ReviewEvidence-based complementary and alternative medicine : eCAM2014
Updates on the clinical evidenced herb-warfarin interactions.
Review in Evidence-based complementary and alternative medicine : eCAM, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance.Phytotherapy research : PTR · 2018Pooled it
- A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin.PloS one · 2017Pooled it
- Hazardous Interactions Between Food, Herbs, and Drugs in the First Stage of Biotransformation: Case Reports of Adverse Drug Interactions in Humans.International journal of molecular sciences · 2025Review
- Gut Microbiota and Cardiovascular Diseases: Unraveling the Role of Dysbiosis and Microbial Metabolites.International journal of molecular sciences · 2025Review
- The Effect of Spinach (Journal of blood medicine · 2025Article
- Review of drug-drug interactions in patients with prostate cancer.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2024Review
- Article
- Safety Issues of Herb-Warfarin Interactions.Current drug metabolism · 2024Review
- Article
- The development and impact of an app for a smart drug interaction reminder system.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Article
- Safety Aspects of Herb Interactions: Current Understanding and Future Prospects.Current drug metabolism · 2024Review
- Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review.Journal of clinical medicine · 2022Review
- Warfarin Pharmacogenomics for Precision Medicine in Real-Life Clinical Practice in Southern Africa: Harnessing 73 Variants in 29 Pharmacogenes.Omics : a journal of integrative biology · 2022Article
- Dietary supplements and bleeding.Proceedings (Baylor University. Medical Center) · 2022Review
- Pharmacy practitioners' practice, awareness and knowledge about herbal products and their potential interactions with cardiovascular drugs.F1000Research · 2022Article
- Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events.PloS one · 2022Article
- Current update on herbal sources of antithrombotic activity-a comprehensive review.The Egyptian journal of internal medicine · 2022Review
- Economy- and Social-Based Strategies for Anticoagulation of Patients with Atrial Fibrillation.Arquivos brasileiros de cardiologia · 2022Article
- Phenolic Bioactives as Antiplatelet Aggregation Factors: The Pivotal Ingredients in Maintaining Cardiovascular Health.Oxidative medicine and cellular longevity · 2021Review
- Assessment of the quality of anticoagulation management with warfarin in a tertiary care center.Saudi medical journal · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Increasing and inadvertent use of herbs makes herb-drug interactions a focus of research. Concomitant use of warfarin, a highly efficacious oral anticoagulant, and herbs causes major safety concerns due to the narrow therapeutic window of warfarin. This paper presents an update overview of clinical findings regarding herb-warfarin interaction, highlighting clinical outcomes, severity of documented interactions, and quality of clinical evidence. Among thirty-eight herbs, Cannabis, Chamomile, Cranberry, Garlic, Ginkgo, Grapefruit, Lycium, Red clover, and St. John's wort were evaluated to have major severity interaction with warfarin. Herbs were also classified on account of the likelihood of their supporting evidences for interaction. Four herbs were considered as highly probable to interact with warfarin (level I), three were estimated as probable (level II), and ten and twenty-one were possible (level III) and doubtful (level IV), respectively. The general mechanism of herb-warfarin interaction almost remains unknown, yet several pharmacokinetic and pharmacodynamic factors were estimated to influence the effectiveness of warfarin. Based on limited literature and information reported, we identified corresponding mechanisms of interactions for a small amount of "interacting herbs." In summary, herb-warfarin interaction, especially the clinical effects of herbs on warfarin therapy should be further investigated through multicenter studies with larger sample sizes.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.