From the Guidelines
If you're taking Plavix (clopidogrel), you should avoid proton pump descriptor (PPI) supplements, such as omeprazole, lansoprazole, or rabeprazole, as they may decrease the medication's effectiveness by inhibiting the CYP450 2C19 enzyme that activates clopidogrel 1. When considering supplements to avoid while taking Plavix, it's essential to prioritize those that may interact with the medication, increasing the risk of adverse effects.
- PPIs, such as omeprazole, lansoprazole, or rabeprazole, should be avoided due to their potential to decrease clopidogrel's effectiveness 1.
- Other supplements, such as St. John's wort, ginkgo biloba, garlic supplements, fish oil, omega-3 fatty acids, vitamin E (in high doses), ginger supplements, turmeric/curcumin, and evening primrose oil, may also increase bleeding risk or reduce Plavix's effectiveness 1. However, the most critical consideration is the potential interaction between PPIs and clopidogrel, as highlighted in the 2011 ACCF/AHA guideline 1. It's crucial to consult your healthcare provider before starting or stopping any supplement while on Plavix, as individual medical circumstances may affect these recommendations.
From the Research
Supplements to Avoid with Plavix (Clopidogrel)
The following supplements may interact with Plavix (clopidogrel) and should be avoided or used with caution:
- Anise and dong quai, which have anticoagulant effects 2
- Omega 3-fatty acids in fish oil, ajoene in garlic, ginger, ginko, and vitamin E, which have antiplatelet properties 2
- Fucus, which has heparin-like activity 2
- Danshen, which has antithrombin III-like activity and anticoagulant bioavailability 2
- St. John's Wort and American Ginseng, which may interfere with drug metabolism 2
- High doses of vitamin E, which has vitamin K antagonist activity 2
- Alfalfa, which has high-vitamin K content 2
- Coenzyme Q10, which has vitamin K-like activity 2
Bleeding Risks with Supplement Interactions
While some studies suggest that certain supplements, such as omega-3 fatty acids, may not increase the risk of bleeding when taken with aspirin and clopidogrel 3, others highlight the potential risks of bleeding with various supplements, including Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John's Wort, and sushi 4.
Considerations for Patients Taking Plavix (Clopidogrel)
Patients taking Plavix (clopidogrel) should be aware of the potential interactions with dietary supplements and consult their healthcare professionals before starting any new supplements 2, 4.