Supplements and Edoxaban.
Edoxaban, sold under the brand names Lixiana, Savaysa, is a direct oral anticoagulant (DOAC): it inhibits factor Xa or thrombin directly, without routine INR monitoring.
Edoxaban 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 Edoxaban 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 Edoxaban?
Avoid taking St John's Wort with edoxaban: it may make your body clear edoxaban faster, which could lower its level and leave you less protected against clots or stroke. The UK product information for Lixiana names St John's Wort among the medicines that may lower edoxaban levels and advises caution. The effect has not been measured with edoxaban itself, and it may be smaller than with some other blood thinners, but edoxaban has no routine blood test that would show a drop. 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 Edoxaban?
Bromelain may add to edoxaban'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 edoxaban or in anyone taking a full-dose blood thinner for months. Tell whoever prescribes your edoxaban 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 Edoxaban?
Curcumin has a mild blood-thinning effect of its own, so combining it with edoxaban may add slightly to the bleeding risk. No study has tested this combination in people, 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 Edoxaban?
Fisetin may mildly thin the blood by reducing platelet clumping, which could add to edoxaban. There is no routine blood test for edoxaban, 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 Edoxaban?
Ginkgo may add to edoxaban's bleeding risk, so we would not start it alongside edoxaban without your prescriber agreeing, and there is no INR blood test on edoxaban to pick up a problem early the way there is on warfarin. Edoxaban depends heavily on one gut transporter that ginkgo appears to slow, and edoxaban's own prescribing information already tells doctors to reduce the dose when another medicine blocks that transporter, so this is a route the drug is known to be sensitive to. In trials in people, ginkgo itself at UK supplement doses has not shown a meaningful effect on standard clotting tests, so 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 Edoxaban?
At supplement doses below 1 gram of EPA+DHA per day, fish oil adds little to edoxaban'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. Edoxaban 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 Edoxaban?
Resveratrol can mildly thin the blood by reducing platelet clumping, which could add to edoxaban. There is no routine blood test for edoxaban, 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 Edoxaban?
Vitamin E at high doses (above 400 IU per day) can raise bleeding risk in its own right, which may add to edoxaban. Lower doses have not been studied with edoxaban, 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. Edoxaban has no routine blood test to monitor this, so tell whoever prescribes your edoxaban 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 Edoxaban?
Andrographis may raise edoxaban levels by slowing a gut pump called P-glycoprotein that normally limits how much edoxaban gets into you, so the concern is added bleeding risk. Studies of andrographis with edoxaban have not been done, so this is a judgement from mechanism rather than a measured effect. If you take edoxaban, 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 Edoxaban?
Schisandra may raise the level of edoxaban in your blood, which could add to its bleeding risk. Schisandra has been shown in people to slow a gut transporter that edoxaban depends on, 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 edoxaban to catch a change.
Evidence: Limited human data, from small studies or case reports.
Other
Good to know Does Vitamin K2 interact with Edoxaban?
Edoxaban 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 edoxaban's effect. If you are on edoxaban 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.
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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.
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