The same is true for direct thrombin inhibitors. Some supplements increase levels of medication in the blood, while others will reduce the levels. Most direct factor Xa inhibitors are processed by the CYP3A4 enzyme. John’s wort with your physician of course. However, it is wise to discuss herbs such as St. There is no direct evidence of food or herbal interaction here. These include thrombin and Factor Xa inhibitors. Thrombin and factor xa inhibitorsĭirect oral anticoagulants are another class of medications to thin the blood. John’s wort will reduce the effectiveness of Warfarin.

There is a clinically significant reaction of mango and Warfarin due to the inhibition of CYP2C19 by retinol found in the mango. There is one reported case of an interaction with a woman on Warfarin who consumed large amounts of chamomile too this was due to CYP1A2, 3A4 and maybe 2C9. There is a potential interaction with grapefruit due to the furanocoumarins. No food or nutrient has been shown to strongly interact with Warfarin (unless it contains Vitamin K). Some herbal remedies are known to act on the CYP2C9 system in the lab, but clinically there is no issue. Most interactions with Warfarin involve other prescription drugs, or OTC drugs. The CYP2C9 enzyme is heavily involved in the metabolism of Warfarin. For those on Warfarin, a very tight range of serum levels are needed for effectiveness. Warfarin is still the most commonly prescribed anticoagulant globally. Of all medications, people most commonly ask about the interaction of herbs and extracts with anticoagulants.

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