Evening Primrose + Warfarin Sodium
Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.
Warfarin Sodium 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 reportEvening Primrose and Warfarin Sodium
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. Warfarin Sodium 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).
ANTICOAGULANT/ANTIPLATELET DRUGS
1 of 2Why this applies to Warfarin Sodium
Warfarin Sodium falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Evening Primrose interacts with.
Evening primrose oil contains gamma linolenic acid (GLA). There is preliminary clinical evidence that GLA can reduce platelet aggregation and prolong bleeding time.
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.
Here's the gist: warfarin already lowers your blood's ability to clot, and evening primrose oil may, in theory, nudge things in the same direction. The GLA in primrose oil has shown some early signs of making platelets a little less sticky and lengthening bleeding time. Stack that on top of warfarin and you could, at least on paper, see more bruising, nosebleeds, bleeding gums, or blood that takes longer to stop.
I want to be honest about how solid this is though. This concern is based on how the two work, not on strong studies showing real harm. Still, warfarin is a drug where small shifts matter and your INR is watched closely, so I'd loop in your pharmacist or doctor before adding evening primrose rather than starting it on your own.
- 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
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
2 of 2Warfarin Sodium also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
In vitro research shows that linoleic acid, a constituent of evening primrose oil, inhibits CYP2C9.
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.
Here's the gist with warfarin and evening primrose oil. Warfarin is cleared by a liver enzyme called CYP2C9, and lab studies suggest a fatty acid in evening primrose (linoleic acid) might slow that enzyme down a little. If that happened in real life, warfarin could build up slightly and thin your blood a touch more than expected, raising the chance of bruising, nosebleeds, or bleeding that's harder to stop.
The good news: this is theoretical, based only on test-tube data, and rated minor. But warfarin is a finicky drug where small shifts can matter, so don't start evening primrose without telling whoever manages your INR. They may simply check your levels a bit sooner to be safe.
- 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.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Evening Primrose Also Interacts With Other Medications
Evening Primrose has 147 moderate, 85 minor 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.
Check Another of Your Medications Against Evening Primrose
We haven’t checked that one against Evening Primrose yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Evening Primrose. Pick one to open its full report.
Questions About Evening Primrose 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 Evening Primrose 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:
- Does Ginger Water Interfere With Amoxicillin-Clavulanate? ›
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Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Warfarin Sodium
This page covers Evening Primrose 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).
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 Warfarin 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:
Where Evening Primrose 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.
#550 of 1,452 supplements looked up here in the last 7 days
#26 of 2,830 medications looked up here in the last 7 days
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.
About Evening Primrose
What is 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.
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.
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.
No drugs match “”.
147 interactions
- Diclofenac Sodium ›
- Ibuprofen ›
- Aspirin ›
- Naproxen ›
- Minocycline ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Ketoprofen ›
- Bivalirudin ›
- Fluphenazine ›
- Bromfenac Sodium ›
- Chlorpromazine ›
- Dabigatran ›
- Diclofenac Epolamine ›
- Iloprost ›
- Lithium Carbonate (prescription Drug) ›
- Piroxicam ›
- Prochlorperazine ›
- Streptokinase ›
- Ticlopidine ›
- Treprostinil (oral) ›
- Abciximab ›
- Abrocitinib ›
- Acenocoumarol ›
- Acepromazine ›
- Acetylsalicylic Acid ›
- Anacaulase-bcdb ›
- Anagrelide ›
- Anisindione ›
- Antithrombin Iii ›
- Apixaban ›
- Argatroban ›
- Betrixaban ›
- Cablivi ›
- Cangrelor ›
- Carphenazine ›
- Cilostazol ›
- Clopidogrel ›
- Cyamemazine ›
- Dalteparin ›
- Danaparoid ›
- Defibrotide Sodium ›
- Diclofenac ›
- Dicumarol ›
- Edoxaban ›
- Effient ›
- Enoxaparin ›
- Eptifibatide ›
- Fish Oil Triglycerides ›
- Fondaparinux ›
- Heparin ›
- Ibrutinib ›
- Ibuprofen Lysine ›
- Icosapent Ethyl (prescription Drug) ›
- Inotersen ›
- Lepirudin ›
- Nadroparin ›
- Naproxen Sodium ›
- Nintedanib Esylate ›
- Nusinersen Sodium ›
Showing 60 of 147 moderate interactions — see all 147 on the Evening Primrose page.
85 interactions
- Glyburide ›
- Flurbiprofen ›
- Phenytoin ›
- Formoterol ›
- Indomethacin ›
- Trimipramine ›
- Diazepam ›
- Meloxicam ›
- Omeprazole ›
- Carvedilol ›
- Celecoxib ›
- Clomipramine ›
- Dronabinol ›
- Fluoxetine ›
- Fluvastatin ›
- Glipizide ›
- Imipramine ›
- Irbesartan ›
- Lacosamide ›
- Pitavastatin ›
- Tamoxifen Citrate ›
- Tapentadol ›
- Torsemide ›
- Valsartan ›
- Zileuton ›
- Agomelatine ›
- Amitriptyline ›
- Azilsartan ›
- Bosentan ›
- Enasidenib ›
- Erdafitinib ›
- Etrasimod ›
- Etravirine ›
- Fomoterol ›
- Fosphenytoin ›
- Fosphenytoin Sodium ›
- Gliclazide ›
- Glimepiride ›
- Lesinurad ›
- Lonafarnib ›
- Losartan Potassium ›
- Lumiracoxib ›
- Mefenamic Acid ›
- Mephenytoin ›
- Montelukast Sodium ›
- Nateglinide ›
- Perampanel ›
- Rabeprazole ›
- Ramelteon ›
- Rosiglitazone Maleate ›
- Sildenafil ›
- Sildenafil Citrate ›
- Siponimod ›
- Sulfamethoxazole ›
- Tipranavir ›
- Tolbutamide ›
- Valdecoxib ›
- Voriconazole ›
- Zafirlukast ›
- Sulfamethoxazole, Trimethoprim ›
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.
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Sertraline ›
- Abemaciclib ›
- Ivermectin ›
- Testosterone ›
- Acetaminophen ›
- Metoprolol ›
- Rosuvastatin ›
- Escitalopram ›
- Atorvastatin ›
- Docusate ›
- Tirzepatide ›
- Methamphetamine ›
- Tadalafil ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Prednisone ›
- Propranolol ›
- Lisdexamfetamine ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Isotretinoin ›
- Methotrexate ›
- Amlodipine Besylate ›
- Bendamustine ›
- Amphetamine ›
- Bupropion ›
- Doxycycline ›
- Azithromycin ›
- Acyclovir ›
- Pregabalin ›
- Lamotrigine ›
- Dextroamphetamine ›
- Gabapentin ›
- Levothyroxine, Liothyronine ›
- Acetaminophen, Codeine ›
- Clonazepam ›
- Quetiapine ›
- Duloxetine ›
- Letrozole ›
- Citalopram ›
- Methylene Blue ›
- Buspirone ›
- Ciprofloxacin ›
- Bisoprolol ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetaminophen, Oxycodone ›
- Acetaminophen, Caffeine, Codeine ›
- Dapsone ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Cephalexin ›
- Cyclopentolate ›
- Ezetimibe ›
- Atorvastatin Calcium ›
Showing the 60 most looked-up of 2,597 medications checked with no known interaction — see the full Evening Primrose list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Taking Evening Primrose and Warfarin Sodium Together: Common Questions
Can you take Evening Primrose with Warfarin Sodium?
Why are there 2 interactions listed for Evening Primrose and Warfarin Sodium?
How serious is the Evening Primrose and Warfarin Sodium interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.