Aspirin with Ginger Interaction Details

Brand Names Associated with Aspirin

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Mar 04, 2024

Interaction Effect

Increased risk of bleeding

Interaction Summary

Theoretically, the possible antiplatelet effect of ginger may increase the risk of bleeding when combined with an antiplatelet agent[1]. Clinical trials have demonstrated a significant effect on platelet aggregation only following a single oral dose of 10 grams of powdered ginger, a higher dose than that usually used [2]. Clinical trials using smaller daily doses of raw ginger, cooked ginger, and dried ginger have not shown a significant effect on platelet aggregation [3][4]. Ginger extract did not significantly alter blood coagulation parameters either alone or in combination with warfarin in rats [5]. In vitro data demonstrate that ginger may inhibit platelet aggregation [6]. The extraction method used may significantly affect the ability of ginger to inhibit platelet aggregation [7][6][8].

Severity

Minor

Onset

Rapid

Evidence

Theoretical

How To Manage Interaction

The clinical significance of any effect ginger may have on platelet aggregation is undetermined. Caution is advised if ginger and an antiplatelet agent are taken concomitantly. Studies suggest that over 4 grams of dried or 15 grams raw ginger root daily must be ingested in order to have any effect on blood coagulation.

Mechanism Of Interaction

Additive antiplatelet effects; ginger may inhibit thromboxane B2 formation and thromboxane synthetase and increase prostacyclin levels

Literature Reports

A) Powdered ginger significantly inhibited platelet aggregation in a placebo-controlled study of 20 patients with coronary artery disease. Patients received powdered ginger, 10 grams as a single dose. Ginger reduced adenosine diphosphate (ADP)- and epinehrine-induced platelet aggregation (p less than 0.05). The platelet response appears to be dose-dependent, as ginger 4 grams daily for 1.5 and 3 months did not exert any appreciable effect on platelet aggregation, fibrinogen, or fibrinolytic activity. All patients had a history of myocardial infarction greater than 6 months old, and all were taking nitrates and aspirin. Aspirin was discontinued 2 weeks prior to the study [2].

B) Raw ginger root had no significant effect on platelet function in 18 healthy volunteers in a randomized, placebo-controlled crossover study. Subjects received either raw Brazilian ginger root 15 grams, cooked stem ginger 40 grams, or placebo for 2 weeks. Subjects discontinued use of any medications for 1 month prior to the study. The mean decrease in thromboxane production was 1 +/- 9% for ginger root and 1 +/- 8% for stem ginger as compared to placebo (p=0.984). Mean thromboxane B2 production was unchanged [3].

C) Dried ginger did not affect platelet function in a randomized, double-blind, placebo-controlled study of 8 healthy male subjects. Subjects received 2 grams dried ginger. The change in bleeding time in the ginger group was not significant, but bleeding time was somewhat less after ginger use than pre-treatment or placebo. Ginger did not significantly inhibit aggregation induction ex vivo by either ADP, ristocetin, arachidonic acid, or collagen 3 and 24 hours after consumption [4].

References

1 ) Norred CL & Brinker F: Potential coagulation effects of preoperative complementary and alternative medicines. Alt Ther 2001; 7(6):58-67.

2 ) Bordia A, Verma SK, & Srivastava KC: Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostagland, Leukotrienes and Ess Fatty Acids 1997; 56:379-384.

3 ) Janssen PLTMK, Meyboom S, van Staveren WA, et al: Consumption of ginger (Zingiber officinale Roscoe) does not affect ex vivo platelet thromboxane production in humans. Eur J Clin Nutrition 1996; 50:772-774.

4 ) Lumb AB: Effect of dried ginger on human platelet function. Thromb Hemostasis 1994; 71:110-111.

5 ) Weidner MS & Sigwart K: The safety of a ginger extract in the rat. J Ethnopharmacol 2000; 73(3):513-530.

6 ) Srivastava KC: Aqueous extracts of onion, garlic and ginger inhibit platelet aggregation and alter arachidonic acid metabolism. Biomed Biochim Acta 1984; 43(8-9):S335-S346.

7 ) Srivastava KC: Isolation and effects of some ginger components on platelet aggregation and eicosanoid biosynthesis. Prostagl Leukotr Med 1986; 25:187-198.

8 ) Srivastava KC: Effects of aqueous extracts of onion, garlic and ginger on platelet aggregation and metabolism of arachidonic acid in the blood vascular system: in vitro study. Prostagl Leukotr Med 1984a; 13:227-235.

Aspirin Overview

• Prescription aspirin is used to relieve the symptoms of rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), osteoarthritis (arthritis caused by breakdown of the lining of the joints), systemic lupus erythematosus (condition in which the immune system attacks the joints and organs and causes pain and swelling) and certain other rheumatologic conditions (conditions in which the immune system attacks parts of the body). Nonprescription aspirin is used to reduce fever and to relieve mild to moderate pain from headaches, menstrual periods, arthritis, toothaches, and muscle aches. Nonprescription aspirin is also used to prevent heart attacks in people who have had a heart attack in the past or who have angina (chest pain that occurs when the heart does not get enough oxygen). Nonprescription aspirin is also used to reduce the risk of death in people who are experiencing or who have recently experienced a heart attack. Nonprescription aspirin is also used to prevent ischemic strokes (strokes that occur when a blood clot blocks the flow of blood to the brain) or mini-strokes (strokes that occur when the flow of blood to the brain is blocked for a short time) in people who have had this type of stroke or mini-stroke in the past. Aspirin will not prevent hemorrhagic strokes (strokes caused by bleeding in the brain). Aspirin is in a group of medications called salicylates. It works by stopping the production of certain natural substances that cause fever, pain, swelling, and blood clots.

• Aspirin is also available in combination with other medications such as antacids, pain relievers, and cough and cold medications. This monograph only includes information about the use of aspirin alone. If you are taking a combination product, read the information on the package or prescription label or ask your doctor or pharmacist for more information.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.