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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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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

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Your whole stack

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This page checks the pairs you enter. The personalised Distil report goes further:

  • the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
  • where your current routine may be leaving you short of your goals
  • the evidence-backed compounds worth adding, and the ones worth dropping

It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.

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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.