Drug & supplement interaction

Vitex Agnus-castus + Ethinyl estradiol, Levonogestrel

Ethinyl estradiol, Levonogestrel brand name: Lybrel.

Moderate Interaction
The bottom line Moderate

Ethinyl estradiol, Levonogestrel falls into 2 drug categories that Vitex Agnus-castus can interact with; the most serious is rated moderate. Theoretically, vitex agnus-castus could interfere with oral contraceptives.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Vitex Agnus-castus and Ethinyl estradiol, Levonogestrel

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Vitex Agnus-castus interacts with whole categories of medication. Ethinyl estradiol, Levonogestrel falls into 2 of those categories, so it can interact with Vitex Agnus-castus in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CONTRACEPTIVE DRUGS

1 of 2

Why this applies to Ethinyl estradiol, Levonogestrel

Ethinyl estradiol, Levonogestrel falls under CONTRACEPTIVE DRUGS — the group Vitex Agnus-castus interacts with.

Theoretically, vitex agnus-castus could interfere with oral contraceptives.
Vitex agnus-castus might interfere with the efficacy of oral contraceptives due to possible hormone modulating activity.
Severity Moderate 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

Lybrel is a combination birth control pill that uses steady hormones (ethinyl estradiol and levonorgestrel) to prevent pregnancy. Vitex (chasteberry) works on your brain's hormone signals and may shift levels of prolactin and other reproductive hormones. The concern here is that this hormone-tinkering could, in theory, work against the carefully balanced hormones in your pill and make it a bit less reliable at preventing pregnancy.

I want to be honest about the evidence: this is mostly theoretical, not proven in solid human studies. Still, since an unplanned pregnancy is a big deal, it is worth a quick chat with your pharmacist or doctor before combining them. They can help you decide, and may suggest a backup method like condoms to be safe. Please don't stop either one on your own.

References
  1. Liu J, Burdette JE, Xu H, et al. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem 2001;49:2472-9.. PubMed
  2. Wuttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications. Phytomedicine 2003;10:348-57. PubMed
Moderate

ESTROGENS

2 of 2

Ethinyl estradiol, Levonogestrel also falls under ESTROGENS.

Theoretically, vitex agnus-castus could interfere with the activity of estrogens.
Vitex agnus-castus has hormone modulating activity that can interfere with the efficacy of hormone replacement therapy.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Lybrel is a continuous birth control pill that combines two hormones, ethinyl estradiol (an estrogen) and levonorgestrel (a progestin). These aren't prodrugs, so they work as soon as they're absorbed. The concern with chasteberry is that it tinkers with your own hormone signals in the brain, which could theoretically work against the steady hormone levels your pill is trying to provide.

Here's the honest part: this worry comes mostly from lab and animal studies, not from solid human data, so we can't say how strong it really is. Still, since Lybrel's job is reliable pregnancy prevention and cycle control, I'd rather you not gamble on it. If you're considering vitex, please check with your pharmacist or doctor first so you don't risk breakthrough bleeding or reduced protection.

References
  1. Liu J, Burdette JE, Xu H, et al. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem 2001;49:2472-9.. PubMed
  2. Wuttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications. Phytomedicine 2003;10:348-57. 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

Vitex Agnus-castus Also Interacts With Other Medications

Vitex Agnus-castus has 120 moderate known drug interactions in our database — the Ethinyl estradiol, Levonogestrel one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Vitex Agnus-castus

Covers the 2,830 medications we’ve checked against Vitex Agnus-castus. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Ethinyl estradiol, Levonogestrel

This page covers Vitex Agnus-castus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl estradiol, Levonogestrel page lists 239 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 · 195 moderate · 38 minor.

From our pharmacist’s overview on the Ethinyl estradiol, Levonogestrel page

“A daily birth control pill like Lybrel (ethinyl estradiol with levonorgestrel) only works when enough hormone stays in the bloodstream, and that is exactly what several supplements on this page can undermine. This list deserves genuine care, starting with the six major-rated entries.”

Reviewed by 2 · Jul 18, 2026

Open the Ethinyl estradiol, Levonogestrel interaction page

One more smart check

Taking Vitex Agnus-castus as Part of a Dietary Supplement Product? Check It for Interactions

We hold 45 real supplement products containing Vitex Agnus-castus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Vitex Agnus-castus. Your product may carry other ingredients that interact with Ethinyl estradiol, Levonogestrel too, on top of Vitex Agnus-castus — 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 Vitex Agnus-castus and Ethinyl estradiol, Levonogestrel 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 Vitex Agnus-castus
Top half

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

29 days ago today
Medication Ethinyl estradiol, Levonogestrel
Top 25%

#530 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 Vitex Agnus-castus

What is Vitex Agnus-castus?

Vitex Agnus-castus
  • Premenstrual syndrome (PMS)
  • Irregular or absent menstrual periods
  • Cyclical breast pain (mastalgia)
  • Menopause symptoms
  • Fertility support

Vitex (chasteberry) is an herbal remedy most often used for PMS and menstrual cycle problems, and the strongest evidence is for easing some PMS symptoms. It is generally well tolerated by many adults, but it can affect hormone-related processes, so anyone who is pregnant, breastfeeding, or has a hormone-sensitive condition should talk with a healthcare professional first.

Read the full Vitex Agnus-castus monograph & all interactions
Keep checking

Other Drugs & Vitex Agnus-castus

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

0Major
120Moderate
0Minor
2,709No known interaction
Moderate

120 interactions

Showing 60 of 120 moderate interactions — see all 120 on the Vitex Agnus-castus page.

No interaction 2,709 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Vitex Agnus-castus and Ethinyl estradiol, Levonogestrel Together: Common Questions

Can you take Vitex Agnus-castus with Ethinyl estradiol, Levonogestrel?
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 2 interactions listed for Vitex Agnus-castus and Ethinyl estradiol, Levonogestrel?
Ethinyl estradiol, Levonogestrel belongs to more than one drug category, and Vitex Agnus-castus 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 Vitex Agnus-castus and Ethinyl estradiol, Levonogestrel 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

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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.