Drug & supplement interaction

Chanca Piedra + Warfarin

Warfarin brand name: Warfarin.

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

Warfarin falls into 3 drug categories that Chanca Piedra can interact with; the most serious is rated moderate. Theoretically, chanca piedra might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Chanca Piedra and Warfarin

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Chanca Piedra interacts with whole categories of medication. Warfarin falls into 3 of those categories, so it can interact with Chanca Piedra in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 3

Why this applies to Warfarin

Warfarin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Chanca Piedra interacts with.

Theoretically, chanca piedra might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
In vitro research suggests that methyl brevifolincarboxylate, a constituent isolated from chanca piedra, can inhibit platelet aggregation. This effect has not been reported in humans.
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

Here's the basic idea: warfarin already lowers your blood's ability to clot, and chanca piedra might nudge things a little further in that same direction. In a lab dish, one compound from this herb (methyl brevifolincarboxylate) slowed platelets from sticking together. Stack that on top of warfarin and, in theory, you could bleed a bit more easily.

I want to be straight with you though: this is a theoretical concern based on test-tube work, not something we've actually seen happen in people. Still, warfarin is a finicky drug where even small shifts matter, so I'd watch for things like easy bruising, nosebleeds, bleeding gums, or pink/dark urine. Please don't start chanca piedra without checking with your doctor or pharmacist first, since they may want to keep a closer eye on your INR.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Iizuka, T., Nagai, M., Taniguchi, A., Moriyama, H., and Hoshi, K. Inhibitory effects of methyl brevifolincarboxylate isolated from Phyllanthus niruri L. on platelet aggregation. Biol.Pharm.Bull. 2007;30(2):382-384. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

Warfarin also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, chanca piedra might reduce the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that chanca piedra extract increases CYP1A2 activity. Theoretically, chanca piedra might increase metabolism of CYP1A2 substrates and lower serum concentrations. This interaction has not been reported in humans.
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

Here's the short version: in lab studies, chanca piedra seems to speed up an enzyme (CYP1A2) that helps break down warfarin. If that happened in your body, your warfarin could be cleared a little faster, which in theory might make it less effective and raise the small risk of a clot forming. So the concern here is a weaker blood thinner, not extra bleeding.

I want to be honest with you, though: this is only a theoretical, test-tube finding and hasn't been seen in real people. Still, warfarin is a drug where even small shifts matter, and your dose is guided by your INR blood test. Please don't start or stop anything on your own. Just loop in your pharmacist or the clinic that manages your INR before adding chanca piedra.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Husain I, Abdulrahman B, Dale OR, et al. Interaction of Phyllanthus amarus extract and its lignans with human xenobiotic receptors, drug metabolizing enzymes and drug transporters. J Ethnopharmacol 2025;339:119142. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Warfarin also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, use of chanca piedra might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that chanca piedra extract inhibits CYP3A4. Theoretically, chanca piedra might increase the levels of CYP3A4 substrates. This interaction has not been reported in humans.
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

Here's the gist for warfarin. Lab studies suggest chanca piedra may slow down an enzyme called CYP3A4, which is one of the pathways your body uses to clear warfarin. If that enzyme gets blocked, warfarin could build up a bit and thin your blood more than intended. That matters because warfarin is a narrow-window drug, meaning even small shifts can tip you toward easy bruising, nosebleeds, or more serious bleeding.

The honest part: this is only a theoretical concern from test-tube research, not something reported in real patients, so I don't want to alarm you. Still, with warfarin I play it safe. Please loop in your pharmacist or doctor before combining them, and keep up with your regular INR checks.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Husain I, Abdulrahman B, Dale OR, et al. Interaction of Phyllanthus amarus extract and its lignans with human xenobiotic receptors, drug metabolizing enzymes and drug transporters. J Ethnopharmacol 2025;339:119142. 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

Chanca Piedra Also Interacts With Other Medications

Chanca Piedra has 870 moderate, 149 minor known drug interactions in our database — the Warfarin one above is among them. If you take anything else, check it against the full list below.

Moderate 870 Minor 149 No known interaction 1,811 (incl. Warfarin)
Taking anything else?

Check Another of Your Medications Against Chanca Piedra

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

From our Q&A

Questions About Chanca Piedra or Warfarin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Chanca Piedra or Warfarin, 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:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Warfarin

This page covers Chanca Piedra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Warfarin 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).

By severity: 16 major · 301 moderate · 44 minor.

From our pharmacist’s overview on the Warfarin page

“People take warfarin to prevent dangerous clots, and many are the same people reaching for glucosamine for sore joints or a multivitamin containing vitamin K, which makes this a list that deserves genuine respect. Of the 361 supplements on file for warfarin, 16 carry a major rating, and the danger runs in both directions: some add to w…”

Reviewed by 2 · Jul 18, 2026

Open the Warfarin interaction page

One more smart check

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

We hold 355 real supplement products containing Chanca Piedra, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chanca Piedra. Your product may carry other ingredients that interact with Warfarin too, on top of Chanca Piedra — 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 Chanca Piedra and Warfarin 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 Chanca Piedra
Top half

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

29 days ago today
Medication Warfarin
Top 10

#4 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 Chanca Piedra

What is Chanca Piedra?

Chanca Piedra
  • Kidney stones
  • Gallstones
  • Liver support
  • Urinary tract health
  • Digestive complaints

Chanca piedra is a tropical herb traditionally used as a 'stone breaker' for kidney and gallstones, and for liver and urinary health. Human evidence for these uses is limited and mostly small or preliminary, so it should not replace proven treatments. Talk with your pharmacist or doctor before using it, especially if you have a medical condition or take medications.

Read the full Chanca Piedra monograph & all interactions
Medication

About Warfarin

What Is Warfarin Used For?

Brand name: Warfarin

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.

See full Warfarin drug information
Keep checking

Other Drugs & Chanca Piedra

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

0Major
870Moderate
149Minor
1,810No known interaction
870 Moderate 149 Minor 1,810 No interaction
Moderate

870 interactions

Showing 60 of 870 moderate interactions — see all 870 on the Chanca Piedra page.

Minor

149 interactions

Showing 60 of 149 minor interactions — see all 149 on the Chanca Piedra page.

No interaction 1,810 drugs checked — show the list

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

Showing the 60 most looked-up of 1,810 medications checked with no known interaction — see the full Chanca Piedra list.

See the full Chanca Piedra interactions page
See every supplement checked against Warfarin, 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
Chanca Piedra monograph › Uses, safety, and every drug interaction in one place Warfarin supplement interactions › Every supplement checked against Warfarin, ranked by severity Warfarin drug information › The full plain-English guide to this medication 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 Chanca Piedra and Warfarin Together: Common Questions

Can you take Chanca Piedra with Warfarin?
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.
Why are there 3 interactions listed for Chanca Piedra and Warfarin?
Warfarin belongs to more than one drug category, and Chanca Piedra interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Chanca Piedra and Warfarin 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 Warfarin and Chanca Piedra?

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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.