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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 or pharmacist, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we grade severity, choose what's in scope, and what we exclude.

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The full report

A full supplement review, built around you, not a generic stack.

The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.

  • what your diet already covers, so you are not adding a capsule for something food is already handling
  • which evidence-graded compounds are worth considering for your goals, and which were considered but left out
  • what to keep, change or stop from what you already take, plus the order to introduce anything new
  • how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment

The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.

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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. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.