Thunder God Vine + Segesterone Acetate, Ethinyl Estradiol
Segesterone Acetate, Ethinyl Estradiol brand name: Annovera.
Segesterone Acetate, Ethinyl Estradiol falls into 3 drug categories that Thunder God Vine can interact with; the most serious is rated moderate. Theoretically, thunder god vine might increase the levels and clinical effects of CYP1A2 substrates.
Read the full interaction reportThunder God Vine and Segesterone Acetate, Ethinyl Estradiol
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Thunder God Vine interacts with whole categories of medication. Segesterone Acetate, Ethinyl Estradiol falls into 3 of those categories, so it can interact with Thunder God Vine in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 3Why this applies to Segesterone Acetate, Ethinyl Estradiol
Segesterone Acetate, Ethinyl Estradiol falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Thunder God Vine interacts with.
In vitro research shows that triptolide, a constituent of thunder god vine, inhibits CYP1A2 enzymes in human microsomes. 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.
Annovera is a vaginal ring that releases two active hormones, segesterone and ethinyl estradiol, which your body partly breaks down through a liver enzyme called CYP1A2. The thought here is that Thunder God Vine may slow that enzyme down a bit. If it does, a little more estrogen could linger in your system, which can nudge up estrogen-type side effects like nausea, breast tenderness, headaches, or bloating.
I want to be honest about how soft this is: it comes only from lab dish studies, not from real people, so it is theoretical. The bigger concern with this herb is its own toxicity, since it must be used under close medical supervision. Before pairing it with your birth control, please check with your doctor or pharmacist.
- Song W, Liu M, Wu J, Zhai H, Chen Y, Peng Z. Preclinical Pharmacokinetics of Triptolide: A Potential Antitumor Drug. Curr Drug Metab. 2019;20(2):147-154. PubMed
CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS
2 of 3Segesterone Acetate, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.
Inhibitors of CYP3A4 can increase the concentration of triptolide, a thunder god vine constituent, and its derivative (5R)-5-hydroxytriptolide. In vitro research shows that triptolide and (5R)-5-hydroxytriptolide are about 94% and 64% metabolized by CYP3A4, respectively.
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 twist with this pairing: it's the Thunder God Vine that we worry about, not your Annovera ring. The hormones in Annovera (segesterone and ethinyl estradiol) can mildly block an enzyme called CYP3A4, and that same enzyme is what your body uses to clear the active compounds in Thunder God Vine. If clearance slows down, those herbal compounds can build up.
Why that matters: Thunder God Vine can already be toxic if dosed wrong, causing things like stomach upset, diarrhea, and in serious cases liver or kidney harm. Higher levels could make those problems more likely. This is a theoretical concern based on lab work, not proven cases, so don't panic. Still, please run it by your doctor or pharmacist before combining the two.
- Xu Y, Zhang YF, Chen XY, Zhong DF. CYP3A4 inducer and inhibitor strongly affect the pharmacokinetics of triptolide and its derivative in rats. Acta Pharmacol Sin. 2018;39(8):1386-1392. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Segesterone Acetate, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that triptolide, a constituent of thunder god vine, inhibits CYP3A4 enzymes in human microsomes. 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.
The Annovera ring releases two hormones, segesterone acetate and ethinyl estradiol, and your liver clears both of them using an enzyme called CYP3A4. In lab dishes, a compound in Thunder God Vine called triptolide appears to slow that enzyme down. If that same effect happened in your body, your hormone levels could drift a little higher than usual. With estrogen especially, that can mean more nausea, breast tenderness, headaches, bloating, or mood changes.
Here's the honest part: this is only a theoretical concern based on test-tube studies, and it has never actually been reported in people. Still, Thunder God Vine itself can be risky and needs medical oversight. Before combining the two, please check with your doctor or pharmacist.
- Song W, Liu M, Wu J, Zhai H, Chen Y, Peng Z. Preclinical Pharmacokinetics of Triptolide: A Potential Antitumor Drug. Curr Drug Metab. 2019;20(2):147-154. PubMed
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.
Thunder God Vine Also Interacts With Other Medications
Thunder God Vine has 848 moderate known drug interactions in our database — the Segesterone Acetate, Ethinyl Estradiol one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Thunder God Vine
We haven’t checked that one against Thunder God Vine yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Thunder God Vine. Pick one to open its full report.
See Every Supplement That Interacts With Segesterone Acetate, Ethinyl Estradiol
This page covers Thunder God Vine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Segesterone Acetate, Ethinyl Estradiol page lists 229 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Beer (major), Grapefruit (major), Siberian Cocklebur (major), St. John's Wort (major) and Wine (major).
By severity: 5 major · 193 moderate · 31 minor.
From our pharmacist’s overview on the Segesterone Acetate, Ethinyl Estradiol page
“St. John's wort is the interaction I would explain first to anyone using Annovera (segesterone acetate with ethinyl estradiol, a vaginal ring for birth control).”
Reviewed by 2 · Jul 18, 2026
Open the Segesterone Acetate, Ethinyl Estradiol interaction page
Where Thunder God Vine and Segesterone Acetate, Ethinyl Estradiol 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.
#996 of 1,452 supplements looked up here in the last 7 days
#569 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 Thunder God Vine
What is Thunder God Vine?
- Rheumatoid arthritis
- Lupus and autoimmune conditions
- Inflammation
- Skin conditions like psoriasis
- Immune-related disorders
Thunder God Vine is a Chinese herb studied mainly for rheumatoid arthritis and other autoimmune conditions, with some promising but limited evidence. It can be toxic if prepared or dosed improperly, and may cause serious side effects, so it should only be used under medical supervision. Avoid it during pregnancy and breastfeeding.
Other Drugs & Thunder God Vine
Browse every other medication we’ve checked against Thunder God Vine — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
848 interactions
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Metronidazole ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Triazolam ›
- Zopiclone ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Doxorubicin ›
- Fluticasone ›
- Miconazole ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Nortriptyline ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Bendamustine ›
- Betamethasone ›
- Caffeine (otc Drug) ›
- Ciclesonide ›
- Cimetidine ›
- Clonazepam ›
- Cyclobenzaprine ›
- Dapsone ›
- Desipramine ›
- Erythromycin Ethylsuccinate ›
- Erythromycin Stearate ›
- Etoposide ›
Showing 60 of 848 moderate interactions — see all 848 on the Thunder God Vine page.
No interaction 1,981 drugs checked — show the list
We also checked Thunder God Vine against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Metoprolol ›
- Escitalopram ›
- Methamphetamine ›
- Tirzepatide ›
- Docusate ›
- Ibuprofen ›
- Isotretinoin ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Semaglutide ›
- Metformin ›
- Lisdexamfetamine ›
- Amphetamine ›
- Methotrexate ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Levothyroxine, Liothyronine ›
- Doxycycline ›
- Pregabalin ›
- Azithromycin ›
- Acyclovir ›
- Lamotrigine ›
- Gabapentin ›
- Dextroamphetamine ›
- Duloxetine ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Bisoprolol ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Cyclopentolate ›
- Cephalexin ›
- Ezetimibe ›
- Insulin Degludec, Liraglutide ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Mannitol ›
- Levetiracetam ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Levodopa ›
- Spironolactone ›
- Mitomycin ›
- Alginic Acid, Aluminum Hydroxide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Valsartan ›
- Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide ›
- Magnesium Hydroxide (otc Drug) ›
- Sacubitril, Valsartan ›
- Venlafaxine ›
- Atenolol ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
Showing the 60 most looked-up of 1,981 medications checked with no known interaction — see the full Thunder God Vine 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
Segesterone Acetate, Ethinyl Estradiol Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Segesterone Acetate, Ethinyl Estradiol as a medicine that can lower these. This is not an interaction with Thunder God Vine — 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 Segesterone Acetate, Ethinyl Estradiol 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 Thunder God Vine and Segesterone Acetate, Ethinyl Estradiol Together: Common Questions
Can you take Thunder God Vine with Segesterone Acetate, Ethinyl Estradiol?
Why are there 3 interactions listed for Thunder God Vine and Segesterone Acetate, Ethinyl Estradiol?
How serious is the Thunder God Vine and Segesterone Acetate, Ethinyl Estradiol interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Segesterone Acetate, Ethinyl Estradiol and Thunder God Vine?
Our pharmacists answer your medication & supplement questions — free.
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.