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Question: Are there supplements I should avoid when taking apixaban (Eliquis) or similar blood thinner drugs?
Answer: Yes, the effectiveness of apixaban (Eliquis), rivaroxaban (Xarelto), betrixaban (Bevyxxa), and other anticoagulant drugs (blood-thinners) classified as "direct factor Xa inhibitors" may be impacted by taking certain supplements.
St. John's wort, for example, activates one of the liver enzymes (CYP3A4) that breaks down these medications in the body. This could potentially reduce the amount of these medications in the body and decrease their effects.
Be aware that the blood thinner dabigatran (Pradaxa), which is classified as a direct thrombin inhibitor, is not metabolized by, and does not inhibit or activate CYP3A4. However, as with direct factor Xa inhibitors, taking supplements that have a blood-thinning effect could potentially increase the risk of bleeding. However, grapefruit juice inhibits a protein involved in the metabolism of Pradaxa (P-glycoprotein, or P-gp) and therefore it may be best to avoid when taking this drug. As with direct factor Xa inhibitors, taking supplements that have a blood-thinning effect (as noted above) can increase the risk of bleeding in people taking Pradaxa.
See the extensive Drug Interactions section on ConsumerLab to look up interactions for these and other drugs you may be taking.
Learn more about supplement interactions with blood thinners: