Drug

Norgestimate-Ethinyl Estradiol

Summary of Interactions with Vitamins, Herbs, & Foods

  • Negative Interactions

    2

    • Norgestimate-Ethinyl Estradiol

      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
      Norgestimate-Ethinyl Estradiol
      ×
      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].

    • Ethinyl Estradiol

      Zinc

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a group of 37 postmenopausal women treated with conjugated estrogens and medroxyprogesterone for 12 months, urinary zinc and magnesium loss was reduced in those women who began the study with signs of osteoporosis and elevated zinc and magnesium excretion. The clinical significance of this interaction remains unclear.

      Zinc
      Ethinyl Estradiol
      ×
      1. Herzberg M, Lusky A, Blonder J, Frenkel. The effect of estrogen replacement therapy on zinc in serum and urine. Obstet Gynecol 1996;87:1035-40.

  • Supportive Interactions

    12

    • Norgestimate-Ethinyl Estradiol

      Folic Acid

      Replenish Depleted Nutrients

      Oral contraceptive use can cause folic acid depletion.

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

    • Norgestimate-Ethinyl Estradiol

      Magnesium

      Replenish Depleted Nutrients

      Women using oral contraceptives were found to have significantly lower serum magnesium levels in a controlled study. In a preliminary study, blood levels of magnesium decreased in women taking an oral contraceptive containing ethinyl estradiol and levonorgestrel. Although the importance of this interaction remains somewhat unclear, supplementation with 250–350 mg of magnesium per day is a safe and reasonable supplemental level for most adults.

      Magnesium
      Norgestimate-Ethinyl Estradiol
      ×
      1. Olatunbosum DA, Adeniyi FA, Adadevoh BK. Effect of oral contraceptives on serum magnesium levels. Int J Fertil 1974;19:224-6.
      2. Blum M, Kitai E, Ariel Y, et al. Oral contraceptive lowers serum magnesium. Harefuah 1991;121:363-4 [in Hebrew].

    • Norgestimate-Ethinyl Estradiol

      Manganese

      Replenish Depleted Nutrients

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

      Manganese
      Norgestimate-Ethinyl Estradiol
      ×
      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. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711-5.
      5. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    • Norgestimate-Ethinyl Estradiol

      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
      Norgestimate-Ethinyl Estradiol
      ×
      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.

    • Norgestimate-Ethinyl Estradiol

      Vitamin B12

      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 B12
      Norgestimate-Ethinyl Estradiol
      ×
      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.

    • Norgestimate-Ethinyl Estradiol

      Vitamin B2

      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 B2
      Norgestimate-Ethinyl Estradiol
      ×
      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.

    • Norgestimate-Ethinyl Estradiol

      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)
      Norgestimate-Ethinyl Estradiol
      ×
      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.

    • Norgestimate-Ethinyl Estradiol

      Vitamin B6

      Replenish Depleted Nutrients
      Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
      Vitamin B6
      Norgestimate-Ethinyl Estradiol
      ×
      1. Adams PW, Folkard J, Wynn V, Seed M. Influence of oral contraceptives, pyridoxine (vitamin B6), and tryptophan on carbohydrate metabolism. Lancet 1976;1:759-64.

    • Norgestimate-Ethinyl Estradiol

      Vitamin C

      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 C
      Norgestimate-Ethinyl Estradiol
      ×
      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.

    • Norgestimate-Ethinyl Estradiol

      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
      Norgestimate-Ethinyl Estradiol
      ×
      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.

    • Norgestimate-Ethinyl Estradiol

      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
      Norgestimate-Ethinyl Estradiol
      ×
      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.

    • Norgestimate-Ethinyl Estradiol

      Vitamin B6

      Reduce Side Effects
      In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
      Vitamin B6
      Norgestimate-Ethinyl Estradiol
      ×
      1. Adams PW, Wynn V, Rose DP, et al. Effect of pyridoxine hydrochloride (vitamin B6) upon depression associated with oral contraception. Lancet 1973;I:897-904.
      2. Adams PW, Wynn V, Seed M, Folkard J. Vitamin B6, depression, and oral contraception. Lancet 1974;2:516-7.

  • Explanation Required

    2

    • Norgestimate-Ethinyl Estradiol

      Iron

      Needs Explanation

      Menstrual blood loss is typically reduced with use of OCs. This can lead to increased iron stores and, presumably, a decreased need for iron in premenopausal women. Premenopausal women taking OCs should have their iron levels monitored and talk with their prescribing doctor before using iron-containing supplements.

      Iron
      Norgestimate-Ethinyl Estradiol
      ×
      1. Frassinelli-Gunderson EP, Margen S, Brown JR. Iron stores in users of oral contraceptive agents. Am J Clin Nutr 1985;41(4):703.

    • Norgestimate-Ethinyl Estradiol

      Vitamin A

      Needs Explanation

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

      Vitamin A
      Norgestimate-Ethinyl Estradiol
      ×
      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. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711-5.
      5. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
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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