Sage + Ethinyl Estradiol, Desogestrel
Ethinyl Estradiol, Desogestrel brand names: Linessa, Apri, Reclipsen, Solia, Kariva, and others.
Ethinyl Estradiol, Desogestrel falls into 4 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C9.
Read the full interaction reportSage and Ethinyl Estradiol, Desogestrel
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Sage interacts with whole categories of medication. Ethinyl Estradiol, Desogestrel falls into 4 of those categories, so it can interact with Sage in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
1 of 4Why this applies to Ethinyl Estradiol, Desogestrel
Ethinyl Estradiol, Desogestrel falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Sage interacts with.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C9. So far, this interaction has not been reported in humans.
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.
Here's the gist for your birth control pill (the ethinyl estradiol and desogestrel combo, like Apri or Kariva). Sage contains compounds that, in test-tube studies, can slow down a liver enzyme called CYP2C9, which helps break down hormones like the estrogen in your pill. In theory, if that enzyme is slowed, a bit more estrogen could hang around, which might mean more of the usual estrogen-type effects such as nausea, breast tenderness, headaches, or bloating.
The important part: this is only a lab-based idea, and it has never actually been reported in people. Normal kitchen amounts of sage in your cooking are very unlikely to matter. Concentrated sage extracts or essential oil are where I'd be more cautious. If you plan to take a sage supplement regularly, just run it by your pharmacist or doctor first.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
P-GLYCOPROTEIN SUBSTRATES
2 of 4Ethinyl Estradiol, Desogestrel also falls under P-GLYCOPROTEIN SUBSTRATES.
In vitro research suggests that common sage (Salvia officinalis) can inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.
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.
Your birth control pill (Apri, Reclipsen, Kariva and similar) combines ethinyl estradiol with desogestrel. One way your body moves these hormones around is through a transporter protein called P-glycoprotein. In lab dishes, common sage appears to slow this pump down a bit. In theory, that could let slightly more hormone hang around, which might nudge up side effects like nausea, breast tenderness, headaches, or spotting.
Here is the important part: this has only been seen in test-tube studies, never in real people, so the evidence is weak. Everyday cooking with sage is not a concern. Concentrated sage extracts or the essential oil are where I would pause. If you use those regularly, just mention it to your pharmacist or doctor.
- Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Ethinyl Estradiol, Desogestrel also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.
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.
Your birth control pill (the combo of ethinyl estradiol and desogestrel) is processed by a liver enzyme called CYP3A4. In test tube studies, water-based sage extracts seemed to slow that enzyme down a little. If that happened in the body, it could let a bit more estrogen and progestin build up, which might mean more of the usual hormone-related effects like nausea, breast tenderness, headaches, or spotting.
Here's the reassuring part: this has only been seen in lab dishes, not in real people, so it's mostly theoretical. Sprinkling sage on your food is very unlikely to matter. Concentrated sage capsules or the essential oil are the bigger question mark. If you're thinking about regular sage supplements, just run it by your pharmacist or doctor first.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
ESTROGENS
4 of 4Ethinyl Estradiol, Desogestrel also falls under ESTROGENS.
In vitro evidence suggests that geraniol, a constituent of Spanish sage (Salvia lavandulaefolia), exerts estrogenic activity. The clinical significance of this effect is unclear.
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.
Your birth control pill combines two hormones, ethinyl estradiol (an estrogen) and desogestrel (a progestin), to prevent pregnancy. The concern here is very mild and mostly theoretical. In lab dishes, one compound found in Spanish sage (called geraniol) showed weak estrogen-like activity. The worry is that, in theory, sage could add a little extra estrogen-type signal on top of your pill.
In real life, this almost certainly doesn't matter. This idea comes only from test-tube studies, not from people, and the amount of sage you'd get from cooking or a cup of tea is tiny. There's no good evidence it weakens your birth control or causes side effects like spotting or breast tenderness. If you plan to use concentrated sage extracts or the essential oil regularly, just mention it to your pharmacist or doctor to be safe.
- Perry, N. S., Houghton, P. J., Sampson, J., Theobald, A. E., Hart, S., Lis-Balchin, M., Hoult, J. R., Evans, P., Jenner, P., Milligan, S., and Perry, E. K. In-vitro activity of S. lavandulaefolia (Spanish sage) relevant to treatment of Alzheimer's diseas
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Sage Also Interacts With Other Medications
Sage has 1,295 moderate known drug interactions in our database — the Ethinyl Estradiol, Desogestrel one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Sage
We haven’t checked that one against Sage yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Sage. Pick one to open its full report.
See Every Supplement That Interacts With Ethinyl Estradiol, Desogestrel
This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Desogestrel page lists 246 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 · 201 moderate · 39 minor.
Taking Sage as Part of a Dietary Supplement Product? Check It for Interactions
We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Your product may carry other ingredients that interact with Ethinyl Estradiol, Desogestrel too, on top of Sage — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Sage and Ethinyl Estradiol, Desogestrel 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.
#253 of 1,452 supplements looked up here in the last 7 days
#1,884 of 2,830 medications looked up here in the last 7 days
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.
About Sage
What is Sage?
- Sore throat and mouth irritation
- Digestive upset
- Excessive sweating
- Memory and thinking
- Menopause symptoms (hot flashes)
- General antioxidant support
Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.
Other Drugs & Sage
Browse every other medication we’ve checked against Sage — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,295 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Glycopyrrolate ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Ipratropium ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
Showing 60 of 1,295 moderate interactions — see all 1,295 on the Sage page.
No interaction 1,534 drugs checked — show the list
We also checked Sage against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Amoxicillin ›
- Bupropion ›
- Bendamustine ›
- Acyclovir ›
- Methotrexate ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cephalexin ›
- Cyclopentolate ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Ezetimibe ›
- Daptomycin ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Amoxicillin, Clavulanate Potassium ›
- Hexobarbitone ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Levodopa ›
- Hethylphenidate Hcl ›
- Mitomycin ›
- Lenvatinib ›
- Cefaclor ›
- Azelaic Acid ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Tenecteplase ›
- Dirithromycin ›
- Vancomycin ›
- Pizotifen ›
- Triptorelin ›
- Bentoquatam ›
- Acetylsalicylic Acid ›
- Ribavirin Aerosol ›
- Dextrothyroxine ›
- Ropinirole ›
- Tocainide ›
- Rocuronium ›
- Mitomycin C ›
- Lomustine ›
- Digitoxin ›
- Chenodiol ›
- Salbutamol Sulfate ›
- Gestodene ›
- Desflurane ›
- Caspofungin ›
Showing the 60 most looked-up of 1,534 medications checked with no known interaction — see the full Sage list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Ethinyl Estradiol, Desogestrel Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Ethinyl Estradiol, Desogestrel as a medicine that can lower these. This is not an interaction with Sage — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Ethinyl Estradiol, Desogestrel nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Sage and Ethinyl Estradiol, Desogestrel Together: Common Questions
Can you take Sage with Ethinyl Estradiol, Desogestrel?
Why are there 4 interactions listed for Sage and Ethinyl Estradiol, Desogestrel?
How serious is the Sage and Ethinyl Estradiol, Desogestrel interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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