Drug & supplement interaction

Yerba Mate + Etonogestrel, Ethinyl Estradiol

Etonogestrel, Ethinyl Estradiol brand name: NuvaRing.

Moderate Interaction
The bottom line Moderate

Etonogestrel, Ethinyl Estradiol falls into 4 drug categories that Yerba Mate can interact with; the most serious is rated moderate. Theoretically, estrogens might increase the levels and adverse effects of the caffeine in yerba mate.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions4
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Yerba Mate and Etonogestrel, Ethinyl Estradiol

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Yerba Mate interacts with whole categories of medication. Etonogestrel, Ethinyl Estradiol falls into 4 of those categories, so it can interact with Yerba Mate in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ESTROGENS

1 of 4

Why this applies to Etonogestrel, Ethinyl Estradiol

Etonogestrel, Ethinyl Estradiol falls under ESTROGENS — the group Yerba Mate interacts with.

Theoretically, estrogens might increase the levels and adverse effects of the caffeine in yerba mate.
Yerba mate contains caffeine. Estrogen inhibits caffeine metabolism.
Severity Moderate Likelihood Probable Evidence B

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

Here's the twist with this pairing: it's not your NuvaRing that changes, it's the caffeine in the yerba mate. The estrogen (ethinyl estradiol) in your ring can slow down how your liver clears caffeine, so the caffeine tends to hang around longer in your system.

What that means in real life is that a mate or two might hit you harder than usual. Think jitteriness, a racing or pounding heart, trouble sleeping, or feeling more anxious or wired. The good news is your birth control still works the same way and your contraception isn't weakened here. This is a fairly mild, manageable thing. If you notice caffeine bothering you more, just ease back on the mate and chat with your pharmacist or doctor if you have questions.

References
  1. Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

2 of 4

Etonogestrel, Ethinyl Estradiol also falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS.

Theoretically, concomitant use of CYP1A2 inhibitors and yerba mate might increase levels and adverse effects of the caffeine in yerba mate.
Yerba mate contains caffeine. Caffeine is metabolized by CYP1A2. Theoretically, drugs that inhibit CYP1A2 may decrease the rate of caffeine clearance and increase caffeine levels.
Severity Minor 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 thing to keep in mind with your NuvaRing (etonogestrel and ethinyl estradiol) and yerba mate: the interaction isn't really about your birth control losing its effect. It's the other way around. The estrogen in your ring can mildly slow down the enzyme (called CYP1A2) that your body uses to clear caffeine. Since yerba mate is loaded with caffeine, that caffeine may hang around a bit longer than usual.

In plain terms, your mate might hit a little harder. You could notice more jitters, a racing heart, trouble sleeping, or feeling wired. This is a theoretical, minor effect based on how these things work, not something proven to cause big problems. If you feel overly buzzed, just ease up on the mate, and check with your pharmacist if you're unsure.

References
  1. Hagg S, Spigset O, Mjorndal T, Dahlqvist R. Effect of caffeine on clozapine pharmacokinetics in healthy volunteers. Br J Clin Pharmacol 2000;49:59-63. PubMed
  2. Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

Etonogestrel, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, yerba mate might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that yerba mate extract inhibits CYP3A4 enzymes. Theoretically, taking yerba mate may increase levels and adverse effects of CYP3A4 substrates.
Severity Minor 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 gist with your NuvaRing, which slowly releases the hormones etonogestrel and ethinyl estradiol. Both of these hormones are partly cleared by a liver enzyme called CYP3A4. In lab dish studies (not in people), yerba mate appears to slow that enzyme down a bit. In theory, that could let a little more of the hormone hang around in your body, which might nudge up typical side effects like nausea, breast tenderness, headaches, or spotting.

The honest truth is this is a minor and mostly theoretical concern, based only on test-tube data, and a cup or two of mate is unlikely to cause real trouble. It will not make your birth control fail. Still, if you drink mate often or feel new side effects, mention it to your pharmacist or doctor.

References
  1. Feltrin C, Farias IV, Sandjo LP, Reginatto FH, Simões CMO. Effects of Standardized Medicinal Plant Extracts on Drug Metabolism Mediated by CYP3A4 and CYP2D6 Enzymes. Chem Res Toxicol 2020;33(9):2408-2419. PubMed
Minor

CONTRACEPTIVE DRUGS

4 of 4

Etonogestrel, Ethinyl Estradiol also falls under CONTRACEPTIVE DRUGS.

Theoretically, contraceptive drugs might increase the levels and adverse effects of the caffeine contained in yerba mate.
Yerba mate contains caffeine. Contraceptive drugs decrease the rate of caffeine clearance by 40% to 65%.
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 a small twist worth knowing if you use the NuvaRing and enjoy yerba mate. In this pairing, the ring isn't the one that builds up. Instead, the estrogen in your birth control slows down how fast your body clears caffeine, by roughly 40% to 65%. Since yerba mate is naturally caffeinated, that caffeine can hang around longer and hit a bit harder than you'd expect.

So you might notice more jitteriness, a racing heart, trouble sleeping, or a nervous feeling from your usual cup. This is rated minor and is mostly theoretical, so it won't make your birth control stop working. If the buzz feels stronger than normal, just ease back on mate or other caffeine, and check with your pharmacist if you're unsure.

References
  1. Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. PubMed
  2. Abernethy DR, Todd EL. Impairment of caffeine clearance by chronic use of low-dose oestrogen-containing oral contraceptives. Eur J Clin Pharmacol 1985;28:425-8. 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

Yerba Mate Also Interacts With Other Medications

Yerba Mate has 8 major, 504 moderate, 573 minor known drug interactions in our database — the Etonogestrel, Ethinyl Estradiol 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 Yerba Mate

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

Everything else you take

See Every Supplement That Interacts With Etonogestrel, Ethinyl Estradiol

This page covers Yerba Mate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etonogestrel, Ethinyl Estradiol page lists 203 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate), Activated Charcoal (moderate) and Adrafinil (moderate).

By severity: 2 major · 168 moderate · 33 minor.

From our pharmacist’s overview on the Etonogestrel, Ethinyl Estradiol page

“St. John's wort belongs at the top of any conversation about NuvaRing (etonogestrel and ethinyl estradiol) and supplements.”

Reviewed by 2 · Jul 18, 2026

Open the Etonogestrel, Ethinyl Estradiol interaction page

One more smart check

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

We hold 68 real supplement products containing Yerba Mate, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Yerba Mate. Your product may carry other ingredients that interact with Etonogestrel, Ethinyl Estradiol too, on top of Yerba Mate — 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 Yerba Mate and Etonogestrel, 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.

Supplement Yerba Mate
Steady interest

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

29 days ago today
Medication Etonogestrel, Ethinyl Estradiol
Top half

#760 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 Yerba Mate

What is Yerba Mate?

Yerba Mate
  • Energy and alertness
  • Weight loss
  • Mental focus
  • Digestive support
  • Antioxidant support

Yerba mate is a caffeine-containing herbal beverage from South America that is widely enjoyed for its stimulating, coffee-like effects. While it is rich in antioxidants and is being studied for weight, blood sugar, and cholesterol, strong human evidence for most health claims is limited. Drinking very hot mate over many years has been linked to higher risk of certain cancers, so enjoy it warm and in moderation.

Read the full Yerba Mate monograph & all interactions
Keep checking

Other Drugs & Yerba Mate

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

8Major
504Moderate
573Minor
1,744No known interaction
Major

8 interactions

Moderate

504 interactions

Showing 60 of 504 moderate interactions — see all 504 on the Yerba Mate page.

Minor

573 interactions

Showing 60 of 573 minor interactions — see all 573 on the Yerba Mate page.

No interaction 1,744 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 Yerba Mate and Etonogestrel, Ethinyl Estradiol Together: Common Questions

Can you take Yerba Mate with Etonogestrel, Ethinyl Estradiol?
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 4 interactions listed for Yerba Mate and Etonogestrel, Ethinyl Estradiol?
Etonogestrel, Ethinyl Estradiol belongs to more than one drug category, and Yerba Mate 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 Yerba Mate and Etonogestrel, Ethinyl Estradiol 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.