Medication interaction hub

What Supplements Interact with Tibolone?

Tibolone brand name: Livial. Every interaction below applies to the brands too.

80 Interactions 2 Major 62 Moderate 16 Minor
Curated & coded by · Clinical Pharmacist · Updated September 22, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Tibolone? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Tibolone against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

Grapefruit is the risk I would learn first with tibolone (Livial), a hormone therapy used for menopause symptoms. Grapefruit can raise estrogen levels in the blood, magnifying both the drug's effects and its side effects, and it shares major status with activated charcoal, which soaks up medications in the gut and can blunt tibolone's benefit entirely. I read this list with real caution. Sixty of the 80 ingredients on file touch the estrogen system in some way, whether by adding hormone activity of their own, competing with the drug (red clover is one example), or hitting harder themselves, since estrogen slows caffeine breakdown and makes coffee and tea feel stronger.

Beyond those two majors sit 62 moderate and 16 minor entries. Bulk-forming fibers can trap oral doses in the gut, so space them well apart from tibolone, and let your pharmacist weigh in on any hormone-active botanical you already take.

— , Clinical Pharmacist · July 18, 2026

Major 2 Moderate 62 Minor 16 No known interaction 1,372

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Top Ingredient Interactions

Tibolone: Top Interactions at a Glance

The most significant Tibolone supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 80 interacting ingredients — plus 1,372 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Tibolone + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Probable Activated Charcoal + Tibolonei

Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the route of administration.

Read the full interaction Major Likelihood Probable Grapefruit + Tibolonei

Grapefruit juice can increase blood levels of estrogens, potentially increasing the effects and adverse effects of estrogens.

Read the full interaction
The complete list

Every Supplement Checked Against Tibolone

All 1,452 ingredients in our database, ranked by severity — 80 with a Tibolone interaction on file and 1,372 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Tibolone?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Pleurisy Root with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, excessive amounts of pleurisy root might interfere with hormone drug therapy.

Full Pleurisy Root + Tibolone answer

Can you take Hemp with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, hemp might interfere with hormone therapy due to its estrogenic effects.

Full Hemp + Tibolone answer

Can you take Karaya Gum with Tibolone?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Co-administration of oral drugs with bulk forming laxatives such as karaya gum may decrease, increase, or have no effect on the absorption o...

Full Karaya Gum + Tibolone answer

Can you take Marshmallow with Tibolone?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, mucilage in marshmallow might impair absorption of oral drugs.

Full Marshmallow + Tibolone answer

Can you take Milk Thistle with Tibolone?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.

Full Milk Thistle + Tibolone answer

Can you take Turmeric with Tibolone?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, large amounts of turmeric might interfere with hormone replacement therapy through competition for estrogen receptors.

Full Turmeric + Tibolone answer

Can you take Xanthan Gum with Tibolone?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, xanthan gum can alter the absorption of oral drugs due to its fiber qualities.

Full Xanthan Gum + Tibolone answer

Can you take Deer Velvet with Tibolone?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, deer velvet might increase the effects and side effects of estrogens.

Full Deer Velvet + Tibolone answer

Can you take Activated Charcoal with Tibolone?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the rout...

Full Activated Charcoal + Tibolone answer

Can you take Grapefruit with Tibolone?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Grapefruit juice can increase blood levels of estrogens, potentially increasing the effects and adverse effects of estrogens.

Full Grapefruit + Tibolone answer

Can you take Black Tea with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, estrogens might increase the levels and adverse effects of caffeine.

Full Black Tea + Tibolone answer

Can you take Caffeine with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, estrogens might increase the levels and adverse effects of caffeine.

Full Caffeine + Tibolone answer

Can you take Cocoa with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, estrogens might increase the levels and adverse effects of caffeine.

Full Cocoa + Tibolone answer

Can you take Coffee with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, estrogens might increase the levels and adverse effects of caffeine.

Full Coffee + Tibolone answer

Can you take Coffee Charcoal with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Coffee charcoal can reduce the absorption of orally administered drugs and should be separated from oral drug administration by at least two...

Full Coffee Charcoal + Tibolone answer

Can you take Cola Nut with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, estrogens might increase the levels and adverse effects of the caffeine in cola nut.

Full Cola Nut + Tibolone answer

Can you take European Mandrake with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European...

Full European Mandrake + Tibolone answer

Can you take Fo-ti with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking large amounts of fo-ti might interfere with hormone replacement therapy through competition for estrogen receptors.

Full Fo-ti + Tibolone answer

Can you take Glucomannan with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, glucomannan may decrease absorption of drugs taken orally.

Full Glucomannan + Tibolone answer

Can you take Green Coffee with Tibolone?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, estrogens might increase the levels and adverse effects of caffeine.

Full Green Coffee + Tibolone answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Tibolone is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Tibolone, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Tibolone sits in 5 interaction categories. Open any one to see what the group means:

Estrogens 60 ingredients

Hormone-related medications. Supplements with hormone-like activity can add to or interfere with them.

60 of the supplement ingredients on this page reach Tibolone through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Tibolone through this category.

Androgens 4 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

4 of the supplement ingredients on this page reach Tibolone through this category.

Progesterone 2 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

2 of the supplement ingredients on this page reach Tibolone through this category.

Progestin 1 ingredient

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

1 of the supplement ingredient on this page reaches Tibolone through this category.

Related: does Tibolone deplete any nutrients?

Tibolone has 5 reported nutrient associations in the research literature — see the Tibolone nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Tibolone

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Tibolone.

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Pharmacist Counseling Corner

Tibolone & Supplements: Common Questions

What supplements interact with Tibolone?
In our interaction database, 80 supplement and herbal ingredients have an interaction with Tibolone on file — 2 rated major, 62 moderate, and 16 minor. That number sounds scarier than it is: severity matters far more than the count, which is why the list on this page is ranked instead of alphabetical. Start at the top. The highest-ranked right now: Activated Charcoal, Grapefruit, Black Tea.
Which Tibolone supplement interactions are the most serious?
The 2 major-rated combinations — led by Activated Charcoal and Grapefruit — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Tibolone?
That depends entirely on which supplement. The honest answer for Tibolone is in the ranked list above — and if what you take is a combination product with a dozen ingredients, don't check them one by one: photograph the label with our scanner and we'll check the whole thing at once. Try the label scanner or the interaction checker.
Do brands like Livial have the same supplement interactions as Tibolone?
Yes — Livial all contain Tibolone, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
Does Tibolone deplete any vitamins or nutrients?
It might — Tibolone has 5 reported nutrient-depletion associations in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Tibolone nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Tibolone and my other medications?
This page covers Tibolone against supplements and herbal ingredients. Checking Tibolone against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 22, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.