Drug & supplement interaction

Dong Quai + Warfarin Sodium

Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.

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

Warfarin Sodium 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 Sodium

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 Sodium 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)

1 of 2
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 deal with combining Dong Quai and warfarin. Warfarin is a very precise medication, what we call a narrow therapeutic index drug, so even small shifts in how thin your blood gets can matter a lot. Dong Quai may add to warfarin's blood-thinning effect, which can push your INR higher than your target range. In one reported case, someone's INR climbed to 4.9 after about four weeks on Dong Quai, then settled back down once they stopped it.

A higher INR means a bigger bleeding risk, think easy bruising, nosebleeds, bleeding gums, or more serious internal bleeding. The evidence here is mostly from case reports, so it's not ironclad, but with warfarin I'd treat it seriously. Please don't start or stop anything on your own. Talk with your pharmacist or doctor first so they can watch your INR closely.

Contact Dr. Brian directly if you have additional questions on this interaction
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

2 of 2

Why this applies to Warfarin Sodium

Warfarin Sodium 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 about pairing Dong Quai with warfarin: this herb contains natural coumarin compounds, which are chemical cousins of warfarin itself. On top of that, lab and animal work suggests it may slow blood clotting a bit. So the worry is that adding it could nudge your blood toward thinning too much, which can show up as easy bruising, nosebleeds, bleeding gums, or in serious cases bleeding that's harder to stop.

I want to be honest about the evidence though. This is mostly theoretical, with a few human case reports but also a study where 1 gram daily caused no real change. Still, warfarin is a finicky drug where small shifts matter, so I wouldn't add Dong Quai on your own. Please check with your pharmacist or doctor first, and if you ever do combine them, your INR should be watched closely.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Sodium one above is among them. If you take anything else, check it against the full list below.

Major 1 Moderate 161 No known interaction 2,668 (incl. Warfarin Sodium)
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 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 Dong Quai 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:

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 Sodium

This page covers Dong Quai 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).

Open the Warfarin Sodium 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 Sodium 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 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.

Supplement Dong Quai
Top 10%

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

29 days ago today
Medication Warfarin Sodium
Top 1%

#18 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 names: Coumadin, Panwarfin, Sofarin

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
1 Major 161 Moderate 2,667 No 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

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

Showing the 60 most looked-up of 2,667 medications checked with no known interaction — see the full Dong Quai list.

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

Can you take Dong Quai with Warfarin Sodium?
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 Sodium?
Warfarin Sodium 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 Sodium 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 Sodium 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.