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Warfarin-herbs,Supplements,Foods Interaction (1)

Warfarin-herbs,Supplements,Foods Interaction (1)

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Published by Sivaraj Raman

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Published by: Sivaraj Raman on Jun 21, 2012
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07/02/2012

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Interactions of Warfarin and Herbs, Dietary Supplements, Foods & Vitamins
There is limited evidence on the exact effect herbs, dietary supplements, foods, and vitamins haveon warfarin. They may potentially affecting the effectiveness of warfarin by altering theclearance/metabolism of warfarin through various pathways, reducing the absorption of warfarin,containing warfarin constituents themselves, inhibiting the synthesis of vitamin K-dependentcoagulation factors, increasing the dietary intake of vitamin K and reducing the effectiveness of warfarin, or inhibiting/decreasing the platelet function.The safest is to avoid all herbal and dietary supplements, of course except foods, unless theirphysicians approve. However, if herbal and dietary supplements are taken regularly on a dailybasis, they pose less of a problem than if taken off and on.The following interaction chart is intended as a quick reference to highlight potential interactionsbetween warfarin and commonly known herbal, dietary supplements, foods, and vitamins. Mostof the potential interactions stated in the following chart have no published human case reports of an interaction with warfarin, and caution with using these supplements in combination withwarfarin is warranted.**Most of the uses of various supplements stated in the following interaction chart areinsufficient of evidence. More evidence is needed to rate the effectiveness of the supplements fortheir respective uses.
 
Warfarin Interaction Chart with Herbs, Dietary Supplements & Foods
1, 2, 3, 4
Herb/Supplement/ Food/ VitaminHerbal/Supplemental/Vitamin Uses PotentialInteractionMechanismAgar
To curb appetite & promote weight loss.
INR
 
May
absorption of warfarin
Agrimony
To treat winter colds, fevers, diarrhea, sores, blemishes & pimples.To stop bleeding in Chinese herbal medicine.
INR May be a coagulant
Alcohol
(acute) -
INR
 
May
warfarin metabolism when consumed excessively
Alcohol
(chronic) -
INR
 
May
warfarin metabolism by inducing CYP enzyme
 Alfalfa
(Medicago sativa) To treat disorders related to the digestive tract and the kidneys.
↑↓
INR
INR → May contain warfarin constituents
 
INR →
 
May be due to the Vitamin K content in herb
Algin
To lower cholesterol & blood pressure.To reduce the amount of heavy chemicals taken up by the body.
INR
 
May
absorption of warfarin
Aloe
To treat osteoarthritis, bowel diseases, fever, itching, inflammation,stomach ulcers, diabetes & asthma.
INR
 
May
absorption of warfarin
Anise
(Aniseed) As a digestive aid and anti-flatulence agent.To relieve coughs & colds. To prevent insomnia.
INR May contain warfarin constituents
Arnica
(Wolf bane)Used in homeopathic preparations to treat sore muscles & bruises.
INR May contain warfarin constituents
Artemesia
To treat malaria & bacterial/fungal/viral infections.
INR May contain warfarin constituents
Asafoetida
To treat bronchitis, H1N1 swine flu, asthma & digestive disorders.
INR May contain warfarin constituents
Avocado
-
INR
 
May
warfarin metabolism
Barley
To lower blood sugar, blood pressure & cholesterol.To promote weight loss & treat diarrhea and stomach pain.
INR
 
May
absorption of warfarin
Bishop’s weed
(Bergapten)To treat digestive disorders, asthma, angina, kidney stones & as adiuretic.
INR
 
May contain warfarin constituentsMay
warfarin metabolism (P450 3A4 inhibitor)
Bitter Orange
To improve appetite, and in contrast, also used for weight loss.To treat upset stomach & nasal congestion
INR
 
May
warfarin metabolism (P450 3A4 inhibitor)
Black cohosh
 (cimicifuga racemosa)To treat symptoms of menopause, premenstrual syndrome, painfulmenstruation, acne, osteoporosis & induce labor.
INR May contain salicylates constituents
Bladderwrack
(Fucus,Kelp)To treat thyroid disorders, obesity, arthritis, joint pain,arteriosclerosis, digestive disorders, heartburn, constipation,bronchitis, emphysema, UTI & anxiety.
INR
 
May have anticoagulant effects
Blond psyllium
As a laxative & for softening stools.
INR
 
May
absorption of warfarin
 
Supplement Uses PotentialInteractionMechanismBogbean
To treat rheumatoid arthritis, loss of appetite & upset stomach.
INR
 
May contain warfarin constituents
Bromelain
To reduce swelling/inflammation of nose & sinuses.
INR
 
May
platelet aggregation
Buchu
To treat cystitis, urethritis, prostatitis & pyelonephritis.
INR
 
May contain warfarin constituents
Burdock
To increase urine flow, kill germs, reduce
fever & “purify” blood.
 
INR
 
May
platelet aggregation
Butternut
To treat constipation, gallbladder disorders & hemorrhoids.
INR
 
May
absorption of warfarin
Caffeine
To improve mental alertness.
INR
 
May have antiplatelet effects
Capsicum
To treat digestive disorders.
INR
 
May contain warfarin constituents
Cascara
As a laxative for constipation.
INR
 
May
absorption of warfarin
Cassia
To treat digestive disorders, common cold & loss of appetite.
INR
 
May contain warfarin constituentsMay inhibit platelet aggregration
Castor
Used for birth control, constipation, leprosy & syphilis.
INR
 
May
absorption of warfarin
Cat’s Claw
 
To treat osteoarthritis, rheumatoid arthritis & digestive disorders.
INR
 
May
warfarin metabolism (P450 3A4 inhibitor)
Celery
(seed/extract) To treat joint pain, gout, headache, nervousness & exhaustion.
INR
 
May contain warfarin constituents
Chamomile
(Matricaria recutita)To treat digestive disorders, travel sickness, stuffy nose, hay fever,ADHD, restlessness & trouble sleeping.
INR
 
May contain warfarin constituents
Chondroitin
To treat osteoarthritis.
INR
 
May increase bleeding & chondroitin sulfate is a component of the antithrombotic danaparoid
Chrysin
To treat anxiety, gout, baldness & erectile dysfunction.
INR
 
May
warfarin metabolism (P450 3A4 inhibitor)
Clove
To treat upset stomach, diarrhea, hernia & bad breath.
INR
 
Contains eugenol
 – 
a platelet inhibitor
Cod Liver Oil
(Fish oil) To treat high cholesterol, high triglycerides, high blood pressure,heart disease, kidney disease, osteoarthritis & depression.
INR
 
May inhibit platelet aggregration
Co-enzyme Q
10
 (Ubiquinone)To treat blood vessel conditions such as CHF, angina & high bloodpressure.
INR
 
May have Vitamin K-like procoagulant effects.
Coffee Charcoal
To treat diarrhea.
INR
 
May
absorption of warfarin
Coltsfoot
To treat bronchitis, asthma, whooping cough.
INR
 
May inhibit platelet aggregration
Cranberry
To prevent and treat UTI.
INR
 
May
warfarin metabolism (P450 2C9 inhibitor)
Dandelion
To treat loss of appetite, upset stomach, gallstones, joint pain,muscle aches, eczema & bruises.
↑↓
INR
 
 
INR → May contain warfarin constituents
 
 
INR → May be due to the Vitamin K content in herb
 
Supplement Uses PotentialInteractionMechanism

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