Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• The use of Coumadin may affect the level of vitamin K.1
• Coumadin may also be affected by CoQ10, which creates a similar action as vitamin K.2
• Avoid foods and supplements containing high dosages of vitamin A (over 10000 IU/day) or vitamin E (over 400 IU/day).3
• More than 5 gms (5,000 mg) of vitamin C may reduce the absorption of Coumadin.4
• Absorption and activity of Coumadin may be decreased by iron, magnesium, and zinc. These minerals should be taken separately from Coumadin, by at least two hours.5
• Please consult with your physician or pharmacist before taking nutritional supplements containing chondroitin sulfate.6
• More than 60 grams of onions (2 ozís) may affect the activity of Coumadin.7
• Avoid avocado with warfarin.8
• Taking high doses of Grapefruit juice with Coumadin may interfere with drug therapy.9
• The following herbs may contribute to blood thinning and should not be used with Coumadin: Angelica, anise, arnica, asafoetida, bogbean, boldo, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng (Panax), horse chestnut, licorice, meadowsweet, prickly ash, passionflower, poplar, quassia, red clover, turmeric, and willow.10
References1 United States Pharmacopeia Drug Index (USPDI). 8th ed. Rockville, Md: US Pharmacopeial Convention, Inc; 1988:259-268.
1 Harris JE. Interaction of dietary factors with oral anticoagulants: Review and applications. J Am Dietet Assoc 1995;95:580-84 [review].
1 Weibert RT, Le DT, Kayser SR, et al. Correction of excessive anticoagulation with low-dose oral vitamin K. Ann Intern Med 1997;125:959-62.
1 Spigset O. Reduced effect of warfarin caused by ubidecarenone. Lancet 1994;344:1372-73 [letter].
1 Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 286.
2 Harris JE. Interaction of dietary factors with oral anticoagulants: Review and applications. J Am Dietet Assoc 1995;95:580-84 [review].
2 Landbo C & Almdal TP [Interaction between warfarin and coenzyme Q10.] Ugeskr Laeger, 1998 May, 160:22, 3226-7.
2 Spigset O. Reduced effect of warfarin caused by ubidecarenone. Lancet 1994;344:1372-73 [letter].
3 Wells, PS et al., Interactions of Warfarin with drugs and food. Ann. Int. Med. 1994, 121:676-683.
3 Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 286.
4 Wells, PS et al., Interactions of Warfarin with drugs and food. Ann. Int. Med. 1994, 121:676-683.
4 Harris JE. Interaction of dietary factors with oral anticoagulants: Review and applications. J Am Dietet Assoc 1995;95:580-84 [review].
4 Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 285.
5 Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998
6 Chavez, M: Glucosamine sulfate and chondroitin sulfates. Hospital Pharmacy, 1997, 52(9): 1,275-1,285.
7 Menon, I.S. et al: Effect of onions on blood fibrinolytic activity. BMJ, 1968,3:351.
7 Pronsky, Z Food Medication Interactions, 11th edition, 1999
7 Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 284.
8 Blickstein, D et al, "Warfarin antagonism by avocado", 1991, The Lancet 337:914-915.
9 Bartle, W. Grapefruit juice might still be factor in warfarin response (letter). American Journal of Health-System Pharmacy 1999; 56 (April 1): 676.
9 Sullivan D, et al. Grapefruit juice and the response to warfarin. American Journal of Health-System Pharmacy 1998; 55: 1581-1583.
10 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
10 Gadkari JV, Joshi VD. Effect of ingestion of raw garlic on serum cholesterol level, clotting time and fibrinolytic activity in normal subjects. J Postgrad Med 1991;37:128-31.
10 Burnham BE. Garlic as a possible risk for postoperative bleeding. Plast-Reconst-Surg 1995;95:213.
10 Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136-39.
10 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
10 The Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.