Drug & supplement interaction

Boldo + Bivalirudin

Bivalirudin brand names: Angiomax, Angiox, Angiomax Rtu.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Boldo has a moderate interaction with Bivalirudin. Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Boldo and Bivalirudin

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Bivalirudin

Bivalirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Boldo interacts with.

Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Animal and in vitro research shows that boldine, a constituent of boldo, has antiplatelet activity. In one case report, an adult taking a combination of boldo and fenugreek with warfarin experienced an increase in international normalized ratio (INR); however, it is unclear if this effect was due to boldo, fenugreek, the combination, or another factor.
Severity Moderate Likelihood Possible Evidence D

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.

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

Bivalirudin is a strong blood thinner given by IV, usually during heart procedures like angioplasty or stenting. It works by directly blocking thrombin, a key clotting protein, so your blood doesn't clot as easily. Boldo isn't broken down the same way, but the concern here is that boldine (a compound in boldo) may have its own mild antiplatelet, blood-thinning activity. Stacked on top of bivalirudin, that could in theory nudge your bleeding risk higher (think easier bruising, oozing at IV or catheter sites, or harder-to-stop bleeding).

Honestly, this is a theoretical worry based mostly on lab and animal studies, not solid human data. Since bivalirudin is given in a closely monitored hospital setting, let your care team know about any boldo use, and never start or stop either one on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. PubMed
  2. Teng, C. M., Hsueh, C. M., Chang, Y. L., Ko, F. N., Lee, S. S., and Liu, K. C. Antiplatelet effects of some aporphine and phenanthrene alkaloids in rabbits and man. J Pharm Pharmacol 1997;49(7):706-711. PubMed

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

Boldo Also Interacts With Other Medications

Boldo has 481 moderate known drug interactions in our database — the Bivalirudin one above is one of them. If you take anything else, check it against the full list below.

Moderate 481 No known interaction 2,349 (incl. Bivalirudin)
Taking anything else?

Check Another of Your Medications Against Boldo

Covers the 2,830 medications we’ve checked against Boldo. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Bivalirudin

This page covers Boldo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bivalirudin page lists 202 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 2 major · 183 moderate · 17 minor.

From our pharmacist’s overview on the Bivalirudin page

“Bivalirudin (Angiomax) is a strong intravenous blood thinner used during heart procedures like angioplasty, and because bleeding is already its main built-in danger, this list deserves genuine care. All 202 supplements on it interact the same basic way: they thin the blood or blunt platelets themselves, stacking bleeding risk on top of…”

Reviewed by 2 · Jul 18, 2026

Open the Bivalirudin interaction page

One more smart check

Taking Boldo as Part of a Dietary Supplement Product? Check It for Interactions

We hold 173 real supplement products containing Boldo, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Boldo. Your product may carry other ingredients that interact with Bivalirudin too, on top of Boldo — 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 Boldo and Bivalirudin 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 Boldo
Top half

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

29 days ago today
Medication Bivalirudin
Top half

#1,058 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 Boldo

What is Boldo?

Boldo
  • Indigestion and bloating
  • Mild constipation
  • Liver and gallbladder support
  • Appetite stimulation
  • Urinary complaints

Boldo is a South American shrub whose leaves are traditionally used for digestive and gallbladder complaints, but good human evidence is very limited. The leaves and oil contain ascaridole, which can be toxic to the liver, so only ascaridole-free products should be used and only for short periods. Talk to your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Boldo monograph & all interactions
Keep checking

Other Drugs & Boldo

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

0Major
481Moderate
0Minor
2,348No known interaction
481 Moderate 2,348 No interaction
Moderate

481 interactions

Showing 60 of 481 moderate interactions — see all 481 on the Boldo page.

No interaction 2,348 drugs checked — show the list

We also checked Boldo against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,348 medications checked with no known interaction — see the full Boldo list.

See the full Boldo interactions page
See every supplement checked against Bivalirudin, ranked by severity
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

Keep exploring
Boldo monograph › Uses, safety, and every drug interaction in one place Bivalirudin supplement interactions › Every supplement checked against Bivalirudin, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Boldo and Bivalirudin Together: Common Questions

Can you take Boldo with Bivalirudin?
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 Boldo and Bivalirudin 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

Still Have a Question About Bivalirudin and Boldo?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.