Drug & supplement interaction

Borage + Inotersen

Inotersen brand name: Tegsedi.

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

Borage has a moderate interaction with Inotersen. Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Borage and Inotersen

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Inotersen

Inotersen falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Borage interacts with.

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In healthy individuals, borage seed oil supplementation does not seem to affect platelet aggregation. However, gamma-linolenic acid, a constituent of borage seed oil, seems to decrease platelet aggregation by 45% and increase the risk of bleeding by 40% in animal and clinical research.
Severity Moderate Likelihood Possible Evidence B

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

Here's the thing about Inotersen (Tegsedi): it's a medication used for a rare nerve condition called hereditary ATTR amyloidosis, and one of its known side effects is that it can lower your platelet count, sometimes quite a bit. That's why people on it get regular blood tests. So even though Inotersen isn't a classic blood thinner, it can already make bleeding more likely.

Borage seed oil contains GLA, which in some research nudged platelets to clump less and bumped up bleeding risk. Stacking that on top of Inotersen's platelet effect could add up. This is a theoretical, modest concern, but with this drug I'd play it safe. Please check with your doctor or pharmacist before adding borage, and watch for easy bruising, nosebleeds, or unusual bleeding.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
  2. Bard, J. M., Luc, G., Jude, B., Bordet, J. C., Lacroix, B., Bonte, J. P., Parra, H. J., and Duriez, P. A therapeutic dosage (3 g/day) of borage oil supplementation has no effect on platelet aggregation in healthy volunteers. Fundam.Clin.Pharmacol. 1997;1

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

Borage Also Interacts With Other Medications

Borage has 225 moderate known drug interactions in our database — the Inotersen one above is one of them. If you take anything else, check it against the full list below.

Moderate 225 No known interaction 2,605 (incl. Inotersen)
Taking anything else?

Check Another of Your Medications Against Borage

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

Everything else you take

See Every Supplement That Interacts With Inotersen

This page covers Borage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Inotersen page lists 208 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Danshen (major), Piracetam (major), Siberian Cocklebur (major) and Aconite (moderate).

By severity: 4 major · 186 moderate · 18 minor.

From our pharmacist’s overview on the Inotersen page

“Danshen is the entry I would flag first for anyone taking inotersen (Tegsedi). Inotersen can drive platelet counts dangerously low, and 202 of the 208 supplements on this page add some blood-thinning or antiplatelet effect on top of that.”

Reviewed by 2 · Jul 18, 2026

Open the Inotersen interaction page

One more smart check

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

We hold 122 real supplement products containing Borage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Borage. Your product may carry other ingredients that interact with Inotersen too, on top of Borage — 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 Borage and Inotersen 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 Borage
Top 25%

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

29 days ago today
Medication Inotersen
Steady interest

#2,457 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 Borage

What is Borage?

Borage
  • Eczema and dry skin
  • Rheumatoid arthritis
  • Inflammation
  • Respiratory complaints
  • Mood and stress

Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arthritis with mixed results. The plant's leaves and flowers can contain liver-toxic pyrrolizidine alkaloids, so only use products clearly labeled 'PA-free' and talk to your pharmacist or doctor before taking it.

Read the full Borage monograph & all interactions
Keep checking

Other Drugs & Borage

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

0Major
225Moderate
0Minor
2,604No known interaction
225 Moderate 2,604 No interaction
Moderate

225 interactions

Showing 60 of 225 moderate interactions — see all 225 on the Borage page.

No interaction 2,604 drugs checked — show the list

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

Showing the 60 most looked-up of 2,604 medications checked with no known interaction — see the full Borage list.

See the full Borage interactions page
See every supplement checked against Inotersen, 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
Borage monograph › Uses, safety, and every drug interaction in one place Inotersen supplement interactions › Every supplement checked against Inotersen, 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 Borage and Inotersen Together: Common Questions

Can you take Borage with Inotersen?
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 Borage and Inotersen 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 Inotersen and Borage?

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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.