bleeding risk
4 interactions related to bleeding risk
chia seeds + warfarin
Chia seeds are high in alpha-linolenic acid (an omega-3 fatty acid) and soluble fiber. Omega-3 intake at high doses may mildly inhibit platelet aggregation and could theoretically enhance warfarin's anticoagulant effect, while the soluble fiber may also blunt warfarin absorption when taken at the same time.
ibuprofen + ginkgo
Ibuprofen inhibits platelet aggregation through COX-1, and Ginkgo biloba inhibits platelet-activating factor through ginkgolide B. Combining them increases the risk of bleeding, with case reports of fatal intracerebral hemorrhage.
naproxen + fish oil
Naproxen impairs platelet aggregation through COX-1 inhibition, and fish oil EPA and DHA have mild antiplatelet and antithrombotic effects. Combining them can modestly increase bleeding risk, especially at high doses or alongside other blood thinners.
cbd + warfarin
CBD inhibits CYP2C9 (and CYP3A4), the enzymes responsible for metabolizing the more potent S-enantiomer of warfarin. Co-use raises plasma warfarin concentrations, elevates INR, and increases bleeding risk; a published case report required a roughly 30% warfarin dose reduction after the patient started CBD.