Ginger Warfarin

Ginger Warfarin Increases effectiveness of warfarin, bleeding... 

Dose Initial 0.25 mg PO tid, wkly 10.25 mg/dose, to 3 mg max max 4 mg for RLS Caution [C, /-] Sev e CV, renal, or hepatic impair Contra Component allergy Disp Tabs SE Syncope, postural X BP, NA, HA, somnolence, dosed-related hallucinations, dyskinesias, dizziness Interactions t Risk of bleeding W/ ASA, NSAIDs, fevCTfew, garlic, ginger, horse chestnut, red clover, EtOH, tobacco t effects OF amitriptyline, Li, MTX, theophylline, warfarin t risk of photosensitivity W/ dong quai— use sunscreen, St. John s wort X effects W/ antacids, rifampin X effects OF ACEIs, diuretics EMS t Bleeding risk w/ concurrent EtOH, tobacco, ASA, and NSAID use t effects of warfarin OD May cause N/V, drowsiness, hypotension, and CP symptomatic and supportive... 

Ginger ASA, NSAIDs Clopidogrel, ticlopidine Warfarin Additive antiplatelet effects Additive antiplatelet effects Increased risk of bleeding... 

Vaes, L.P.J. Chyka, P.A. Interactions of warfarin with garlic, ginger, ginkgo, or ginseng nature of the evidence. Ann. Pharmacother. 2000, 34 (12), 1478-1482. 

Jiang X, Williams K, Liauw W, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Brit J Clin Pharmacol 2005 59(4) 425 132. 

These appear to be the only reports of ginger as a probable cause of overanticoagulation, despite the fact that prior to these Ginger Zingiber officinale ) has been sometimes listed as a herb that interacts with warfarin. on the basis that in vitro it inhibits platelet aggregation. However, this antiplatelet effect has not been demonstrated in clinical studies (which have been the subject of a review ), see also Coumarins + Herbal medicines , p.414. 

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