Drug

Levonorgestrel

Common brand names:

Mirena, Norplant System, Plan B

Summary of Interactions with Vitamins, Herbs, & Foods

  • Negative Interactions

    1
    • Levonorgestrel

      St. John’s Wort

      Potential Negative Interaction

      Eight cases reported to the Medical Products Agency of Sweden suggest that St. John’s wort may interact with oral contraceptives and cause intramenstrual bleeding and/or changes in menstrual bleeding. One reviewer has suggested that St. John’s wort may reduce serum levels of estradiol. It should be noted, however, that only three of the eight Swedish women returned to normal menstrual cycles after stopping St. John’s wort. Women taking oral contraceptives for birth control should consult with their doctor before taking St. John’s wort.

      St. John’s Wort
      Levonorgestrel
      ×
      1. Safety of St. John's wort (Hypericum perforatum) [letters to the editor from various authors]. Lancet 2000;355:575-7.
      2. Ernst E. Second thoughts about safety of St. John's wort. Lancet 1999;354:2014-6 [letter].
  • Supportive Interactions

    5
    • Levonorgestrel

      Folic Acid

      Replenish Depleted Nutrients

      Oral contraceptive use can cause folic acid depletion.

      Folic Acid
      Levonorgestrel
      ×
      1. Lindenbaum J, Whitehead N, Reyner F. Oral contraceptive hormones, folate metabolism, and the cervical epithelium. Am J Clin Nutr 1975;28:346-53.
    • Levonorgestrel

      Vitamin B1

      Replenish Depleted Nutrients

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.

      Vitamin B1
      Levonorgestrel
      ×
      1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
      2. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
      3. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
      4. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
    • Levonorgestrel

      Vitamin B3 (Niacin)

      Replenish Depleted Nutrients

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.

      Vitamin B3 (Niacin)
      Levonorgestrel
      ×
      1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
      2. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
      3. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
      4. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
    • Levonorgestrel

      Zinc

      Replenish Depleted Nutrients

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.

      Zinc
      Levonorgestrel
      ×
      1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
      2. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
      3. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
      4. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
    • Levonorgestrel

      Folic Acid

      Reduce Side Effects

      In a double-blind trial of oral contraceptive users with cervical dysplasia, supplementation with very large amounts (10 mg per day) of folic acid improved cervical health. Women with cervical dysplasia diagnosed while they are taking oral contraceptives should consult a doctor. Mega-folate supplementation should not be attempted without a doctor’s supervision, nor is there any reason to believe that folic acid supplementation would help people with cervical cancer.

      Folic Acid
      Levonorgestrel
      ×
      1. Butterworth CE Jr, Hatch KD, Gore H, et al. Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr 1982;35:73-82.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

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