Supplements and Aspirin.
Aspirin, sold under the brand name Disprin, is an antiplatelet agent: it reduces platelet aggregation.
Aspirin at low dose (75mg) is prescribed for secondary cardiovascular prevention in around two million people in England. It sits at NHSBSA rank ten. The drug irreversibly acetylates COX-1 in platelets, blocking thromboxane A2 production for the platelet's seven to ten day lifespan. The supplement interactions that matter are additive antiplatelet. Ginkgo biloba, garlic in concentrated extract form, fish oil at higher doses, and curcumin all have measurable platelet effects in human studies. None individually changes bleeding risk much at OTC doses. But the stack matters, and the six week washout window before surgery applies to aspirin too. The other surface is GI. Aspirin's gastric irritation profile combines with NSAIDs and, separately, with anything that further reduces protective prostaglandin signalling. Anyone on long aspirin therapy plus a stack of antiplatelet compounds benefits from explicit GP awareness, rather than discovering the combination at the dental appointment.
Below are the 11 documented pairs we have explicitly assessed against Aspirin in the Distil database: 11 amber. The pairs cluster around 1 mechanism: Additive antiplatelet effect. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 14 June 2026. Each interaction below is assessed against PubMed-indexed evidence.
Additive antiplatelet effect
Amber Does Andrographis interact with ?
Andrographis has a mild blood-thinning signal in laboratory studies, so in theory it could add to aspirin's effect on platelets and slightly raise bleeding risk. A small one-day study in healthy people found no clear change, so any real effect looks modest. If you take aspirin, it is worth telling your doctor or pharmacist before starting andrographis, and watch for easy bruising or unusual bleeding.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Bromelain interact with ?
Bromelain has mild blood-thinning activity that can add to aspirin's. The combination is usually fine at typical doses, but watch for easy bruising or bleeding, and stop high-dose bromelain about two weeks before any planned surgery or dental procedure.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Curcumin interact with ?
Curcumin has a mild blood-thinning effect of its own, so taking it alongside aspirin may add to the bleeding risk. The combination is not dangerous at typical doses, but it is worth stopping curcumin before any planned surgery or dental work and telling your GP you take it.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Fisetin interact with ?
Fisetin may mildly reduce how platelets clump, which could add a little to aspirin's blood-thinning effect. This is most relevant during a high-dose fisetin course rather than the small amount in food. If you take aspirin and run a fisetin course, mention it to your GP and watch for easy bruising or bleeding.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Garlic Extract interact with ?
Garlic has mild blood-thinning activity that can add to aspirin's. The combination is usually fine at culinary doses but stop high-dose garlic supplements at least a week before surgery.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does Ginger interact with ?
Ginger can mildly reduce platelet stickiness, and aspirin does the same thing through a different route, so in theory taking high-dose ginger supplements alongside aspirin could add to the blood-thinning effect. This is based on how ginger works in the laboratory rather than on studies of people taking both together, so the real-world effect is likely small. Normal dietary ginger is not a concern. If you take high-dose ginger supplements with aspirin, stop them about a week before any planned surgery and tell your dentist or surgeon.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Ginkgo Biloba interact with ?
Both ginkgo and aspirin reduce platelet aggregation, so combining them increases bleeding risk additively. The combination is not catastrophic at typical doses but is worth stopping six weeks before any planned surgery or dental procedure.
Evidence: Supported by human study data.
Amber Does Omega-3 EPA interact with ?
Standard supplement doses of fish oil (under 1 gram of EPA+DHA per day) add only marginally to the antiplatelet effect of aspirin. At higher cardiology doses (3 grams per day and above), the combination meaningfully increases bleeding risk. Tell your GP what dose you take.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does Pine Bark Extract interact with ?
Pine bark extract (pycnogenol) has a mild blood-thinning effect of its own, most clearly shown in smokers, that can add to aspirin's. For most people this is minor, but the combined effect can mean more bruising or bleeding, and it matters more before surgery. Stop high-dose pine bark extract at least a week before any planned procedure and tell your GP if you notice easy bruising.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Resveratrol interact with ?
Resveratrol can mildly reduce how platelets clump, which adds to aspirin's blood-thinning effect and may slightly raise bleeding risk. The amount in food is not the concern; concentrated supplements are. If you take aspirin and use resveratrol supplements, mention it to your GP and watch for easy bruising or bleeding.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Vitamin E interact with ?
At low supplement doses (100 to 200 IU) vitamin E adds little to aspirin. At high doses (above 400 IU per day) it can add to aspirin's blood-thinning effect and raise bleeding risk. Use mixed-tocopherol products at modest doses and stop high-dose vitamin E six weeks before any surgery.
Evidence: Limited human data, based on case reports and a known mechanism.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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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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