Evidence map›Paper›PMID 42367450›Full record

ArticleCureus2026

Possible Interaction Between Hibiscus and Warfarin Resulting in Severe International Normalized Ratio Elevation: A Case Report.

Khaled Bani Yaseen, Mohammad Al-Radaideh, Majed Almadaineh, Ahmad W Haddad

Abstract readCase Reports
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Khaled Bani YaseenInternal Medicine, Saint Michael's Medical Center, Newark, USA.
Mohammad Al-RadaidehInternal Medicine, Saint Michael's Medical Center, Newark, USA.
Majed AlmadainehInternal Medicine, Saint Michael's Medical Center, Newark, USA.
Ahmad W HaddadInternal Medicine, Saint Michael's Medical Center, Newark, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Warfarin has a narrow therapeutic window and is susceptible to interactions with medications, foods, and herbal products. We describe the case of a 59-year-old woman with a mechanical mitral valve receiving chronic warfarin therapy who developed a markedly elevated international normalized ratio (INR) after recently consuming hibiscus tea. No other clear precipitating factor for the supratherapeutic INR was identified. Warfarin was temporarily withheld, hibiscus intake was discontinued, and oral vitamin K was administered with subsequent normalization of the INR. This case highlights the importance of obtaining a thorough dietary and herbal history in patients receiving warfarin therapy and raises awareness of a possible interaction between warfarin and hibiscus products.

Indexed as

anticoagulationcytochrome p450 2c9drug interactionherb–drug interactionhibiscusmechanical valvesupratherapeutic inrwarfarinwarfarin toxicity

Identifiers

PMID42367450
PMCPMC13310002

What OpenQuestion holds

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Registered trials

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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.