Drug & supplement interaction

Phellodendron + Elagolix, Estradiol Norethindrone Acetate, Elagolix

Elagolix, Estradiol Norethindrone Acetate, Elagolix brand name: Oriahnn.

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

Phellodendron has a moderate interaction with Elagolix, Estradiol Norethindrone Acetate, Elagolix. Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP3A4.

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

Phellodendron and Elagolix, Estradiol Norethindrone Acetate, Elagolix

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Elagolix, Estradiol Norethindrone Acetate, Elagolix

Elagolix, Estradiol Norethindrone Acetate, Elagolix falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Phellodendron interacts with.

Theoretically, phellodendron might increase serum levels of drugs metabolized by CYP3A4.
Phellodendron contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, phellodendron might also inhibit CYP3A4.
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 for Oriahnn (elagolix with estradiol and norethindrone). Your body partly clears the elagolix and the hormone pieces using a liver enzyme called CYP3A4. The berberine in phellodendron may gently slow that same enzyme down. If it does, these medicines could clear a bit more slowly and build up, which might nudge up side effects like hot flashes, headaches, nausea, mood changes, or, with the estrogen part, a slightly higher clotting concern.

I want to be honest about the strength here: this is theoretical, based on lab and early research, not real-world reports with this drug. It may not amount to much in practice. Still, since Oriahnn already carries clotting cautions, it's worth a quick chat with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. 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

Phellodendron Also Interacts With Other Medications

Phellodendron has 1,159 moderate known drug interactions in our database — the Elagolix, Estradiol Norethindrone Acetate, Elagolix one above is one of them. If you take anything else, check it against the full list below.

Moderate 1,159 No known interaction 1,671 (incl. Elagolix, Estradiol Norethindrone Acetate, Elagolix)
Taking anything else?

Check Another of Your Medications Against Phellodendron

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

Everything else you take

See Every Supplement That Interacts With Elagolix, Estradiol Norethindrone Acetate, Elagolix

This page covers Phellodendron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Elagolix, Estradiol Norethindrone Acetate, Elagolix page lists 161 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 · 120 moderate · 38 minor.

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

“A woman managing heavy fibroid bleeding with Oriahnn (elagolix, estradiol, and norethindrone acetate) often reaches for supplements too, and here that deserves genuine care. Nearly all 161 entries change how much of the medication reaches her blood, mostly by speeding up or slowing down CYP3A4, the liver enzyme that processes it.”

Reviewed by 2 · Jul 18, 2026

Open the Elagolix, Estradiol Norethindrone Acetate, Elagolix interaction page

One more smart check

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

We hold 393 real supplement products containing Phellodendron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phellodendron. Your product may carry other ingredients that interact with Elagolix, Estradiol Norethindrone Acetate, Elagolix too, on top of Phellodendron — 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 Phellodendron and Elagolix, Estradiol Norethindrone Acetate, Elagolix 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 Phellodendron
Top 25%

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

29 days ago today
Medication Elagolix, Estradiol Norethindrone Acetate, Elagolix
Steady interest

#2,151 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 Phellodendron

What is Phellodendron?

Phellodendron
  • Digestive complaints and diarrhea
  • Inflammation and joint discomfort
  • Stress and weight management (in combination products)
  • Skin conditions (topical, traditional)
  • Antimicrobial support

Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflammatory activity in lab studies. Human evidence for most uses is limited, and it is often sold in combination with other herbs, making its individual effects hard to judge. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Phellodendron monograph & all interactions
Medication

About Elagolix, Estradiol, and Norethindrone

What Is Elagolix, Estradiol, and Norethindrone Used For?

Brand name: Oriahnn

Oriahnn is used to manage heavy menstrual bleeding linked to uterine leiomyomas — the medical name for fibroids, which are noncancerous growths in the uterus. It is approved for premenopausal women who experience abnormally heavy periods because of these fibroids.

Because the treatment can cause ongoing bone loss, it should be used for no more than 24 months. It is not a cure for fibroids — it manages symptoms while you are taking it.

See full Elagolix, Estradiol, and Norethindrone drug information
Keep checking

Other Drugs & Phellodendron

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

0Major
1,159Moderate
0Minor
1,670No known interaction
1,159 Moderate 1,670 No interaction
Moderate

1,159 interactions

Showing 60 of 1,159 moderate interactions — see all 1,159 on the Phellodendron page.

No interaction 1,670 drugs checked — show the list

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

Showing the 60 most looked-up of 1,670 medications checked with no known interaction — see the full Phellodendron list.

See the full Phellodendron interactions page
See every supplement checked against Elagolix, Estradiol Norethindrone Acetate, Elagolix, 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
Phellodendron monograph › Uses, safety, and every drug interaction in one place Elagolix, Estradiol Norethindrone Acetate, Elagolix supplement interactions › Every supplement checked against Elagolix, Estradiol Norethindrone Acetate, Elagolix, ranked by severity Elagolix, Estradiol, and Norethindrone drug information › The full plain-English guide to this medication 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 Phellodendron and Elagolix, Estradiol Norethindrone Acetate, Elagolix Together: Common Questions

Can you take Phellodendron with Elagolix, Estradiol Norethindrone Acetate, Elagolix?
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.
How serious is the Phellodendron and Elagolix, Estradiol Norethindrone Acetate, Elagolix 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 Elagolix, Estradiol Norethindrone Acetate, Elagolix and Phellodendron?

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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.