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Class landing · Anticoagulants

Supplements and anticoagulants.

What to check alongside warfarin, apixaban, rivaroxaban, dabigatran and edoxaban.

Anticoagulants sit in a narrow therapeutic window. Push too far in either direction and the consequence is either a bleed or a clot. Warfarin is the most interaction-prone, but the direct oral anticoagulants (apixaban, rivaroxaban, dabigatran, edoxaban) also have documented supplement interactions.

Several supplements have INR-shifting evidence: curcumin, CoQ10, garlic extract, ginger, ginkgo, and high-dose fish oil push toward more anticoagulation. Vitamin K2 in higher doses pulls in the opposite direction and reduces warfarin's effect. St John’s Wort reduces warfarin levels via CYP induction and is a hard exclusion. Most of these are manageable with INR monitoring at initiation; we flag the ones that are not.

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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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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history.