Black Pepper - Pradaxa (dabigatran) Interaction
Herbal: Black Pepper
Also Known As: Piper nigrum, Black Peppercorn, Extrait de Poivre, Grain de Poivre, Hu Jiao, Kali Mirchi, Kosho, Marich, Maricha, Miris, Peber, Peper, Pepe, Peppar, Pepper, Pepper Extract, Peppercorn, Pfeffer, Pimenta, Pimienta, Pimienta Negra, Pipar, Piper, Piperine, Pippuri, Poivre
Drug: dabigatran
Brand names:
Pradaxa, Pradax
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 26, 2024
Interaction Details
dabigatran is classified as belonging to the following category: P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50.
- Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289.
- Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186.
Interaction Details
dabigatran is classified as belonging to the following category: Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Raghavendra, R. H. and Naidu, K. A. Spice active principles as the inhibitors of human platelet aggregation and thromboxane biosynthesis. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(1):73-78.
Black Pepper Overview
Black pepper is a spice made from the dried, unripe fruit of the Piper nigrum plant, which is native to the southwestern coast of India. It is one of the most widely used spices in the world, and it is often utilized to add flavor and heat to a wide variety of dishes.
In traditional medicine, black pepper is purported to have a number of health benefits. It is a good source of antioxidants and is thought to have anti-inflammatory properties, which may make it useful in reducing inflammation and swelling in the body. Black pepper is also used as a natural remedy for digestive problems, such as indigestion and bloating, and to boost the immune system.
Black pepper is widely used in dietary supplements, specifically, an extract from black pepper known as piperine. Piperine can affect the absorption of many drugs, which is why it has a large number of reported interactions. Oftentimes, these 'interactions' are purposeful, such as when piperine is used with turmeric, to increase its absorption.
dabigatran Overview
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Dabigatran is used to treat deep vein thrombosis (DVT; a blood clot, usually in the leg) and pulmonary embolism (PE; a blood clot in the lung) in adults and children 3 months of age and older who have been treated with an injectable anticoagulant ('blood thinner'). It is also used to reduce the risk of a DVT and PE from happening again after initial treatment is completed in adults and children 3 months of age and older. Dabigatran is used to help prevent DVT and PE in adults who have had hip replacement surgery. Dabigatran is also used to help prevent strokes or serious blood clots in adults who have atrial fibrillation (a condition in which the heart beats irregularly, increasing the chance of clots forming in the body, and possibly causing strokes) without heart valve disease. Dabigatran is in a class of anticoagulant medications called direct thrombin inhibitors. It works by preventing blood clots from forming in the body.
Black Pepper - More Interactions
Black Pepper interacts with 948 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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