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Heparin

Drug Information

Heparin is a natural product, available by prescription, which is used as an anticoagulant (slows the rate of blood clot formation). Blood clots can cause severe and life-threatening problems. Heparin is used to prevent formation of blood clots (after surgery and in other settings) and in circumstances to help dissolve blood clots already formed (deep vein thrombosis, pulmonary embolism, and other situations involving excessive blood clotting).

Common brand names:

Hep-Lock, Hep-Lock Flush

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Vitamin D

    Heparin may interfere with activation of vitamin D in the body.1 Osteoporosis (thinning of the bone) has been reported in patients who received high amounts of heparin for several months.2 Osteopenia (decreased bone density) has been reported in women who received heparin therapy during pregnancy .3 , 4

Reduce Side Effects

  • none

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • Reishi

    As it may increase bleeding time, reishi (Ganoderma lucidum) is not recommended for those taking anticoagulant (blood-thinning) medications.5

  • Dong Quai

    Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding.6 These herbs include dong quai , fenugreek , horse chestnut , red clover , sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Fenugreek

    Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding.7 These herbs include dong quai , fenugreek , horse chestnut , red clover , sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Ginger

    Ginger has been shown to reduce platelet stickiness in test tubes. Although there are no reports of interactions with anticoagulant drugs, people should consult a healthcare professional if they are taking an anticoagulant and wish to use ginger.8

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Ginkgo

    Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding.9 Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem.10 , 11 People taking heparin should consult with a physician knowledgeable about botanical medicines if they are considering taking ginkgo.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Horse Chestnut

    Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding.12 These herbs include dong quai , fenugreek , horse chestnut , red clover , sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Red Clover

    Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding.13 These herbs include dong quai , fenugreek , horse chestnut , red clover , sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Sweet Clover

    Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding.14 These herbs include dong quai , fenugreek , horse chestnut , red clover , sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Sweet Woodruff

    Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding.15 These herbs include dong quai , fenugreek , horse chestnut , red clover , sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Explanation Required 

  • Potassium

    Heparin therapy may cause hyperkalemia (abnormally high potassium levels).16 , 17 Potassium supplements, potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others), and even high-potassium foods (primarily fruit) should be avoided by persons on heparin therapy, unless directed otherwise by their doctor.

  • Digitalis

    Digitalis (Digitalis purpurea) refers to a group of plants commonly called foxglove, which contains chemicals related to the drug digoxin . Digitalis may interfere with the anticoagulant action of heparin, reducing its action.18 Digitalis should only be used under the direct supervision of a doctor trained in its use.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Aarskog D, Aksens L, Markestad TK, et al. Heparin induced inhibition of 1,25-dihydroxyvitamin D formation. Am J Obstet Gynecol 1984;148:1141–2.

2. Majerus PW, Broze GJ Jr, Miletich JP, Tollefsen DM. Anticoagulant, thrombolytic, and antiplatelet drugs. In Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 9th ed. New York: McGraw-Hill 1996, 1346.

3. Wise PH, Hall AS. Heparin induced osteopenia in pregnancy. BMJ 1980;281:110–1.

4. Haram K, Hervig T, Thordarson H, Aksnes L. Osteopenia caused by heparin treatment in pregnancy. Acta Obstet Gynecol Scand 1993;72:674–5.

5. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Medical Publications, 1998,166–9.

6. Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician’s Guide. New York: Pharmaceutical Products Press, 1999, 313–5.

7. Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician’s Guide. New York: Pharmaceutical Products Press, 1999, 313–5.

8. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press, 1996, 135–7.

9. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136–9.

10. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba in whom bleeding occurred after the addition of ginkgo.

11. Mathews MK. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1934.

12. Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician’s Guide. New York: Pharmaceutical Products Press, 1999, 313–5.

13. Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician’s Guide. New York: Pharmaceutical Products Press, 1999, 313–5.

14. Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician’s Guide. New York: Pharmaceutical Products Press, 1999, 313–5.

15. Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician’s Guide. New York: Pharmaceutical Products Press, 1999, 313–5.

16. Threlkeld DS, ed. Blood Modifiers, Anticoagulants, Heparin. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1997, 87a–7f.

17. Perazella MA. Drug-induced hyperkalemia: Old culprits and new offenders. Am J Med 2000;109:307–14 [review].

18. Threlkeld DS, ed. Blood Modifiers, Anticoagulants, Heparin. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1997, 87a–7f.

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