Can I take Berberine and Nexplanon together?

Why this happens

Berberine can affect certain liver enzymes (specifically CYP3A4) that are responsible for breaking down the hormones in Nexplanon (etonogestrel). By interfering with these enzymes, berberine may lower the levels of the contraceptive hormone in your bloodstream.

What you should do

You should avoid taking berberine while using the Nexplanon implant. If you have already taken them together, use a barrier method of contraception (like condoms) and speak with your GP or pharmacist for further advice.

Important precautions

Pregnancy and Breastfeeding

Berberine can cross the placenta and pass into breast milk. It may cause brain damage (kernicterus) in newborns and infants by displacing bilirubin from albumin. Do not use if pregnant or breastfeeding.

Diabetes medication use

Berberine significantly lowers blood sugar. When taken with insulin or other diabetes medicines (like metformin), it can cause dangerously low blood sugar (hypoglycaemia).

Liver enzyme interaction (CYP3A4)

Berberine inhibits the enzymes that break down many medications. It may increase the levels of other drugs in your system or potentially interfere with the metabolism of hormonal contraceptives like Nexplanon.

Food and drink warnings

Alcohol

Berberine may slow down the rate at which your body breaks down alcohol. This could potentially increase the effects of alcohol or lead to higher levels of acetaldehyde (a toxic byproduct) in your system, causing increased nausea or headaches. Use caution when combining the two.

Grapefruit juice

Berberine is processed by the same liver enzymes (specifically CYP3A4) as many other medications. Grapefruit juice can inhibit these enzymes, potentially leading to higher levels of berberine in your blood, which may increase the risk of side effects like stomach upset.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.