Drug & supplement interaction

Feverfew + Effient

Effient brand name: Prasugrel.

Moderate Interaction
The bottom line Moderate

Effient falls into 4 drug categories that Feverfew can interact with; the most serious is rated moderate. Theoretically, feverfew might increase levels of drugs metabolized by CYP2C19.

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

Feverfew and Effient

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

Why Are There 4 Interactions?

Feverfew interacts with whole categories of medication. Effient falls into 4 of those categories, so it can interact with Feverfew 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 2C19 (CYP2C19) SUBSTRATES

1 of 4

Why this applies to Effient

Effient falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Feverfew interacts with.

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C19.
Laboratory research shows that feverfew might inhibit CYP2C19. So far, this interaction 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 thing about Effient (prasugrel): it's a prodrug, meaning it has to be switched on by your body's enzymes before it can stop platelets from clumping. CYP2C19 plays a part in that activation. So if feverfew slows that enzyme down, as some lab studies hint it might, you could theoretically end up with a bit less of the active, clot-fighting form. With a medicine you're taking to prevent another heart attack or stroke, even a small drop in protection is worth taking seriously.

That said, this is only suggested by test-tube and animal research, and it has never actually been reported in people. I wouldn't panic, but I'd loop in your pharmacist or cardiologist before adding feverfew, since Effient is doing such an important job.

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

2 of 4

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

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C9.
Laboratory research shows that feverfew might inhibit CYP2C9. So far, this interaction 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 thing about Effient (prasugrel): it's actually a prodrug, meaning your body has to switch it on before it can do its job of keeping platelets from clumping. So if feverfew slowed down an enzyme that helps activate it, you might worry about getting less protection. But honestly, prasugrel relies mostly on other enzymes for activation, not heavily on CYP2C9, so this particular concern is pretty shaky.

On top of that, this interaction is purely theoretical, seen only in lab dishes, never in real people. Still, since Effient affects bleeding and clotting, it's worth a quick chat with your pharmacist or doctor before adding feverfew, especially since feverfew itself may nudge platelets a bit.

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

3 of 4

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

Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Laboratory research shows that feverfew might inhibit CYP3A4. So far, this interaction 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 thing about Effient (prasugrel): it's a prodrug, meaning you swallow it in an inactive form and your body has to switch it on. Several enzymes do that activation, and CYP3A4 is one of them. Lab studies hint that feverfew might slow CYP3A4 down a bit. In theory, slowing that step could mean slightly less of the active, clot-blocking form of prasugrel forming.

Honestly though, this is very theoretical. It's only been seen in test-tube and animal research, never in real people, and prasugrel relies on more than one enzyme to get activated. So I wouldn't lose sleep over it. Still, since Effient protects your heart and stents, it's worth a quick chat with your pharmacist or doctor before adding feverfew.

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
  2. Sil'vestrov VP, Kinitin AV, and Chesnokova, IV. [Immunological and metabolic disorders and the means for their correction in patients with chronic bronchitis]. Ter.Arkh. 1991;63:7-11.
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

4 of 4

Effient also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, feverfew might have additive effects and increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Laboratory research suggests that feverfew may inhibit platelet aggregation. Additionally, in one case report, a 36-year-old patient taking feverfew 2400 mg daily for 3 months experienced vaginal bleeding and a prolonged menstrual cycle, with a modest increase in partial thromboplastin time (PTT) and prothrombin time (PT).
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 these two together. Effient (prasugrel) already keeps your platelets from clumping so you don't form dangerous clots. Feverfew, at least in lab studies, seems to nudge platelets in that same direction. Stack them and you may get a little more blood-thinning than intended, which can show up as easier bruising, nosebleeds, bleeding gums, or longer-than-usual bleeding from a cut.

I want to be honest about the strength of this, though. It's mostly test-tube research plus one case report in someone taking a high dose, so it's more of a theoretical caution than a proven problem. Cooking-level amounts aren't the concern; concentrated supplements are. Since you're on Effient for serious heart reasons, please loop in your pharmacist or doctor before adding feverfew rather than deciding on your own.

References
  1. Awang DVC. Prescribing therapeutic feverfew (Tancetum pathrnium (L.) Schultz Bip., syn. Chrysanthemumparthenium (L.) Bernh). Int Med 1998;1:11-3.
  2. Heptinstall S, Groenewegen WA, Spangenberg P, Loesche W. Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. J Pharm Pharmacol 1987;39:459-65. PubMed
  3. Heptinstall S, White A, Williamson L, Mitchell JR. Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet 1985;1:1071-4. PubMed
  4. Makheja AN, Bailey JM. A platelet phospholipase inhibitor from the medicinal herb feverfew (Tanacetum parthenium). Prostaglandins Leukot Med 1982;8:653-60.
  5. Groenewegen WA, Heptinstall S. A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. J Pharm Pharmacol 1990;42:553-7. PubMed
  6. Heptinstall S, Groenewegen WA, Spangenberg P, Losche W. Inhibition of platelet behaviour by feverfew: a mechanism of action involving sulphydryl groups. Folia Haematol Int Mag Klin Morphol Blutforsch 1988;115:447-9.
  7. Biggs MJ, Johnson ES, Persaud NP, Ratcliffe DM. Platelet aggregation in patients using feverfew for migraine. Lancet 1982;2:776. PubMed
  8. Alenzi KA, Alharbi FH, Tawhari FM, Fradees GS. Alteration of Coagulation Test Results and Vaginal Bleeding Associated With the Use of Feverfew (Tanacetum parthenium). J Med Cases 2021;12(1):9-12.

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

Feverfew Also Interacts With Other Medications

Feverfew has 928 moderate 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 Feverfew

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

From our Q&A

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

We hold 520 real supplement products containing Feverfew, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Feverfew. Your product may carry other ingredients that interact with Effient too, on top of Feverfew — 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 Feverfew 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 Feverfew
Top 25%

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

29 days ago today
Medication Effient
Top half

#754 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 Feverfew

What is Feverfew?

Feverfew
  • Migraine prevention
  • Headache
  • Fever (traditional)
  • Arthritis and joint pain
  • Menstrual discomfort

Feverfew is a daisy-family herb best known for migraine prevention, where some studies suggest it may modestly lower how often migraines occur, though the evidence is mixed. It is generally well tolerated for short-term use in most adults but should be avoided during pregnancy and breastfeeding and by people allergic to ragweed and related plants. Talk to your pharmacist or doctor before starting it.

Read the full Feverfew monograph & all interactions
Medication

About Prasugrel

What Is Prasugrel Used For?

Brand name: Prasugrel

Prasugrel tablets (brand names Effient and Prasugrel) are used to lower the risk of dangerous blood clots — including clots that can block a stent — in people with acute coronary syndrome (ACS), which includes unstable angina (chest pain at rest) and heart attacks (both NSTEMI and STEMI types). It is used specifically in patients who are being treated with a procedure called percutaneous coronary intervention (PCI), in which a catheter is used to open a blocked coronary artery, often with a stent.

Effient has been shown to reduce the combined rate of cardiovascular death, nonfatal heart attack, or nonfatal stroke compared to clopidogrel — with the benefit driven mainly by fewer heart attacks.

See full Prasugrel drug information
Keep checking

Other Drugs & Feverfew

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

0Major
928Moderate
0Minor
1,901No known interaction
Moderate

928 interactions

Showing 60 of 928 moderate interactions — see all 928 on the Feverfew page.

No interaction 1,901 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 Feverfew and Effient Together: Common Questions

Can you take Feverfew 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 4 interactions listed for Feverfew and Effient?
Effient belongs to more than one drug category, and Feverfew 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 Feverfew 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 Feverfew?

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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.