What herbal supplements interact with Eliquis (apixaban)?

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Last updated: February 26, 2025View editorial policy

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From the Research

Patients taking Eliquis (apixaban) should avoid St. John's Wort, as it can significantly decrease Eliquis levels in the blood, potentially reducing its effectiveness in preventing blood clots, as noted in a study published in 2021 1. When considering herbal supplements that interact with Eliquis, it's essential to prioritize those with the most significant potential for adverse interactions.

  • St. John's Wort is a primary concern due to its potential to decrease Eliquis levels, as mentioned in the 2021 study 1.
  • Other herbal supplements that may interact with Eliquis include:
    • Garlic
    • Ginger
    • Ginkgo biloba
    • Green tea
    • Turmeric/curcumin supplements
    • Dong quai
    • Feverfew
    • Ginseng These interactions can occur because many herbs affect the cytochrome P450 enzyme system in the liver that metabolizes Eliquis or have inherent antiplatelet or anticoagulant properties themselves, as discussed in a 2017 study 2. It's crucial for patients to inform their healthcare provider about all supplements they are taking and not start or stop any herbal supplement without medical consultation while on Eliquis therapy, as emphasized in a 2021 review 3. The most recent and highest quality study, published in 2021 1, highlights the importance of avoiding certain herbal supplements, such as St. John's Wort, to minimize the risk of adverse interactions with Eliquis. Healthcare providers should be aware of these potential interactions and take appropriate precautions to ensure patient safety, as noted in a 2002 study 4 and a 1999 review 5.

References

Research

The Clinical Significance of Drug-Food Interactions of Direct Oral Anticoagulants.

International journal of molecular sciences, 2021

Research

Common Herbal Dietary Supplement-Drug Interactions.

American family physician, 2017

Research

Herbal Supplements: Precautions and Safe Use.

The Nursing clinics of North America, 2021

Research

Herbal medication: potential for adverse interactions with analgesic drugs.

Journal of clinical pharmacy and therapeutics, 2002

Research

Herbal remedies: adverse effects and drug interactions.

American family physician, 1999

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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