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Bilberry
The anthocyanidins in bilberry may inhibit blood coagulation and increase the risk of bleeding in those taking anticoagulants, particularly warfarin. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Coenzyme Q10
Coenzyme Q-10 is chemically similar to vitamin K and may compromise the therapeutic effect of warfarin. Use with caution if taking warfarin (coumadin.) |
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Dong Quai
Dong quai has been reported to inhibit platelet aggregation and increase the anticoagulant effects of warfarin thus increasing risk of bleeding. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Evening Primrose Oil
Evening primrose oil contains gamma-linolenic acid (GLA) which may reduce the potential for platelets to aggregate and thus increase the risk of bleeding when used with anticoagulants. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Feverfew
Feverfew may reduce the potential for platelets to aggregate and thus increase the risk of bleeding when used with anticoagulants. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Fish Oil
Omega-3 fatty acids in fish oil may reduce the potential for platelets to aggregate and thus increase the risk of bleeding when used with anticoagulants. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Flaxseed Oil
Omega-3 fatty acids in fish oil may reduce the potential for platelets to aggregate and thus increase the risk of bleeding when used with anticoagulants. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Garlic
Garlic has been shown to increase INR and may reduce platelet aggregation, increasing the risk of bleeding when combined with anticoagulants. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Ginger Root
Higher doses of ginger may further reduce platelet aggregation when combined with anticoagulants. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Ginkgo Biloba
Ginkgo may further reduce platelet aggregation when combined with anticoagulants. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Ginseng
Ginseng may possibly decrease the effectiveness of the anticoagulant warfarin or may inhibit platelet aggregation and increase the risk of bleeding. Use with caution due to these opposing and complex effects that may occur. |
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Glucosamine
Amounts higher than the recommended doses of both glucosamine and chondroitin have been reported to increase INR. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Goldenseal
Berberine, a constituent of goldenseal, may compromise the therapeutic benefits of warfarin or heparin. Use caution and monitor INRs. |
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Grape Seed
Grape seed extract contains tocopherol which might increase warfarin's effects and increase the risk of bleeding. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Green Tea Catechins
Green tea contains vitamin K which can compromise the therapeutic effects of warfarin and increase the risk of clotting. Conversely, caffeine in green tea may have antiplatelet activity. Due to these opposing and complex effects, use with caution if combining green tea with anticoagulants. |
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Horse Chestnut
Horse chestnut may increase the risk of bleeding if used with anticoagulants or antiplatelet drugs. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Iron
Caution patients of increased risk of stomach upset or other GI symptoms when combining iron supplements with aspirin or NSAIDs. |
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Milk Thistle
Milk thistle might inhibit the cytochrome P450 2C9 (CYP2C9) enzyme which could reduce the clearance of warfarin and increase the risk of bleeding. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Saw Palmetto
Saw palmetto has been reported to prolong bleeding time. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Vinpocetine
When combined with anticoagulants, vinpocetine may further reduce platelet aggregation and thus increase the risk of bleeding. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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Vitamin C
Concomitant use of warfarin with excessive doses of vitamin C (> 1000 mg per day) may alter the therapeutic benefits of warfarin and increase risk for clots. Caution patients to avoid excessive doses of vitamin C with warfarin and to have INRs checked if supplementing with vitamin C. |
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Vitamin E
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding, possibly through inhibition of platelet aggregation and antagonism of vitamin K-dependent clotting factors. Weigh desired benefits of supplement versus potential increased risk of bleeding and use with caution. |
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