bleeding risk
4 interactions related to bleeding risk
chia seeds + warfarin
Chia seeds are rich in the omega-3 fatty acid alpha-linolenic acid (ALA) and in soluble fiber. High, sustained omega-3 intake can mildly inhibit platelet aggregation and may modestly add to warfarin's effect, while the soluble fiber can slow warfarin absorption if the two are taken together. Rare case reports describe enhanced anticoagulation or bleeding with chia and related Salvia species. The practical concern is dietary consistency rather than any single serving.
ibuprofen + ginkgo
Ibuprofen reduces platelet aggregation through COX-1 inhibition, and Ginkgo biloba has antiplatelet activity through ginkgolide B's antagonism of platelet-activating factor. Used together they can compound the effect on platelets and raise bleeding risk; a fatal intracerebral hemorrhage has been reported in a long-term ginkgo user who started regular ibuprofen.
naproxen + fish oil
Naproxen and fish oil both mildly reduce platelet aggregation through separate pathways, so their effects are additive in theory. Pooled clinical-trial data show no meaningful increase in major bleeding at typical doses.
cbd + warfarin
CBD inhibits the liver enzymes (notably CYP2C9, and also CYP3A4) that clear warfarin, especially its more potent S-enantiomer. Adding CBD to a stable warfarin regimen can slow warfarin breakdown, raise its blood level, push the INR upward, and increase bleeding risk. A published case report described a patient who needed a meaningful warfarin dose reduction after starting CBD.