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 5 documented pairs we have explicitly assessed against Aspirin in the Distil database: 5 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
Additive antiplatelet effect
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.
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.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
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.
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.
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.
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.
For adults over 18.
This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, pharmacist, or specialist before making them, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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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If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.