Drug & supplement interaction

Evening Primrose + Nusinersen Sodium

Nusinersen Sodium brand name: Spinraza.

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

Evening Primrose has a moderate interaction with Nusinersen Sodium. Theoretically, evening primrose oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Evening Primrose and Nusinersen Sodium

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Nusinersen Sodium

Nusinersen Sodium 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 something worth knowing about pairing evening primrose oil with Spinraza (nusinersen). The concern on file is a possible bleeding interaction, since evening primrose contains GLA, which may make platelets a little less sticky and slightly prolong bleeding time. This is worth flagging because Spinraza is given by a spinal injection (a lumbar puncture into the fluid around your spine), and anything that nudges bleeding risk upward could matter around that procedure.

That said, this is a theoretical concern based mostly on how GLA behaves, not strong proof of real-world harm. Spinraza itself isn't broken down by enzymes the way pills are, so it's really the bleeding angle to watch. Please tell your care team you take evening primrose, especially before each injection, and don't stop anything on your own.

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

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 Nusinersen Sodium one above is one of them. If you take anything else, check it against the full list below.

Moderate 147 Minor 85 No known interaction 2,598 (incl. Nusinersen Sodium)
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.

Everything else you take

See Every Supplement That Interacts With Nusinersen Sodium

This page covers Evening Primrose only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nusinersen Sodium page lists 208 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Danshen (major), Piracetam (major), Siberian Cocklebur (major) and Aconite (moderate).

By severity: 4 major · 186 moderate · 18 minor.

From our pharmacist’s overview on the Nusinersen Sodium page

“Spinraza (nusinersen) is given by spinal injection to treat spinal muscular atrophy, and it carries its own warnings for low platelets and kidney stress, which makes the 208 supplements on this page worth real vigilance rather than a shrug. All but six of them, 202 ingredients, could raise bleeding risk by thinning the blood or dulling…”

Reviewed by 2 · Jul 18, 2026

Open the Nusinersen Sodium 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 Nusinersen Sodium 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 Nusinersen 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 Evening Primrose
Top half

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

29 days ago today
Medication Nusinersen Sodium
Top half

#1,220 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 Nusinersen Injection

What Is Nusinersen Injection Used For?

Brand name: Spinraza

Spinraza (nusinersen) is used to treat spinal muscular atrophy (SMA) — a genetic disease that causes progressive muscle weakness by reducing the body's ability to make a protein called SMN (survival motor neuron). Spinraza is approved for pediatric and adult patients with SMA.

Spinraza is given by intrathecal injection — directly into the fluid surrounding the spinal cord — so the medicine can reach the central nervous system where it's needed most.

See full Nusinersen Injection 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
147 Moderate 85 Minor 2,597 No 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.

See the full Evening Primrose interactions page
See every supplement checked against Nusinersen 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
Evening Primrose monograph › Uses, safety, and every drug interaction in one place Nusinersen Sodium supplement interactions › Every supplement checked against Nusinersen Sodium, ranked by severity Nusinersen Injection 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 Evening Primrose and Nusinersen Sodium Together: Common Questions

Can you take Evening Primrose with Nusinersen 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.
How serious is the Evening Primrose and Nusinersen 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 Nusinersen Sodium 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.