Drug & supplement interaction

Docosahexaenoic Acid (dha) + Ibrutinib

Ibrutinib brand name: Imbruvica.

Moderate Interaction
The bottom line Moderate

Docosahexaenoic Acid (dha) has a moderate interaction with Ibrutinib. Theoretically, DHA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Docosahexaenoic Acid (dha) and Ibrutinib

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Ibrutinib

Ibrutinib falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Docosahexaenoic Acid (dha) interacts with.

Theoretically, DHA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Although some clinical evidence suggests that DHA might reduce collagen-stimulated platelet aggregation and thromboxane release, most clinical evidence suggests that DHA alone does not affect blood clotting. However, theoretically, when given in combination with EPA as fish oil, concomitant use with anticoagulant or antiplatelet drugs (including aspirin) might increase risk of bleeding.
Severity Moderate Likelihood Unlikely Evidence B

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

Here's the thing to know about pairing DHA with ibrutinib (Imbruvica): ibrutinib already raises your bleeding risk on its own. It blocks an enzyme called BTK, and one side effect of that is easier bruising and bleeding, like nosebleeds, bleeding gums, or blood in the urine or stool. DHA isn't a blood thinner in the classic sense, and most studies suggest DHA by itself doesn't change how your blood clots much. But it can have a mild effect on platelets, especially at higher supplement doses or as part of fish oil with EPA.

So the concern here is mostly additive bleeding, and it's considered unlikely and theoretical. Fish you eat at dinner won't be the issue. Before starting a concentrated DHA or fish oil supplement, just run it by your oncology team or pharmacist, since ibrutinib needs that extra caution.

References
  1. Leng GC, Smith FB, Fowkes FG, et al. Relationship between plasma essential fatty acids and smoking, serum lipids, blood pressure and haemostatic and rheological factors. Prostaglandins Leukot Essent Fatty Acids 1994;51:101-8. PubMed
  2. Nelson GJ, Schmidt PS, Bartolini GL, et al. The effect of dietary docosahexaenoic acid on platelet function, platelet fatty acid composition, and blood coagulation in humans. Lipids 1997;32:1129-36. PubMed
  3. Woodman, R. J., Mori, T. A., Burke, V., Puddey, I. B., Barden, A., Watts, G. F., and Beilin, L. J. Effects of purified eicosapentaenoic acid and docosahexaenoic acid on platelet, fibrinolytic and vascular function in hypertensive type 2 diabetic patients 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

Docosahexaenoic Acid (dha) Also Interacts With Other Medications

Docosahexaenoic Acid (dha) has 374 moderate known drug interactions in our database — the Ibrutinib 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 Docosahexaenoic Acid (dha)

Covers the 2,830 medications we’ve checked against Docosahexaenoic Acid (dha). Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Ibrutinib

This page covers Docosahexaenoic Acid (dha) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibrutinib page lists 282 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 236 moderate · 41 minor.

From our pharmacist’s overview on the Ibrutinib page

“Ibrutinib (Imbruvica) treats blood cancers such as chronic lymphocytic leukemia, and because the drug itself makes bruising and bleeding more likely, adding the wrong supplement here can carry real consequences. Most of the entries below have blood-thinning or antiplatelet activity that stacks on top of that built-in bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Ibrutinib interaction page

How much people look this up

Where Docosahexaenoic Acid (dha) and Ibrutinib 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 Docosahexaenoic Acid (dha)
Top half

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

29 days ago today
Medication Ibrutinib
Top 25%

#527 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 Docosahexaenoic Acid (dha)

What is Docosahexaenoic Acid (dha)?

Docosahexaenoic Acid (dha)
  • Brain and cognitive health
  • Eye and vision health
  • Fetal and infant development
  • Heart and triglyceride support
  • General omega-3 supplementation

DHA is an omega-3 fatty acid found in fatty fish and algae that is a building block for the brain, nervous system, and eyes. It is widely used and generally well tolerated, with the strongest support for fetal/infant development and lowering triglycerides; evidence for many other uses is mixed. Talk with your pharmacist or doctor before starting, especially if you are pregnant, have a bleeding risk, or take blood thinners.

Read the full Docosahexaenoic Acid (dha) monograph & all interactions
Medication

About Ibrutinib

What Is Ibrutinib Used For?

Brand name: Imbruvica

Imbruvica (ibrutinib) is used in adults to treat chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), including cases with a specific genetic change called 17p deletion. It is also used in adults to treat Waldenström's macroglobulinemia (WM), a rare type of slow-growing blood cancer.

Imbruvica is also approved for adults and children aged 1 year and older with chronic graft-versus-host disease (cGVHD) — a serious immune complication that can occur after a stem cell or bone marrow transplant — when at least one prior treatment has not worked.

See full Ibrutinib drug information
Keep checking

Other Drugs & Docosahexaenoic Acid (dha)

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

0Major
374Moderate
0Minor
2,455No known interaction
Moderate

374 interactions

Showing 60 of 374 moderate interactions — see all 374 on the Docosahexaenoic Acid (dha) page.

No interaction 2,455 drugs checked — show the list

We also checked Docosahexaenoic Acid (dha) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,455 medications checked with no known interaction — see the full Docosahexaenoic Acid (dha) 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 Docosahexaenoic Acid (dha) and Ibrutinib Together: Common Questions

Can you take Docosahexaenoic Acid (dha) with Ibrutinib?
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 Docosahexaenoic Acid (dha) and Ibrutinib 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.