Drug & supplement interaction

Yohimbe + drospirenone, ethinyl estradiol, levomefolate

drospirenone, ethinyl estradiol, levomefolate brand name: Beyaz.

Moderate Interaction
The bottom line Moderate

drospirenone, ethinyl estradiol, levomefolate falls into 3 drug categories that Yohimbe can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Yohimbe and drospirenone, ethinyl estradiol, levomefolate

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Yohimbe interacts with whole categories of medication. drospirenone, ethinyl estradiol, levomefolate falls into 3 of those categories, so it can interact with Yohimbe in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

1 of 3

Why this applies to drospirenone, ethinyl estradiol, levomefolate

drospirenone, ethinyl estradiol, levomefolate falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Yohimbe interacts with.

Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of yohimbine, a constituent of yohimbe bark.
In vitro and clinical research shows that the yohimbe bark constituent, yohimbine, is metabolized by CYP3A4 enzymes. Theoretically, drugs that inhibit CYP3A4 might increase the levels and adverse effects of yohimbine.
Severity Moderate 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 simple version. Your birth control pill (Beyaz) contains ethinyl estradiol, which gently blocks a liver enzyme called CYP3A4. That same enzyme happens to break down yohimbine, the active part of yohimbe. So if you take yohimbe while on this pill, the yohimbine may clear more slowly and build up a bit, which could make its side effects stronger.

With yohimbe, that means a higher chance of things like a pounding or racing heart, jitteriness, anxiety, and elevated blood pressure. To be clear, this concern is theoretical, based mostly on how the enzyme works rather than strong human studies. Still, because over-the-counter yohimbe is already unpredictable, I'd run it by your pharmacist or doctor before combining the two.

References
  1. Le Corre P, Parmer RJ, Kailasam MT, et al. Human sympathetic activation by alpha2-adrenergic blockade with yohimbine: Bimodal, epistatic influence of cytochrome P450-mediated drug metabolism. Clin Pharmacol Ther. 2004;76(2):139-53.
  2. Bharucha AE, Skaar T, Andrews CN, et al Relationship of cytochrome P450 pharmacogenetics to the effects of yohimbine on gastrointestinal transit and catecholamines in healthy subjects. Neurogastroenterol Motil. 2008;20(8):891-9. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

drospirenone, ethinyl estradiol, levomefolate also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, yohimbe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that yohimbe extract induces CYP1A2 enzymes.
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 Beyaz, your combination birth control pill, and yohimbe. In lab dishes, yohimbe extract seems to speed up an enzyme called CYP1A2, which can help break down certain medications. The theory is that if your body clears the hormones in your pill a bit faster, the levels could dip slightly. In a worst case, that might mean breakthrough bleeding or, in theory, slightly less reliable pregnancy protection.

That said, I want to keep this in perspective. This is rated minor and is based only on test-tube research, not on real people. CYP1A2 isn't even the main pathway for these hormones. So I wouldn't lose sleep over it, but since yohimbe can also raise blood pressure and heart rate on its own, please run it by your pharmacist or doctor first.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

drospirenone, ethinyl estradiol, levomefolate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that yohimbe extract induces CYP3A4 enzymes.
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

Beyaz is a birth control pill, and the estrogen part (ethinyl estradiol) is partly broken down by a liver enzyme called CYP3A4. Some early lab research suggests yohimbe might speed up that enzyme. In theory, that could lower the hormone levels in your body a little, which might slightly weaken how well the pill works or cause breakthrough spotting.

I want to be honest though: this is only a theoretical concern based on test-tube studies, not real patients, and it's rated minor. The bigger worry with yohimbe for most people is its effect on blood pressure and heart rate. Since reliable birth control matters, it's worth a quick chat with your pharmacist or doctor before adding yohimbe, but please don't change how you take your pill on your own.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. 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

Yohimbe Also Interacts With Other Medications

Yohimbe has 9 major, 679 moderate, 436 minor known drug interactions in our database — the drospirenone, ethinyl estradiol, levomefolate 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 Yohimbe

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

Everything else you take

See Every Supplement That Interacts With drospirenone, ethinyl estradiol, levomefolate

This page covers Yohimbe only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the drospirenone, ethinyl estradiol, levomefolate page lists 245 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 · 200 moderate · 39 minor.

Open the drospirenone, ethinyl estradiol, levomefolate interaction page

One more smart check

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

We hold 1,054 real supplement products containing Yohimbe, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Yohimbe. Your product may carry other ingredients that interact with drospirenone, ethinyl estradiol, levomefolate too, on top of Yohimbe — 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 Yohimbe and drospirenone, ethinyl estradiol, levomefolate 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 Yohimbe
Top 10%

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

29 days ago today
Medication drospirenone, ethinyl estradiol, levomefolate
Top 25%

#326 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 Yohimbe

What is Yohimbe?

Yohimbe
  • Erectile dysfunction
  • Low sex drive
  • Sexual performance
  • Weight loss
  • Athletic performance

Yohimbe is a West African tree bark that contains yohimbine, a compound mainly promoted for erectile dysfunction and as an aphrodisiac. A prescription form of yohimbine has some evidence for erectile dysfunction, but over-the-counter yohimbe supplements vary widely in content and can cause serious side effects like high blood pressure and fast heart rate. Because of these safety concerns, talk to your pharmacist or doctor before using it.

Read the full Yohimbe monograph & all interactions
Keep checking

Other Drugs & Yohimbe

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

9Major
679Moderate
436Minor
1,705No known interaction
Major

9 interactions

Moderate

679 interactions

Showing 60 of 679 moderate interactions — see all 679 on the Yohimbe page.

Minor

436 interactions

Showing 60 of 436 minor interactions — see all 436 on the Yohimbe page.

No interaction 1,705 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 Yohimbe and drospirenone, ethinyl estradiol, levomefolate Together: Common Questions

Can you take Yohimbe with drospirenone, ethinyl estradiol, levomefolate?
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 3 interactions listed for Yohimbe and drospirenone, ethinyl estradiol, levomefolate?
drospirenone, ethinyl estradiol, levomefolate belongs to more than one drug category, and Yohimbe 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 Yohimbe and drospirenone, ethinyl estradiol, levomefolate 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.