Cinnamon Interactions

Concentrated cassia cinnamon supplements are a major source of coumarin, a compound that can be hard on the liver and may interfere with how the body clears warfarin. Because warfarin has a very narrow safety margin, even small shifts can raise bleeding risk, and a published case report describes an elevated INR after a multi-herb drink containing cinnamon was added to stable warfarin therapy, though the other herbs in the drink could also have contributed.

Cinnamon has a mild glucose-lowering effect that can add modestly to metformin's. In pooled human trial data the effect on fasting glucose is small and there are no reports of serious low blood sugar from the combination, so the practical concern is minor for most people. The main extra consideration is choosing the lower-coumarin Ceylon variety for long-term daily supplement use.