Drug & supplement interaction

Evening Primrose + Effient

Effient brand name: Prasugrel.

Moderate Interaction
The bottom line Moderate

Effient falls into 2 drug categories that Evening Primrose can interact with; the most serious is rated moderate. Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Evening Primrose and Effient

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

Why Are There 2 Interactions?

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Effient

Effient falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Evening Primrose interacts with.

Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Evening primrose oil contains gamma linolenic acid (GLA). There is preliminary clinical evidence that GLA can reduce platelet aggregation and prolong bleeding time.
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 deal with pairing evening primrose oil and Effient (prasugrel). Effient already does one big job very well: it keeps your platelets from sticking together so they can't form dangerous clots. That's exactly why your doctor prescribed it after your heart procedure. Evening primrose oil contains GLA, and there's some early lab-type evidence that GLA may also make platelets a little less sticky and slightly lengthen bleeding time.

So the concern is additive. Two things gently nudging in the same anti-clotting direction could, in theory, raise your bleeding risk. That might show up as easier bruising, nosebleeds, bleeding gums, or cuts that take longer to stop. To be fair, this is theoretical and based on weak evidence, not strong human studies. Still, since Effient is potent and you're also likely on aspirin, please check with your pharmacist or doctor before adding it.

References
  1. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

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

Theoretically, evening primrose may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.
Severity Minor 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 honest picture with Effient (prasugrel) and evening primrose oil. The concern on file is that a fatty acid in the oil might mildly slow a liver enzyme called CYP2C9. But this is purely theoretical, coming from lab dish (in vitro) studies, not from people. On top of that, Effient mainly relies on other enzymes for its activation, so CYP2C9 isn't its main pathway.

Even if there were a tiny effect, Effient is already a strong blood thinner used with aspirin, so anything that nudges its activity could in theory add to bruising or bleeding risk. In practice, this combo is considered minor. Still, since you're on a serious heart medication, it's worth a quick word with your pharmacist or doctor before adding the supplement.

References
  1. Zou L, Harkey MR, and Henderson GL. Effects of herbal components on cDNA-expressed cytochrome P450 enzyme catalytic activity. Life Sci 8-16-2002;71(13):1579-1589. 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

Evening Primrose Also Interacts With Other Medications

Evening Primrose has 147 moderate, 85 minor known drug interactions in our database — the Effient 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 Evening Primrose

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

From our Q&A

Questions About Evening Primrose or Effient

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Evening Primrose or Effient, 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 Effient

This page covers Evening Primrose only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Effient page lists 295 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 · 248 moderate · 42 minor.

From our pharmacist’s overview on the Effient page

“Effient (prasugrel) keeps platelets from forming clots, usually after a stent or a heart attack, and I would not pair supplements with it casually. Roughly 200 ingredients on this list can thin the blood further and raise bleeding risk, including two of the five rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Effient interaction page

One more smart check

Taking Evening Primrose as Part of a Dietary Supplement Product? Check It for Interactions

We hold 98 real supplement products containing Evening Primrose, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Evening Primrose. Your product may carry other ingredients that interact with Effient too, on top of Evening Primrose — 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 Evening Primrose and Effient 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 Evening Primrose
Top half

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

29 days ago today
Medication Effient
Top 25%

#543 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 Evening Primrose

What is Evening Primrose?

Evening Primrose
  • Eczema and skin health
  • PMS symptoms
  • Breast pain (mastalgia)
  • Menopause symptoms
  • Inflammation
  • Diabetic nerve pain

Evening primrose oil is a seed oil rich in gamma-linolenic acid (GLA), an omega-6 fatty acid, that is popularly used for skin conditions, PMS, and breast pain. The evidence behind most of these uses is mixed or weak, and it is not proven to be a reliable treatment for any condition. It is generally well tolerated for short-term use, but talk to your pharmacist or doctor before starting it, especially if you are pregnant or have a bleeding disorder.

Read the full Evening Primrose monograph & all interactions
Medication

About Prasugrel

What Is Prasugrel Used For?

Brand name: Prasugrel

Prasugrel is used to reduce blood clot–related heart events, including clots forming in a stent (stent thrombosis). It is for people with acute coronary syndrome who are going to be treated with percutaneous coronary intervention (PCI, a procedure to open blocked heart arteries).

This includes people with unstable angina or a non-ST-elevation heart attack (NSTEMI), and people with an ST-elevation heart attack (STEMI) treated with primary or delayed PCI. Both Effient and generic Prasugrel tablets carry this use.

See full Prasugrel drug information
Keep checking

Other Drugs & Evening Primrose

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

0Major
147Moderate
85Minor
2,597No known interaction
Moderate

147 interactions

Showing 60 of 147 moderate interactions — see all 147 on the Evening Primrose page.

Minor

85 interactions

Showing 60 of 85 minor interactions — see all 85 on the Evening Primrose page.

No interaction 2,597 drugs checked — show the list

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

Showing the 60 most looked-up of 2,597 medications checked with no known interaction — see the full Evening Primrose 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 Evening Primrose and Effient Together: Common Questions

Can you take Evening Primrose with Effient?
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 2 interactions listed for Evening Primrose and Effient?
Effient belongs to more than one drug category, and Evening Primrose 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 Evening Primrose and Effient 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 Effient and Evening Primrose?

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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.