Drug & supplement interaction

Blue-green Algae + Lepirudin

Lepirudin brand name: Refludan.

Moderate Interaction
The bottom line Moderate

Blue-green Algae has a moderate interaction with Lepirudin. Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Blue-green Algae and Lepirudin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Lepirudin

Lepirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Blue-green Algae interacts with.

Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs. However, this is unlikely.
Spirulina blue-green algae have shown antiplatelet and anticoagulant effects in vitro. However, one preliminary study in 24 patients receiving spirulina blue-green algae 2.3 grams daily for 2 weeks showed no effect on platelet activation or measures of clotting time.
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Lepirudin (Refludan) is a powerful injectable blood thinner. It works by directly blocking thrombin, a key player in forming clots, so it's typically used in a hospital setting where your clotting is watched closely. The concern here is purely additive: blue-green algae like spirulina have shown mild blood-thinning and antiplatelet activity in lab dishes, so stacking it on top of an anticoagulant could, in theory, nudge your bleeding risk higher.

Honestly, this is very theoretical. A small human study using spirulina daily for two weeks showed no real change in clotting. Still, since lepirudin is strong medicine, I'd mention any supplement to your hospital team and watch for easy bruising, unusual bleeding, or pink urine. Don't change anything on your own.

References
  1. Chiu HF, Yang SP, Kuo YL, et al. Mechanisms involved in the antiplatelet effect of C-phycocyanin. Br J Nutr 2006;95:435-40. PubMed
  2. Hsiao G, Chou PH, Shen MY, et al. C-phycocyanin, a very potent and novel platelet aggregation inhibitor from Spirulina platensis. J Agric Food Chem 2005;53:7734-40.
  3. Madhyastha, H. K., Radha, K. S., Sugiki, M., Omura, S., and Maruyama, M. Purification of c-phycocyanin from Spirulina fusiformis and its effect on the induction of urokinase-type plasminogen activator from calf pulmonary endothelial cells. Phytomedicine PubMed
  4. Majdoub H, Ben Mansour M, Chaubet F, et al. Anticoagulant activity of a sulfated polysaccharide from the green alga Arthrospira platensis. Biochim Biophys Acta 2009;1790(10):1377-81. PubMed
  5. Cha BG, Kwak HW, Park AR, et al. Structural characteristics and biological performance of silk fibroin nanofiber containing microalgae spirulina extract. Biopolymers 2014;101(4):307-18. PubMed
  6. Jensen GS, Drapeau C, Lenninger M, Benson KF. Clinical safety of a high dose of phycocyanin-enriched aqueous extract from Arthrospira (Spirulina) platensis: results from a randomized, double-Blind, placebo-controlled study with a focus on anticoagulant ac

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Blue-green Algae Also Interacts With Other Medications

Blue-green Algae has 326 moderate known drug interactions in our database — the Lepirudin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Blue-green Algae

Covers the 2,830 medications we’ve checked against Blue-green Algae. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Lepirudin

This page covers Blue-green Algae only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lepirudin page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Lepirudin page

“Lepirudin (Refludan) is a potent injectable blood thinner, typically given when heparin has caused a dangerous platelet reaction, and that makes this a list to read with real care. Of the 218 supplements and herbs with interactions on file, 202 can slow clotting on their own, piling extra bleeding risk onto a drug whose chief hazard is…”

Reviewed by 2 · Jul 18, 2026

Open the Lepirudin interaction page

One more smart check

Taking Blue-green Algae as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3,180 real supplement products containing Blue-green Algae, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Blue-green Algae. Your product may carry other ingredients that interact with Lepirudin too, on top of Blue-green Algae — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Blue-green Algae and Lepirudin 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.

Supplement Blue-green Algae
Top 10%

#84 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Lepirudin
Steady interest

#2,224 of 2,830 medications looked up here in the last 7 days

29 days ago today

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.

Supplement

About Blue-green Algae

What is Blue-green Algae?

Blue-green Algae
  • General nutrition and energy
  • Antioxidant support
  • Cholesterol and metabolic health
  • Immune support
  • Weight management

Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and general wellness. Evidence for most health claims is limited, and some products can be contaminated with toxins or heavy metals, so quality testing matters. Talk to your pharmacist or doctor before using, especially during pregnancy or breastfeeding.

Read the full Blue-green Algae monograph & all interactions
Keep checking

Other Drugs & Blue-green Algae

Browse every other medication we’ve checked against Blue-green Algae — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
326Moderate
0Minor
2,503No known interaction
Moderate

326 interactions

Showing 60 of 326 moderate interactions — see all 326 on the Blue-green Algae page.

No interaction 2,503 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

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Pharmacist Counseling Corner

Taking Blue-green Algae and Lepirudin Together: Common Questions

Can you take Blue-green Algae with Lepirudin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Blue-green Algae and Lepirudin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.