Supplements and Dabigatran etexilate.
Dabigatran etexilate, sold under the brand name Pradaxa, is a direct oral anticoagulant (DOAC): it inhibits factor Xa or thrombin directly, without routine INR monitoring.
Dabigatran etexilate is a direct oral anticoagulant (DOAC). The class includes the factor Xa inhibitors (apixaban, rivaroxaban, edoxaban) and the direct thrombin inhibitor (dabigatran). DOACs replaced warfarin in atrial fibrillation stroke prevention and most venous thromboembolism treatment, because they need no routine INR monitoring. The tradeoff. No antidote for most clinical situations, and reduced flexibility around excess anticoagulation. The supplement surface is quieter than warfarin's but real. DOACs are CYP3A4 metabolised (apixaban, rivaroxaban) and P-glycoprotein substrates, so strong dual 3A4 plus P-gp inhibitors raise plasma levels. Additive antiplatelet or fibrinolytic supplements (fish oil at high doses, ginkgo, garlic extract, curcumin, bromelain, andrographis, nattokinase) add to bleeding risk through platelets or clotting rather than through the DOAC's blood level. Washout before surgery is 24 to 48 hours depending on renal function and bleeding risk. Supplement washout should align with it.
Below are the 11 documented pairs we have explicitly assessed against Dabigatran etexilate in the Distil database: 1 severe, 9 caution, and 1 good to know. The pairs cluster around 4 mechanisms: P-glycoprotein induction (lowers drug levels), Additive anticoagulation, Additive antiplatelet effect, and P-glycoprotein inhibition (raises drug levels). 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 12 November 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
P-glycoprotein induction (lowers drug levels)
Severe Does St John's Wort interact with Dabigatran etexilate?
Avoid taking St John's Wort with dabigatran: it may reduce how much dabigatran your gut absorbs, which could lower its level and leave you less protected against clots or stroke. The UK product information for Pradaxa names St John's Wort and says to avoid taking the two together. Dabigatran's level falls by about two thirds with a strong medicine that works on the same gut pump; the effect of St John's Wort itself has not been measured. Dabigatran has no routine blood test that would show a drop, so tell your GP or pharmacist if you take or have recently taken St John's Wort.
Evidence: Supported by human study data.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive anticoagulation
Caution Does Bromelain interact with Dabigatran etexilate?
Bromelain may add to dabigatran's bleeding risk. Its effect on blood clotting has been seen mainly in laboratory tests, though in one small 1972 study bromelain tablets reduced platelet clumping in volunteers. The only data on bromelain alongside a blood thinner, from surgical patients on a preventive dose of heparin, found their clotting tests little changed, but no study has tested bromelain with dabigatran or in anyone taking a full-dose blood thinner for months. Dabigatran blocks thrombin rather than factor Xa, and bromelain has shown an effect on thrombin-driven platelet clumping in the laboratory, which is one more reason to treat this pair with care. Tell whoever prescribes your dabigatran before starting bromelain, watch for unusual bruising, nosebleeds or bleeding gums, and stop it about two weeks before any planned surgery or dental work.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Curcumin interact with Dabigatran etexilate?
Curcumin has a mild blood-thinning effect of its own, so combining it with dabigatran may add slightly to the bleeding risk. The one small study of the combination used a blood test that does not reliably reflect dabigatran's effect, so the sensible step is to tell your GP you take it and stop curcumin before any planned surgery or dental work.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive antiplatelet effect
Caution Does Fisetin interact with Dabigatran etexilate?
Fisetin may mildly thin the blood by reducing platelet clumping, which could add to dabigatran. There is no routine blood test for dabigatran, so keep any fisetin course modest and tell your GP if you take both. The amount in food is not the concern.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Ginkgo Biloba interact with Dabigatran etexilate?
Ginkgo may add to dabigatran's bleeding risk, and dabigatran is the blood thinner in this group where that matters most, so we would not start ginkgo alongside it without your prescriber agreeing. Dabigatran relies almost entirely on one gut transporter that ginkgo appears to slow, and in a study of nearly 50,000 people with an irregular heartbeat, medicines that block that transporter raised bleeding on dabigatran while leaving apixaban and rivaroxaban unchanged. In trials in people, ginkgo itself has not shown a meaningful effect on standard clotting tests, so the concern here is about drug levels rather than a proven blood-thinning effect, and there is no INR blood test on dabigatran to catch a rise early. If you and your prescriber continue both, watch for unusual bruising, nosebleeds or black stools, and stop the ginkgo at least two weeks before planned surgery or dental work.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Omega-3 EPA interact with Dabigatran etexilate?
At supplement doses below 1 gram of EPA+DHA per day, fish oil adds little to dabigatran's bleeding risk. At higher cardiology doses (3 grams per day and above) the antiplatelet effect is more meaningful and the combined bleeding risk rises. Dabigatran has no INR test to monitor this, so tell your GP what dose of fish oil you take.
Evidence: Limited human data, from small studies or case reports.
Caution Does Resveratrol interact with Dabigatran etexilate?
Resveratrol can mildly thin the blood by reducing platelet clumping, which could add to dabigatran. There is no routine blood test for dabigatran, so keep any resveratrol dose modest and tell your GP if you take both. Food amounts are not the concern.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Vitamin E interact with Dabigatran etexilate?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which may add to dabigatran. Lower doses have not been studied with dabigatran, and a pooled analysis of the trials behind vitamin E's own bleeding signal did not find that the dose explained it, so a low dose cannot be assumed to be free of it. Dabigatran has no routine blood test to monitor this, so tell whoever prescribes your dabigatran before taking vitamin E at any dose, and stop vitamin E at least two weeks before planned surgery.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
P-glycoprotein inhibition (raises drug levels)
Caution Does Andrographis interact with Dabigatran etexilate?
Andrographis may raise dabigatran levels by slowing a gut pump called P-glycoprotein, and dabigatran leans on that pump more than the other blood thinners in its class, so the concern is added bleeding risk. Studies of andrographis with dabigatran have not been done, so this is a judgement from mechanism rather than a measured effect. If you take dabigatran, tell your doctor or pharmacist before starting andrographis and watch for unusual bruising, nosebleeds, or blood in your urine or stool.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Schisandra interact with Dabigatran etexilate?
Schisandra may raise the level of dabigatran in your blood, which could add to its bleeding risk. Schisandra has been shown in people to slow the gut transporter that dabigatran depends on, and dabigatran is sensitive to medicines that do this, but the two have never been tested together. Tell your prescriber or pharmacist before you start, and watch for unusual bruising, nosebleeds or black stools, because there is no routine blood test for dabigatran to catch a change.
Evidence: Limited human data, from small studies or case reports.
Other
Good to know Does Vitamin K2 interact with Dabigatran etexilate?
Dabigatran is not a warfarin-type blood thinner, so vitamin K does not work against it the way it works against warfarin. Vitamin K2 is not expected to reduce dabigatran's effect. If you are on dabigatran rather than warfarin, this common worry is unlikely to apply to you.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
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.
No affiliates. No commission. We earn nothing on what you buy.
How the checker decides
Every result has a source
Each pair we have assessed is cited to a published study (PMID) or the British National Formulary, so you can read the source yourself.
Four kinds of answer
Severe, caution, no known interaction, and not yet assessed. A pair we have not assessed is never shown as clear.
- Severe
- Caution
- No known interaction
- Not yet assessed
Nothing in our data is not a clearance
When nothing in our data records a problem with a pair, the result says no known interaction at typical doses, which is not a clearance: your pharmacist or GP can check the pair against your full medical history.
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.
£49 until 30 June 2027 · £79 from 1 July 2027.
Something missing?
If a supplement or medication you take isn't in our autocomplete, tell us. What people flag joins the queue of what we add next.