Sage + Relugolix, Estradiol, Norethindrone Acetate
Relugolix, Estradiol, Norethindrone Acetate brand name: Myfembree.
Relugolix, Estradiol, Norethindrone Acetate falls into 3 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, sage might increase levels of drugs transported by P-glycoprotein.
Read the full interaction reportSage and Relugolix, Estradiol, Norethindrone Acetate
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Sage interacts with whole categories of medication. Relugolix, Estradiol, Norethindrone Acetate falls into 3 of those categories, so it can interact with Sage in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
P-GLYCOPROTEIN SUBSTRATES
1 of 3Why this applies to Relugolix, Estradiol, Norethindrone Acetate
Relugolix, Estradiol, Norethindrone Acetate falls under P-GLYCOPROTEIN SUBSTRATES — the group Sage interacts with.
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.
Here's the gist for Myfembree, which combines relugolix with estradiol and norethindrone. One of its ingredients, relugolix, gets moved around your body by a sort of cellular pump called P-glycoprotein. In laboratory dishes, sage seems to slow that pump down. If the same thing happened in people, more relugolix could stay in your system, which in theory might mean stronger effects or more side effects like headache, hot flashes, mood changes, or fatigue.
That said, this is only a test-tube finding and has never been seen in real patients. Cooking with sage is very unlikely to matter. Concentrated sage extracts or capsules are the bigger question mark. If you take or are considering one, just run it by your pharmacist or doctor first.
- 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
2 of 3Relugolix, Estradiol, Norethindrone Acetate 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.
Myfembree combines three active medicines (relugolix, estradiol, and norethindrone), and your body partly clears them using a liver enzyme called CYP3A4. In lab tests, sage extracts appear to slow that enzyme down a little. In theory, if CYP3A4 is slowed, these hormones could hang around a bit longer and their effects could be slightly stronger. With the estrogen and progestin pieces, that might mean more nausea, headache, breast tenderness, mood changes, or spotting.
The important thing to know is that this is only a laboratory finding. It has not actually been seen in people, and normal cooking amounts of sage are very unlikely to matter. Concentrated sage capsules or the essential oil are a different story. If you use those regularly, just mention it to 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
3 of 3Relugolix, Estradiol, Norethindrone Acetate 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.
Myfembree combines relugolix with two hormones, estradiol (an estrogen) and norethindrone. Because part of this pill is estrogen, here's the theoretical concern: a compound in certain sage species (geraniol from Spanish sage) showed weak estrogen-like activity in lab dish studies. In theory, that could add a little to the estrogen signal your body already gets from the medicine.
I want to be honest with you though, this is very early, test-tube evidence only. There are no real-world reports of sage causing problems with hormone therapy, and normal cooking amounts of sage are not a worry at all. The bigger question mark is concentrated sage extracts or essential oil taken daily. If you're considering those, just run it by your pharmacist or doctor first so they can keep an eye on things.
- 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 Relugolix, Estradiol, Norethindrone Acetate 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 Relugolix, Estradiol, Norethindrone Acetate
This page covers Sage 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
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 Relugolix, Estradiol, Norethindrone Acetate 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 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.
#246 of 1,452 supplements looked up here in the last 7 days
#694 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.
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.
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 ›
- Methotrexate ›
- Acyclovir ›
- Isotretinoin ›
- Azithromycin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Amoxicillin, Clavulanate Potassium ›
- Ezetimibe ›
- Pegunigalsidase Alfa-iwxj ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Daptomycin ›
- Thyroid Hormone ›
- Mitomycin ›
- Hexobarbitone ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Levodopa ›
- Acetylsalicylic Acid ›
- Cefaclor ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Lenvatinib ›
- Phenylephrine ›
- Bentoquatam ›
- Hydroxychloroquine ›
- Pizotifen ›
- Tenecteplase ›
- Vancomycin ›
- Triptorelin ›
- Ribavirin Aerosol ›
- Dirithromycin ›
- Alglucosidase Alpha ›
- Salbutamol Sulfate ›
- Flutemetamol F-18 ›
- Rocuronium ›
- Dextrothyroxine ›
- Ropinirole ›
- Tocainide ›
- Mitomycin C ›
- Lomustine ›
- Magnesium Hydroxide (otc Drug) ›
- Ferric Derisomaltose ›
- Birth Control Pills ›
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
Relugolix, Estradiol, Norethindrone Acetate Is Linked to Lower Levels of 5 Nutrients
Natural Medicines records Relugolix, Estradiol, Norethindrone Acetate 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 Relugolix, Estradiol, Norethindrone Acetate 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 Relugolix, Estradiol, Norethindrone Acetate Together: Common Questions
Can you take Sage with Relugolix, Estradiol, Norethindrone Acetate?
Why are there 3 interactions listed for Sage and Relugolix, Estradiol, Norethindrone Acetate?
How serious is the Sage and Relugolix, Estradiol, Norethindrone Acetate interaction?
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.