Drug & supplement interaction

Rhodiola + Relugolix, Estradiol, Norethindrone Acetate

Relugolix, Estradiol, Norethindrone Acetate brand name: Myfembree.

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

Relugolix, Estradiol, Norethindrone Acetate falls into 3 drug categories that Rhodiola can interact with; the most serious is rated moderate. Theoretically, rhodiola might increase levels of P-glycoprotein substrates.

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

Rhodiola and Relugolix, Estradiol, Norethindrone Acetate

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

Why Are There 3 Interactions?

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

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 3

Why this applies to Relugolix, Estradiol, Norethindrone Acetate

Relugolix, Estradiol, Norethindrone Acetate falls under P-GLYCOPROTEIN SUBSTRATES — the group Rhodiola interacts with.

Theoretically, rhodiola might increase levels of P-glycoprotein substrates.
In vitro research shows that rhodiola inhibits P-glycoprotein. Theoretically, using rhodiola with P-glycoprotein substrates might increase drug levels and potentially increase the risk of adverse effects.
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 deal with combining Rhodiola and Myfembree (which is relugolix, estradiol, and norethindrone). The relugolix part is moved through your gut by a transporter pump called P-glycoprotein. In lab studies (test tubes only, not people), Rhodiola seemed to slow that pump down a bit. If that happened in your body, a little more relugolix could get absorbed, which in theory might nudge up side effects like headaches, hot flashes, mood changes, or fatigue.

I want to be honest though: this is a theoretical concern based only on lab data, so we really don't know if it matters in real life. Since Myfembree is an important hormone medication, just give your pharmacist or doctor a heads-up before adding Rhodiola so they can weigh in for your situation.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hellum BH, Tosse A, Hoybakk K, et al. Potent in vitro inhibition of CYP3A4 and P-glycoprotein by Rhodiola rosea. Planta Med 2010;76:331-8.
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

Relugolix, Estradiol, Norethindrone Acetate also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that rhodiola inhibits CYP1A2. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of caffeine, a CYP1A2 substrate.
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 gist with Myfembree (relugolix, estradiol, norethindrone). In lab dishes, rhodiola can mildly slow down a liver enzyme called CYP1A2, which helps process estradiol, one of the hormones in this combo pill. In theory, slowing that enzyme could let estradiol build up a little, which might bump up estrogen-type side effects like nausea, breast tenderness, headaches, or fluid retention.

The good news: this is mostly theoretical and weak. The effect varies a lot by product, and a real human study found rhodiola didn't actually slow CYP1A2 in a meaningful way. So for most people it's unlikely to cause trouble. Still, since Myfembree is a hormone medication, it's worth running rhodiola past your pharmacist or doctor before starting it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Thu OK, Nilsen OG, Hellum B. In vitro inhibition of cytochrome P-450 activities and quantification of constituents in a selection of commercial Rhodiola rosea products. Pharm Bio. 2016 Dec;54(12):3249-3256.
  2. Thu OK, Spigset O, Nilsen OG, Hellum B. Effect of commercial Rhodiola rosea on CYP enzyme activity in humans. Eur J Clin Pharmacol. 2016 Mar;72(3):295-300. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

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

Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that rhodiola inhibits CYP3A4. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of midazolam, a CYP3A4 substrate.
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

Myfembree combines three active hormones (relugolix, estradiol, and norethindrone), and parts of this combo are broken down by a liver enzyme called CYP3A4. On paper, Rhodiola can block that enzyme a little, which could let these hormones build up slightly. In theory, that might nudge up side effects you'd already watch for with Myfembree, like headaches, nausea, mood changes, breast tenderness, or spotting.

Here's the reassuring part: this is mostly lab-dish data, and the effect is inconsistent from product to product. A real human study found Rhodiola didn't actually slow CYP3A4 in a meaningful way. So a true problem here is unlikely, but since Myfembree is a long-term medicine, it's worth a quick word with your pharmacist or doctor before adding Rhodiola.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hellum BH, Tosse A, Hoybakk K, et al. Potent in vitro inhibition of CYP3A4 and P-glycoprotein by Rhodiola rosea. Planta Med 2010;76:331-8.
  2. Thu OK, Nilsen OG, Hellum B. In vitro inhibition of cytochrome P-450 activities and quantification of constituents in a selection of commercial Rhodiola rosea products. Pharm Bio. 2016 Dec;54(12):3249-3256.
  3. Thu OK, Spigset O, Nilsen OG, Hellum B. Effect of commercial Rhodiola rosea on CYP enzyme activity in humans. Eur J Clin Pharmacol. 2016 Mar;72(3):295-300. 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

Rhodiola Also Interacts With Other Medications

Rhodiola has 623 moderate, 647 minor known drug interactions in our database — the Relugolix, Estradiol, Norethindrone Acetate one above is among them. If you take anything else, check it against the full list below.

Moderate 623 Minor 647 No known interaction 1,560 (incl. Relugolix, Estradiol, Norethindrone Acetate)
Taking anything else?

Check Another of Your Medications Against Rhodiola

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

From our Q&A

Questions About Rhodiola or Relugolix, Estradiol, Norethindrone Acetate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rhodiola or Relugolix, Estradiol, Norethindrone Acetate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

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

This page covers Rhodiola only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Relugolix, Estradiol, Norethindrone Acetate page lists 219 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 174 moderate · 37 minor.

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

“Grapefruit is where I would start on this page. Myfembree (relugolix, estradiol, and norethindrone acetate) depends on the CYP3A4 enzyme to be cleared, and grapefruit juice blocks that enzyme, raising drug levels and side effect risk.”

Reviewed by 2 · Jul 18, 2026

Open the Relugolix, Estradiol, Norethindrone Acetate interaction page

One more smart check

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

We hold 2,713 real supplement products containing Rhodiola, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rhodiola. Your product may carry other ingredients that interact with Relugolix, Estradiol, Norethindrone Acetate too, on top of Rhodiola — 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 Rhodiola and Relugolix, 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 Rhodiola
Top 5%

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

29 days ago today
Medication Relugolix, Estradiol, Norethindrone Acetate
Top 10%

#257 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 Rhodiola

What is Rhodiola?

Rhodiola
  • Fatigue and low energy
  • Stress and coping (adaptogen)
  • Mental performance and focus
  • Mild depression
  • Physical and exercise performance

Rhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue and improve mood, but the evidence is limited and not strong. It is generally well tolerated for short-term use, but talk to your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Rhodiola monograph & all interactions
Medication

About Relugolix, Estradiol, and Norethindrone

What Is Relugolix, Estradiol, and Norethindrone Used For?

Brand name: Myfembree

Myfembree is approved for two conditions in premenopausal women: managing heavy menstrual bleeding caused by uterine fibroids (non-cancerous growths in the uterus), and managing moderate to severe pain caused by endometriosis (a condition where tissue similar to the uterine lining grows outside the uterus).

Treatment with Myfembree should not exceed 24 months because of the risk of ongoing bone loss that may not fully reverse after stopping the medication.

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

Other Drugs & Rhodiola

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

0Major
623Moderate
647Minor
1,559No known interaction
623 Moderate 647 Minor 1,559 No interaction
Moderate

623 interactions

Showing 60 of 623 moderate interactions — see all 623 on the Rhodiola page.

Minor

647 interactions

Showing 60 of 647 minor interactions — see all 647 on the Rhodiola page.

No interaction 1,559 drugs checked — show the list

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

Showing the 60 most looked-up of 1,559 medications checked with no known interaction — see the full Rhodiola list.

See the full Rhodiola interactions page
See every supplement checked against Relugolix, 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
Rhodiola monograph › Uses, safety, and every drug interaction in one place Relugolix, Estradiol, Norethindrone Acetate supplement interactions › Every supplement checked against Relugolix, Estradiol, Norethindrone Acetate, ranked by severity Relugolix, 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 Rhodiola and Relugolix, Estradiol, Norethindrone Acetate Together: Common Questions

Can you take Rhodiola with Relugolix, 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 3 interactions listed for Rhodiola and Relugolix, Estradiol, Norethindrone Acetate?
Relugolix, Estradiol, Norethindrone Acetate belongs to more than one drug category, and Rhodiola 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 Rhodiola and Relugolix, 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 Relugolix, Estradiol, Norethindrone Acetate and Rhodiola?

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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.