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      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
      Drugs & Diseases

      Phytoestrogens (Herb/Suppl)

      Brand and Other Names:isoflavones, daidzein, more...genistein, ipriflavone, ostivone, soy isoflavones
      • Print

      Suggested Dosing

      Isoflavones

      40 mg PO qD

      Menopausal symptoms: 34-120 mg/d

      Hypertension: 18 mg PO BID

      Lung cancer prevention: 8.3 -83.2 mcg/d

      Ipriflavone

      200 mg PO TID

      CrCl 40-80 mL/min

      200 mg PO BID

      CrCl <40 mL/min

      200 mg PO qD

      Next:

      Suggested Uses

      Menopausal vasomotor symptoms, osteoporosis

      Decrease risk of breast cancer, CVD

      Efficacy

      Studies show reasonable efficacy for breast cancer, diabetes, osteoporosis prevention/treatment, hot flashes, CVD risk

      Mixed results for cancer prevention

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      Interactions

      Interaction Checker

      and Phytoestrogens

      No Results

         activity indicator 
        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

              Minor

                All Interactions Sort By:
                 activity indicator 

                Contraindicated (0)

                  Serious - Use Alternative (0)

                    Monitor Closely (69)

                    • aceclofenac

                      aceclofenac and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • acemetacin

                      acemetacin and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • agrimony

                      agrimony and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • alfalfa

                      alfalfa and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • American ginseng

                      American ginseng and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • antithrombin alfa

                      antithrombin alfa and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • antithrombin III

                      antithrombin III and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • argatroban

                      argatroban and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • aspirin

                      aspirin and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • aspirin rectal

                      aspirin rectal and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • aspirin/citric acid/sodium bicarbonate

                      aspirin/citric acid/sodium bicarbonate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • bemiparin

                      bemiparin and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • bivalirudin

                      bivalirudin and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • celecoxib

                      celecoxib and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • choline magnesium trisalicylate

                      choline magnesium trisalicylate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • cinnamon

                      cinnamon and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • cordyceps

                      cordyceps and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • dalteparin

                      dalteparin and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • diclofenac

                      diclofenac and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • diflunisal

                      diflunisal and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • dong quai

                      dong quai and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • enoxaparin

                      enoxaparin and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • epoprostenol

                      epoprostenol and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • etodolac

                      etodolac and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • fennel

                      fennel and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • fenoprofen

                      fenoprofen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • feverfew

                      feverfew and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • flaxseed

                      phytoestrogens, flaxseed. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both contain phytoestrogens.

                    • flurbiprofen

                      flurbiprofen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • fondaparinux

                      fondaparinux and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • forskolin

                      forskolin and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • garlic

                      garlic and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • ginger

                      ginger and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • ginkgo biloba

                      ginkgo biloba and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • heparin

                      heparin and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • horse chestnut seed

                      horse chestnut seed and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • ibuprofen

                      ibuprofen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • ibuprofen IV

                      ibuprofen IV and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • indomethacin

                      indomethacin and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • ketoprofen

                      ketoprofen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • ketorolac

                      ketorolac and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • ketorolac intranasal

                      ketorolac intranasal and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • lornoxicam

                      lornoxicam and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • meclofenamate

                      meclofenamate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • mefenamic acid

                      mefenamic acid and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • meloxicam

                      meloxicam and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • mistletoe

                      phytoestrogens increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                    • nabumetone

                      nabumetone and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • naproxen

                      naproxen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • nettle

                      phytoestrogens increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                    • oxaprozin

                      oxaprozin and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • panax ginseng

                      panax ginseng and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • parecoxib

                      parecoxib and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • pau d'arco

                      pau d'arco and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • phenindione

                      phenindione and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • piroxicam

                      piroxicam and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • protamine

                      protamine and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • red clover

                      phytoestrogens, red clover. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both contain phytoestrogens.

                    • reishi

                      phytoestrogens and reishi both increase anticoagulation. Use Caution/Monitor.

                    • reteplase

                      reteplase and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • salicylates (non-asa)

                      salicylates (non-asa) and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • salsalate

                      salsalate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • Siberian ginseng

                      phytoestrogens and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.

                    • sulfasalazine

                      sulfasalazine and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • sulindac

                      sulindac and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • tenecteplase

                      tenecteplase and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

                    • tolfenamic acid

                      tolfenamic acid and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • tolmetin

                      tolmetin and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

                    • vitamin K1 (phytonadione)

                      phytoestrogens increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                    Minor (22)

                    • anamu

                      anamu and phytoestrogens both increase anticoagulation. Minor/Significance Unknown.

                    • bazedoxifene/conjugated estrogens

                      phytoestrogens decreases effects of bazedoxifene/conjugated estrogens by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • cimetidine

                      cimetidine decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • conjugated estrogens

                      phytoestrogens decreases effects of conjugated estrogens by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • conjugated estrogens, vaginal

                      phytoestrogens decreases effects of conjugated estrogens, vaginal by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • danshen

                      danshen and phytoestrogens both increase anticoagulation. Minor/Significance Unknown.

                    • devil's claw

                      devil's claw and phytoestrogens both increase anticoagulation. Minor/Significance Unknown.

                    • dexlansoprazole

                      dexlansoprazole decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • esomeprazole

                      esomeprazole decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • estradiol

                      phytoestrogens decreases effects of estradiol by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • estrogens conjugated synthetic

                      phytoestrogens decreases effects of estrogens conjugated synthetic by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • estrogens esterified

                      phytoestrogens decreases effects of estrogens esterified by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • estropipate

                      phytoestrogens decreases effects of estropipate by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • famotidine

                      famotidine decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • ibuprofen/famotidine

                      ibuprofen/famotidine decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • lansoprazole

                      lansoprazole decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • mestranol

                      phytoestrogens decreases effects of mestranol by pharmacodynamic antagonism. Minor/Significance Unknown.

                    • nizatidine

                      nizatidine decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • omeprazole

                      omeprazole decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • pantoprazole

                      pantoprazole decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • rabeprazole

                      rabeprazole decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                    • theophylline

                      phytoestrogens increases levels of theophylline by decreasing metabolism. Minor/Significance Unknown.

                      phytoestrogens increases levels of theophylline by decreasing elimination. Minor/Significance Unknown.

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                    Adverse Effects

                    Frequency Not Defined

                    Allergic reaction

                    Previous
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                    Warnings

                    Contraindications

                    Pregnancy

                    Previous
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                    Pregnancy & Lactation

                    Pregnancy Category: avoid use

                    Lactation: N/A

                    Pregnancy Categories

                    A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                    B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                    C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                    D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                    X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                    NA: Information not available.

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                    Pharmacology

                    Metabolism: N/A

                    Excretion: N/A

                    Mechanism of Action

                    Partial estrogen receptor agonists; anti-estrogenic effects in premenopausal women, but weak estrogenic effects in postmenopausal women

                    May stimulate osteoblastic activity

                    Incr sex hormone binding globulin (SHBG) levels; antioxidant activity

                    Previous
                    Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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