Drug & supplement interaction

Eucalyptus + Warfarin Sodium

Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.

Moderate Interaction
The bottom line Moderate

Warfarin Sodium falls into 4 drug categories that Eucalyptus can interact with; the most serious is rated moderate. Theoretically, eucalyptus might increase the levels of CYP1A2 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Eucalyptus and Warfarin Sodium

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Eucalyptus interacts with whole categories of medication. Warfarin Sodium falls into 4 of those categories, so it can interact with Eucalyptus in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 4

Why this applies to Warfarin Sodium

Warfarin Sodium falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Eucalyptus interacts with.

Theoretically, eucalyptus might increase the levels of CYP1A2 substrates.
In vitro research suggests that eucalyptus oil might inhibit CYP1A2, although this 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 with eucalyptus and your warfarin. Lab studies hint that eucalyptus oil might slow down a liver enzyme called CYP1A2, which is one of the pathways your body uses to break warfarin down. If that pathway slows, warfarin could build up a little and thin your blood more than intended. With warfarin, even small shifts matter, because too much raises your risk of bruising, nosebleeds, blood in the urine or stool, or harder-to-stop bleeding.

I want to be honest, though: this is only seen in a test tube, not in real people, so it's theoretical and may not happen at all. Inhaling vapor rubs or lozenges is very different from swallowing the oil (which you should never do). Just give your pharmacist or doctor a heads-up before using eucalyptus, especially around INR check time.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

2 of 4

Warfarin Sodium also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.

Theoretically, eucalyptus might increase the levels of CYP2C19 substrates.
In vitro research suggests that eucalyptus oil might inhibit CYP2C19, although this 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 with warfarin and eucalyptus. Lab studies hint that eucalyptus oil may slow down a liver enzyme called CYP2C19, which is one of the pathways your body uses to clear warfarin. If that enzyme is blocked, warfarin could build up a bit, which in theory might make your blood too thin. With a drug like warfarin, even small shifts matter, because too much can mean easy bruising, nosebleeds, or more serious bleeding.

Now, the honest part: this is only seen in test-tube research, never confirmed in real people, so I wouldn't lose sleep over it. Occasional inhaling of a vapor rub or lozenge is very different from swallowing concentrated oil (which you should never do anyway). Just give your pharmacist or doctor a heads-up before using eucalyptus regularly, and keep up with your INR checks.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 4

Warfarin Sodium also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, eucalyptus might increase the levels of CYP2C9 substrates.
In vitro research suggests that eucalyptus oil might inhibit CYP2C9, although this 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. Your liver uses an enzyme called CYP2C9 to break warfarin down. In lab (test tube) studies, eucalyptus oil appeared to slow that enzyme. If that happened in a person, warfarin could clear a little more slowly and build up, which means a stronger blood-thinning effect. With warfarin, even small shifts matter because it has a narrow safety window, so that could show up as easier bruising, nosebleeds, bleeding gums, or a higher INR on your next blood test.

Now the reassuring part: this is theoretical and has only been seen in lab studies, never confirmed in real people. Breathing in a vapor rub is very different from swallowing concentrated oil. Still, before using eucalyptus supplements, please check with your pharmacist or doctor who follows your INR.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

4 of 4

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

Theoretically, eucalyptus might increase the levels of CYP3A4 substrates.
In vitro research suggests that eucalyptus oil might inhibit CYP3A4, although this 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 with warfarin and eucalyptus. Lab studies hint that eucalyptus oil might slow down an enzyme called CYP3A4, which is one of the pathways your body uses to clear warfarin. If that pathway slows, warfarin could in theory build up a little and thin your blood more than intended, raising the chance of bruising, nosebleeds, or other bleeding.

That said, this is only seen in test-tube research, not in real people, so I wouldn't lose sleep over it. The bigger point is that warfarin is a finicky drug where even small swings matter, and your INR is the number to watch. Smelling a vapor rub is unlikely to do much, but tell your pharmacist or doctor before taking any eucalyptus by mouth.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 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

Eucalyptus Also Interacts With Other Medications

Eucalyptus has 877 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.

Taking anything else?

Check Another of Your Medications Against Eucalyptus

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

From our Q&A

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

We hold 216 real supplement products containing Eucalyptus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eucalyptus. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Eucalyptus — 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 Eucalyptus 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 Eucalyptus
Top half

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

29 days ago today
Medication Warfarin Sodium
Top 1%

#20 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 Eucalyptus

What is Eucalyptus?

Eucalyptus
  • Cough and chest congestion
  • Colds and flu symptoms
  • Stuffy nose
  • Sore throat
  • Minor muscle and joint aches
  • Aromatherapy

Eucalyptus is best known for its strong-smelling oil used in vapor rubs, inhalants, and lozenges to ease coughs and congestion. It may provide mild, short-term relief of cold symptoms, but the oil is toxic if swallowed and must never be taken by mouth undiluted. Talk to a pharmacist or doctor before using it, especially in children, during pregnancy, or while breastfeeding.

Read the full Eucalyptus 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 & Eucalyptus

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

0Major
877Moderate
0Minor
1,952No known interaction
Moderate

877 interactions

Showing 60 of 877 moderate interactions — see all 877 on the Eucalyptus page.

No interaction 1,952 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 Eucalyptus and Warfarin Sodium Together: Common Questions

Can you take Eucalyptus with Warfarin Sodium?
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 4 interactions listed for Eucalyptus and Warfarin Sodium?
Warfarin Sodium belongs to more than one drug category, and Eucalyptus 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 Eucalyptus and Warfarin Sodium 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 Sodium and Eucalyptus?

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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.