Bacopa + Warfarin Sodium
Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.
Warfarin Sodium falls into 4 drug categories that Bacopa can interact with; the most serious is rated moderate. Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full interaction reportBacopa and Warfarin Sodium
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Bacopa interacts with whole categories of medication. Warfarin Sodium falls into 4 of those categories, so it can interact with Bacopa in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 4Why this applies to Warfarin Sodium
Warfarin Sodium falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Bacopa interacts with.
Research on the effects of bacopa extracts on CYP1A2 enzymes is conflicting. Some in vitro evidence shows that bacopa extract can moderately and non-competitively inhibit CYP1A2, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Interaction 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.
Here's the gist for warfarin: it's processed in part by a liver enzyme called CYP1A2, and lab studies hint that bacopa might slow that enzyme down a bit. If that happened in your body, your warfarin could clear more slowly and build up, which means a stronger blood-thinning effect. With warfarin, that can show up as easy bruising, nosebleeds, bleeding gums, or blood in your urine or stool.
That said, this is mostly theoretical and based only on test-tube research, and the findings actually conflict, so it may not matter much in real life. But warfarin is a finicky drug where small shifts count. If you're thinking about bacopa, please check with your pharmacist or doctor first so your INR can be watched.
- Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
2 of 4Warfarin Sodium also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.
In vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C19 enzymes. It is not known whether this is clinically significant.
Interaction 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.
Here's the gist for warfarin. Part of how your body clears warfarin runs through a liver enzyme called CYP2C19. In test-tube studies, bacopa appears to mildly slow that enzyme down. If that were to happen in real life, warfarin could hang around a bit longer and act a little stronger than expected, which for a blood thinner means a higher chance of bruising, nosebleeds, or other bleeding.
I want to be honest about the evidence though: this is only lab data, not proven in people, so we really don't know if it matters clinically. The catch is that warfarin is a finicky drug where even small shifts can move your INR. So please don't start or stop bacopa on your own. Check with your pharmacist or doctor first, and they may want to watch your INR a little more closely.
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
3 of 4Warfarin Sodium also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
Research on the effect of bacopa extracts on CYP2C9 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C9, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Interaction 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.
Here's the basic idea with these two. Your liver uses an enzyme called CYP2C9 to clear warfarin out of your system. In test-tube studies, bacopa might slow that enzyme down a bit. If it does, warfarin could hang around longer and your blood could end up thinner than intended, which raises the chance of bruising, nosebleeds, bleeding gums, or more serious bleeding.
I want to be honest about how shaky this evidence is. It comes only from lab studies, and even those disagree, so we don't know if it matters in real people. But warfarin is a narrow-margin drug where small shifts can change your INR. If you want to try bacopa, talk with your pharmacist or doctor first and keep up with your INR checks. Please don't start or stop anything on your own.
- Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
4 of 4Warfarin Sodium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Research on the effects of bacopa extracts on CYP3A4 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and competitively inhibit CYP3A4, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Interaction 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.
Here's the short version on combining bacopa with warfarin. The idea is that bacopa might slow down an enzyme in your liver called CYP3A4, which is one of the pathways your body uses to break warfarin down. If that pathway slows, a little more warfarin could hang around, which in theory could thin your blood more than intended. With a drug like warfarin, where the dose is fine-tuned and small shifts matter, that could mean easier bruising, nosebleeds, or bleeding that takes longer to stop.
That said, the evidence here is weak and mostly from lab dishes, and the studies even disagree with each other. Warfarin is not a prodrug, so it works directly. Still, I'd loop in your pharmacist or doctor before starting bacopa, and keep up with your regular INR checks.
- Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- 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.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Bacopa Also Interacts With Other Medications
Bacopa has 916 moderate, 13 minor known drug interactions in our database — the Warfarin Sodium one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Bacopa
We haven’t checked that one against Bacopa yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Bacopa. Pick one to open its full report.
Questions About Bacopa or Warfarin Sodium
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Bacopa or Warfarin Sodium, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
- Does Ginger Water Interfere With Amoxicillin-Clavulanate? ›
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Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Warfarin Sodium
This page covers Bacopa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Warfarin Sodium page lists 361 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Alfalfa (major), American Ginseng (major), Beer (major) and Cannabis (major).
Taking Bacopa as Part of a Dietary Supplement Product? Check It for Interactions
We hold 1,420 real supplement products containing Bacopa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bacopa. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Bacopa — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Bacopa and Warfarin Sodium Sit Against Everything Else
Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.
#140 of 1,452 supplements looked up here in the last 7 days
#18 of 2,830 medications looked up here in the last 7 days
Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.
About Bacopa
What is Bacopa?
- Memory and cognitive support
- Anxiety and stress
- ADHD symptoms
- Age-related memory decline
- General brain health
Bacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for several weeks, but the evidence is limited and quality varies. It is generally well tolerated but can cause stomach upset, and it should be avoided in pregnancy and breastfeeding due to a lack of safety data.
About Warfarin
What Is Warfarin Used For?
Brand names: Coumadin, Panwarfin, Sofarin
Warfarin sodium tablets and Jantoven tablets are both used to prevent and treat venous thrombosis (blood clots in the veins) and pulmonary embolism (a clot in the lungs). They are also used to prevent clot-related complications in people with atrial fibrillation (an irregular heart rhythm) or who have had a heart valve replaced.
In people who have had a heart attack, warfarin is used to reduce the risk of death, another heart attack, stroke, or other clotting events. It does not dissolve an existing clot, but it helps prevent the clot from growing and stops new dangerous clots from forming.
Other Drugs & Bacopa
Browse every other medication we’ve checked against Bacopa — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
916 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Glycopyrrolate ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Ipratropium ›
- Miconazole ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Dimenhydrinate ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Nortriptyline ›
- Pilocarpine ›
- Procyclidine ›
- Rifampin ›
Showing 60 of 916 moderate interactions — see all 916 on the Bacopa page.
13 interactions
No interaction 1,900 drugs checked — show the list
We also checked Bacopa against these medications and found no known interaction in our sources. Open any page to confirm.
- Methylphenidate ›
- Metoprolol ›
- Aspirin ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Valacyclovir ›
- Docusate ›
- Hydroxyurea ›
- Methamphetamine ›
- Semaglutide ›
- Sumatriptan ›
- Tirzepatide ›
- Lisdexamfetamine ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Acyclovir ›
- Lisinopril ›
- Doxycycline ›
- Lamotrigine ›
- Methotrexate ›
- Pregabalin ›
- Gabapentin ›
- Amphetamine ›
- Isotretinoin ›
- Azithromycin ›
- Dextroamphetamine ›
- Methylene Blue ›
- Duloxetine ›
- Ciprofloxacin ›
- Bisoprolol ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Daptomycin ›
- Hexobarbitone ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Mitomycin ›
- Minoxidil ›
- Factor 7a ›
- Cefaclor ›
- Carbidopa, Levodopa ›
- Ezetimibe ›
- Levodopa ›
- Vancomycin ›
- Phenylephrine ›
- Spironolactone ›
- Venlafaxine ›
- Dirithromycin ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Phentermine, Topiramate ›
- Bentoquatam ›
Showing the 60 most looked-up of 1,900 medications checked with no known interaction — see the full Bacopa list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
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
Taking Bacopa and Warfarin Sodium Together: Common Questions
Can you take Bacopa with Warfarin Sodium?
Why are there 4 interactions listed for Bacopa and Warfarin Sodium?
How serious is the Bacopa and Warfarin Sodium interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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