Drug & supplement interaction

Fenugreek + Acenocoumarol

Acenocoumarol brand name: Sintrom.

Moderate Interaction
The bottom line Moderate

Fenugreek has a moderate interaction with Acenocoumarol. Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.

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

Fenugreek and Acenocoumarol

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Acenocoumarol

Acenocoumarol falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Fenugreek interacts with.

Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .
Severity Moderate Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the deal with acenocoumarol (Sintrom). It's a blood thinner that's a lot like warfarin, and it's a 'narrow window' drug, meaning small shifts in how it works can tip you toward bleeding or toward a clot. The concern on file is that fenugreek might add a mild blood-thinning nudge on top of your acenocoumarol, in theory making bleeding (easy bruising, nosebleeds, bleeding gums) a touch more likely.

Honestly though, the evidence here is thin. The antiplatelet effect was mostly seen in lab and animal studies, and one human study found regular fenugreek seed didn't actually change clotting. A pinch in your cooking is very unlikely to matter. Concentrated supplements are the bigger question. Since acenocoumarol needs close monitoring, please loop in your doctor or pharmacist before adding fenugreek capsules.

References
  1. Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. PubMed
  2. Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty PubMed
  3. Parvizpur, A., Ahmadiani, A., and Kamalinejad, M. Probable role of spinal purinoceptors in the analgesic effect of Trigonella foenum (TFG) leaves extract. J Ethnopharmacol 3-8-2006;104(1-2):108-112. 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

Fenugreek Also Interacts With Other Medications

Fenugreek has 223 moderate, 165 minor known drug interactions in our database — the Acenocoumarol one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Fenugreek

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

Everything else you take

See Every Supplement That Interacts With Acenocoumarol

This page covers Fenugreek only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acenocoumarol page lists 221 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Acetyl-l-carnitine (moderate) and Aconite (moderate).

By severity: 3 major · 193 moderate · 25 minor.

From our pharmacist’s overview on the Acenocoumarol page

“Acenocoumarol (Sintrom) is a blood thinner in the warfarin family, and it lives in a narrow zone where a little too much means bleeding and a little too little means clots. So treat its 221 supplement interactions as a real safety issue, not fine print.”

Reviewed by 2 · Jul 18, 2026

Open the Acenocoumarol interaction page

One more smart check

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

We hold 2,385 real supplement products containing Fenugreek, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fenugreek. Your product may carry other ingredients that interact with Acenocoumarol too, on top of Fenugreek — 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 Fenugreek and Acenocoumarol 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 Fenugreek
Top 10%

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

29 days ago today
Medication Acenocoumarol
Top 25%

#574 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 Fenugreek

What is Fenugreek?

Fenugreek
  • Blood sugar control
  • Boosting breast milk supply
  • High cholesterol
  • Digestive upset
  • Low testosterone or libido

Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blood sugar, but overall the evidence is mixed and far from settled. It is generally well tolerated as food, but talk with your pharmacist or doctor before using it as a supplement, especially if you are pregnant.

Read the full Fenugreek monograph & all interactions
Keep checking

Other Drugs & Fenugreek

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

0Major
223Moderate
165Minor
2,441No known interaction
Moderate

223 interactions

Showing 60 of 223 moderate interactions — see all 223 on the Fenugreek page.

Minor

165 interactions

Showing 60 of 165 minor interactions — see all 165 on the Fenugreek page.

No interaction 2,441 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 Fenugreek and Acenocoumarol Together: Common Questions

Can you take Fenugreek with Acenocoumarol?
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 Fenugreek and Acenocoumarol 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

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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.