Chiropractic + Warfarin Sodium
Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.
Chiropractic has a moderate interaction with Warfarin Sodium. Chiropractic cervical spine manipulation can increase the risk of spinal epidural hematoma in patients taking warfarin.
Read the full interaction reportChiropractic and Warfarin Sodium
Here is the interaction we found between these two, with the evidence behind it.
WARFARIN (Coumadin)
There are at least two reports of spinal epidural hematoma in patients taking warfarin who have received chiropractic cervical spine manipulation. Advise patients taking warfarin not to receive cervical manipulation treatment.
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 thing to know if you take warfarin (Coumadin) and are thinking about chiropractic care, especially neck adjustments. Warfarin keeps your blood from clotting normally, which is exactly what it's supposed to do. But that also means if any small blood vessel gets nicked or torn, it can bleed more than it would in someone not on a blood thinner.
The specific worry here is cervical (neck) spine manipulation. There have been a couple of rare reports of bleeding around the spinal cord (a spinal epidural hematoma) in people on warfarin who had their neck adjusted. This is anecdotal, so it's uncommon, but it can be serious. I wouldn't avoid chiropractic care for your back over this, but I'd talk with your doctor and chiropractor first and be cautious about forceful neck adjustments.
- Whedon JM, Quebada PB, Roberts DW, Radwan TA. Spinal epidural hematoma after spinal manipulative therapy in a patient undergoing anticoagulant therapy: a case report. J Manipulative Physiol Ther 2006;29:582-5. 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.
Chiropractic Also Interacts With Other Medications
Chiropractic has 1 moderate known drug interaction in our database — the Warfarin Sodium one above is one of them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Chiropractic
We haven’t checked that one against Chiropractic yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Chiropractic. Pick one to open its full report.
Questions About Chiropractic 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 Chiropractic 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:
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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 Chiropractic 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).
Where Chiropractic 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.
#819 of 1,452 supplements looked up here in the last 7 days
#25 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 Chiropractic
What is Chiropractic?
- Low back pain
- Neck pain
- Tension and certain headaches
- Joint and muscle pain
- Posture and mobility concerns
Chiropractic is a licensed health profession that treats muscle and joint problems mostly through hands-on spinal manipulation, not a dietary supplement or herb. There is reasonable evidence it can help short-term low back pain and neck pain in many people, but it is not a cure-all, and you should see a qualified provider and rule out serious causes of pain first.
About Warfarin
What Is Warfarin Used For?
Brand names: Coumadin, Panwarfin, Sofarin
Warfarin helps prevent and treat harmful blood clots. The label lists these uses for both Warfarin Sodium tablets and Jantoven tablets:
- Preventing and treating venous thrombosis (clots in the veins) and pulmonary embolism (clots in the lungs).
- Preventing and treating clot-related complications of atrial fibrillation and/or heart valve replacement.
- Lowering the risk of death, another heart attack, and clot-related events such as stroke after a heart attack.
Warfarin does not dissolve a clot that has already formed. It helps stop the clot from growing and prevents further clot-related complications.
Other Drugs & Chiropractic
Browse every other medication we’ve checked against Chiropractic — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1 interaction
No interaction 2,828 drugs checked — show the list
We also checked Chiropractic against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Ivermectin ›
- Abemaciclib ›
- Testosterone ›
- Sertraline ›
- Losartan Potassium ›
- Rosuvastatin ›
- Acetaminophen ›
- Aspirin ›
- Metoprolol ›
- Clopidogrel ›
- Escitalopram ›
- Atorvastatin ›
- Rivaroxaban ›
- Isotretinoin ›
- Tirzepatide ›
- Ibuprofen ›
- Levothyroxine, Liothyronine ›
- Docusate ›
- Metformin ›
- Amlodipine Besylate ›
- Amitriptyline ›
- Prednisone ›
- Methamphetamine ›
- Tadalafil ›
- Semaglutide ›
- Amphetamine ›
- Lisdexamfetamine ›
- Propranolol ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Amoxicillin ›
- Lisinopril ›
- Methotrexate ›
- Bupropion ›
- Azithromycin ›
- Fluoxetine ›
- Doxycycline ›
- Pregabalin ›
- Gabapentin ›
- Acetaminophen, Aspirin, Caffeine ›
- Dextroamphetamine ›
- Naproxen ›
- Lamotrigine ›
- Clonazepam ›
- Quetiapine ›
- Bendamustine ›
- Acyclovir ›
- Buspirone ›
- Duloxetine ›
- Omeprazole ›
- Letrozole ›
- Citalopram ›
- Methylene Blue ›
- Ciprofloxacin ›
- Acetaminophen, Codeine ›
Showing the 60 most looked-up of 2,828 medications checked with no known interaction — see the full Chiropractic 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
Having Chiropractic While Taking Warfarin Sodium: Common Questions
Can you have Chiropractic while taking Warfarin Sodium?
How serious is the Chiropractic and Warfarin Sodium interaction?
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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.