Drug & supplement interaction

Dong Quai + Warfarin

Warfarin brand name: Warfarin.

Major Interaction
The bottom line Major

Warfarin falls into 2 drug categories that Dong Quai can interact with; the most serious is rated major. Dong quai may increase the risk of bleeding when used with warfarin.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Dong Quai and Warfarin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Dong Quai interacts with whole categories of medication. Warfarin falls into 2 of those categories, so it can interact with Dong Quai in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

WARFARIN (Coumadin)

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Dong quai may increase the risk of bleeding when used with warfarin.
Case reports suggest that concomitant use of dong quai with warfarin can increase the anticoagulant effects of warfarin and increase the risk of bleeding. In one case, after 4 weeks of taking dong quai 565 mg once or twice daily, the international normalized ratio (INR) increased to 4.9. The INR normalized 4 weeks after discontinuation of dong quai.
Severity Major Likelihood Probable Evidence D

Interaction 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..

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

Here's the practical picture with warfarin. Warfarin is a finely tuned blood thinner, and your dose is set so your INR (a blood test that measures how thin your blood is) stays in a safe window. Adding Dong Quai can push that effect too far. In one reported case, someone taking Dong Quai for about a month saw their INR climb to 4.9, which is well above the usual target, and it settled back down only after they stopped the herb.

When warfarin gets too strong, the real risk is bleeding: easy bruising, nosebleeds, bleeding gums, blood in the urine or stool, or bleeding that won't stop. The evidence here is mostly case reports, not big studies, but because warfarin leaves so little room for error, I'd treat this seriously. Please don't start or stop anything on your own. Talk with your pharmacist or doctor first.

References
  1. Page RL II, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy 1999;19:870-6. PubMed
  2. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
  3. Ellis GR, Stephens MR. Untitled (photograph and a brief case report). BMJ 1999;319:650.
  4. Scott, G. N. and Elmer, G. W. Update on natural product--drug interactions. Am J Health Syst.Pharm 2-15-2002;59(4):339-347. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

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Why this applies to Warfarin

Warfarin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Dong Quai interacts with.

Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Animal studies suggest that dong quai has antithrombin activity and inhibits platelet aggregation due to its coumarin components. Additionally, some case reports in humans suggest that dong quai can increase the anticoagulant effects of warfarin. However, clinical research in healthy adults shows that taking 1 gram of dong quai root daily for 3 weeks does not significantly inhibit platelet aggregation or cause bleeding. Until more is known, use dong quai with caution in patients taking antiplatelet/anticoagulant drugs.
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 thing to keep an eye on with Dong Quai and warfarin. Dong Quai naturally contains coumarin-like compounds, and animal studies plus a few human case reports suggest it may add to warfarin's blood-thinning effect. If that happens, your blood could become too thin, which raises the risk of easy bruising, nosebleeds, bleeding gums, or more serious bleeding.

Now, the honest part: this is mostly theoretical, and the evidence is mixed. One study in healthy people taking 1 gram daily for three weeks didn't show a real change. But warfarin is a narrow-margin drug where small shifts in your INR matter a lot. So please don't start or stop anything on your own. Check with your pharmacist or doctor first, and they may simply watch your INR a bit more closely.

References
  1. Page RL II, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy 1999;19:870-6. PubMed
  2. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
  3. Hoult JR, Paya M. Pharmacological and biochemical actions of simple coumarins: natural products with therapeutic potential. Gen Pharmacol 1996;27:713-22.. PubMed
  4. Ellis GR, Stephens MR. Untitled (photograph and a brief case report). BMJ 1999;319:650.
  5. Scott, G. N. and Elmer, G. W. Update on natural product--drug interactions. Am J Health Syst.Pharm 2-15-2002;59(4):339-347. PubMed
  6. Fung FY, Wong WH, Ang SK, et al. A randomized, double-blind, placebo- controlled study on the anti-haemostatic effects of Curcuma longa, Angelica sinensis and Panax ginseng. Phytomedicine. 2017;32:88-96. 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

Dong Quai Also Interacts With Other Medications

Dong Quai has 1 major, 161 moderate 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.

Taking anything else?

Check Another of Your Medications Against Dong Quai

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

From our Q&A

Questions About Dong Quai 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 Dong Quai 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 Dong Quai 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 Dong Quai as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,989 real supplement products containing Dong Quai, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Dong Quai. Your product may carry other ingredients that interact with Warfarin too, on top of Dong Quai — 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 Dong Quai 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 Dong Quai
Top 10%

#127 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 Dong Quai

What is Dong Quai?

Dong Quai
  • Menopause symptoms
  • Menstrual cramps and irregular periods
  • Premenstrual syndrome (PMS)
  • Blood circulation support
  • General women's health tonic

Dong Quai is a traditional Chinese herb often called "female ginseng" and is mostly used for menstrual and menopausal complaints. High-quality scientific evidence that it works for these uses is limited, and it can affect bleeding, so talk with your pharmacist or doctor before trying it.

Read the full Dong Quai 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 & Dong Quai

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

1Major
161Moderate
0Minor
2,667No known interaction
Major

1 interaction

Moderate

161 interactions

Showing 60 of 161 moderate interactions — see all 161 on the Dong Quai page.

No interaction 2,667 drugs checked — show the 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 Dong Quai and Warfarin Together: Common Questions

Can you take Dong Quai with Warfarin?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Dong Quai and Warfarin?
Warfarin belongs to more than one drug category, and Dong Quai 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 Dong Quai and Warfarin interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Warfarin and Dong Quai?

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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.