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    Norethindrone-Mestranol

    Norethindrone-Mestranol

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    Drug Information

    Common brand names:

    Necon 1/50, Norinyl 1+50, Ortho-Novum 1/50

    Summary of Interactions with Vitamins, Herbs, & Foods

    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • Folic Acid

      Oral contraceptive use can cause folic acid depletion.1

    • Manganese

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.2 , 3 , 4 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .5 , 6 , 7 Oral contraceptives may interfere with manganese absorption.8 The clinical importance of these actions remains unclear.

    • Vitamin B6
      Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.9
    • Magnesium

      Women using oral contraceptives were found to have significantly lower serum magnesium levels in a controlled study.10 In a preliminary study, blood levels of magnesium decreased in women taking an oral contraceptive containing ethinyl estradiol and levonorgestrel.11 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.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Vitamin B1

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.12 , 13 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .14 , 15 Oral contraceptives may interfere with manganese absorption.16 The clinical importance of these actions remains unclear.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Vitamin B12

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.17 , 18 , 19 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .20 , 21 , 22 Oral contraceptives may interfere with manganese absorption.23 The clinical importance of these actions remains unclear.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Vitamin B2

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.24 , 25 , 26 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .27 , 28 Oral contraceptives may interfere with manganese absorption.29 The clinical importance of these actions remains unclear.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Vitamin B3 (Niacin)

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.30 , 31 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .32 , 33 Oral contraceptives may interfere with manganese absorption.34 The clinical importance of these actions remains unclear.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Vitamin C

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.35 , 36 , 37 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .38 , 39 Oral contraceptives may interfere with manganese absorption.40 The clinical importance of these actions remains unclear.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Zinc

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.41 , 42 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .43 , 44 Oral contraceptives may interfere with manganese absorption.45 The clinical importance of these actions remains unclear.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Reduce Side Effects

    • none

    Support Medicine

    • Calcium

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.46 , 47 , 48 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .49 , 50 , 51 Oral contraceptives may interfere with manganese absorption.52 The clinical importance of these actions remains unclear.

    • Copper

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.53 , 54 , 55 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .56 , 57 , 58 Oral contraceptives may interfere with manganese absorption.59 The clinical importance of these actions remains unclear.

    Reduces Effectiveness

    • none

    Potential Negative Interaction

    • St. John's Wort

      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.60 One reviewer has suggested that St. John's wort may reduce serum levels of estradiol.61 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.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Explanation Required 

    • Iron

      Menstrual blood loss is typically reduced with use of oral contraceptives. This can lead to increased iron stores and, presumably, a decreased need for iron in premenopausal women.62 Premenopausal women taking oral contraceptives should have their iron levels monitored and talk with their prescribing doctor before using iron-containing supplements.

    • Vitamin A

      A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1 , B2 , B3 , B12 , C , and zinc levels.63 , 64 , 65 Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A .66 , 67 , 68 Oral contraceptives may interfere with manganese absorption.69 The clinical importance of these actions remains unclear.

    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.

    References

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

    2. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    3. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    4. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    5. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    6. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    7. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711-5.

    8. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    9. 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.

    10. Olatunbosum DA, Adeniyi FA, Adadevoh BK. Effect of oral contraceptives on serum magnesium levels. Int J Fertil 1974;19:224-6.

    11. Blum M, Kitai E, Ariel Y, et al. Oral contraceptive lowers serum magnesium. Harefuah 1991;121:363-4 [in Hebrew].

    12. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    13. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    14. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    15. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    16. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    17. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    18. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    19. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    20. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    21. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    22. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711-5.

    23. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    24. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    25. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    26. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    27. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    28. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    29. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    30. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    31. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    32. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    33. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    34. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    35. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    36. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    37. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    38. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    39. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    40. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    41. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    42. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    43. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    44. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    45. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    46. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    47. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    48. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    49. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    50. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    51. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711-5.

    52. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    53. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    54. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    55. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    56. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    57. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    58. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711-5.

    59. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

    60. Safety of St. John's wort (Hypericum perforatum)[letters to the editor from various authors]. Lancet 2000;355:575-7.

    61. Ernst E. Second thoughts about safety of St. John's wort. Lancet 1999;354:2014-6 [letter].

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

    63. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    64. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    65. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.

    66. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].

    67. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.

    68. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711-5.

    69. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.

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