815 moderate interactions — see all 815 on the Lentinan page.

No interaction 2,014 drugs checked — show the list

We also checked Lentinan against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,014 medications checked with no known interaction — see the full Lentinan list.

See the full Lentinan interactions page
See every supplement checked against Estradiol, Norethindrone Acetate, ranked by severity
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

Keep exploring
Lentinan monograph › Uses, safety, and every drug interaction in one place Estradiol, Norethindrone Acetate supplement interactions › Every supplement checked against Estradiol, Norethindrone Acetate, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Lentinan and Estradiol, Norethindrone Acetate Together: Common Questions

Can you take Lentinan with Estradiol, Norethindrone Acetate?
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 2 interactions listed for Lentinan and Estradiol, Norethindrone Acetate?
Estradiol, Norethindrone Acetate belongs to more than one drug category, and Lentinan 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 Lentinan and Estradiol, Norethindrone Acetate 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

Still Have a Question About Estradiol, Norethindrone Acetate and Lentinan?

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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.