Estradiol and norethindrone and St. John's wort interaction

Estradiol and norethindrone and St. John's wort: the Estradiol and norethindrone prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

Curated guidance for St. John's wort

Major

St. John's wort can make birth control pills less effective.

Curated ruleNCCIH, St. John's Wort

From the Estradiol and norethindrone (Estradiol / Norethindrone Acetate) label · effective 2026-06-26

Moderate

John's wort ( Hypericum perforatum ) preparations, phenobarbital, carbamazepine, and rifampin may reduce plasma concentrations of estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile.

Drug interactionsnames St. John's wortView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.