Medication · hrt tibolone

Supplements and Tibolone.

Every documented pair, every citation. Below: 1 documented pair grouped by mechanism.

Tibolone, sold under the brand name Livial, is tibolone, a synthetic steroid used in HRT with combined oestrogen, progestogen, and androgen effects.

Tibolone is tibolone, a synthetic steroid prescribed in UK practice for menopausal symptom control, and it has combined oestrogenic, progestogenic, and androgenic effects through metabolite activity that varies by tissue. UK prescribing places tibolone alongside HRT as an alternative when conventional oestrogen plus progestogen combinations are not suitable. The supplement surface is small but includes the standard hormonal therapy concerns. Anything with phyto-oestrogenic activity (soya isoflavones, red clover) sits in a poorly studied additive space. St John's Wort is flagged by the BNF across hormonal therapies for enzyme induction reducing efficacy. Bone density protection underpins the use of tibolone in women past menopause. Vitamin D and calcium status warrant attention. Symptom relief supplements often taken during HRT (black cohosh, evening primrose oil) sit on top of tibolone without strong interaction signals. The additive benefit evidence base for any of them is modest.

Below are the 1 documented pair we have explicitly assessed against Tibolone in the Distil database: 1 red. The pairs cluster around 1 mechanism: CYP3A4 induction. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

CYP3A4 induction

Red St John's Wort

St John's Wort can reduce circulating tibolone metabolite levels by speeding up its breakdown. For HRT users this means menopausal symptom control may slip. We treat this as a do-not-combine pair without specialist sign-off.

BNF: Hypericum · BNF: Tibolone

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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