Drug & supplement interaction

Feverfew + Warfarin

Warfarin brand name: Warfarin.

Moderate Interaction
The bottom line Moderate

Warfarin falls into 6 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
Interactions6
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Feverfew and Warfarin

These two interact in 6 distinct ways. Each one is explained separately below.

Why Are There 6 Interactions?

Feverfew interacts with whole categories of medication. Warfarin falls into 6 of those categories, so it can interact with Feverfew in 6 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 6

Why this applies to Warfarin

Warfarin 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 gist for warfarin and feverfew. Lab studies hint that feverfew may slow down an enzyme called CYP2C19, which is one of the pathways your body uses to clear warfarin. If that enzyme gets blocked, warfarin could build up a bit and thin your blood more than intended. That matters because warfarin has a very narrow safety window, so even small shifts can nudge your INR up and raise the risk of bruising, nosebleeds, or more serious bleeding.

The honest part: this is theoretical, based only on test-tube research, and hasn't been seen in real patients. Still, with a drug like warfarin I'd play it safe. Don't start or stop anything on your own. Check with your pharmacist or doctor first, and keep up with your regular INR checks.

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 1A2 (CYP1A2) SUBSTRATES

2 of 6

Warfarin also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Laboratory research shows that feverfew might inhibit CYP1A2. 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 gist for warfarin: lab studies hint that feverfew might slow down a liver enzyme called CYP1A2, which helps clear certain medications. Since warfarin is partly broken down by that pathway, the worry is that the drug could build up a bit and thin your blood more than intended. With warfarin, even small shifts matter, because it has a narrow safety window. Too much thinning can mean easy bruising, nosebleeds, or more serious bleeding.

That said, this is only a theoretical concern from test-tube research, and it hasn't actually been seen in people. I wouldn't panic. But because warfarin is so finicky, please loop in your pharmacist or doctor before adding feverfew so they can watch your INR if needed.

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

3 of 6

Warfarin 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 gist for warfarin and feverfew. Your body uses an enzyme called CYP2C9 to clear warfarin out. Lab studies hint that feverfew might slow that enzyme down. If it does, warfarin could build up a bit and thin your blood more than intended, which can show up as easy bruising, nosebleeds, bleeding gums, or blood in your urine or stool.

The good news: this is only theoretical, seen in test-tube and animal research, and it has never actually been reported in people. Still, warfarin is a touchy drug where small shifts matter, so don't start feverfew without a heads-up to your pharmacist or doctor. If you do add it, they may want to check your INR more closely for a while.

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

4 of 6

Warfarin 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 gist with feverfew and warfarin: in the test tube, feverfew appears to slow down a liver enzyme called CYP3A4, one of the pathways your body uses to clear warfarin. If that enzyme is blocked, warfarin could build up a little and thin your blood more than intended. With a drug this finely tuned, even a small shift can matter, possibly raising your risk of bruising, nosebleeds, or harder-to-stop bleeding.

That said, this is only a theoretical concern from lab work, and it has not actually been reported in people. Still, because warfarin is dosed so carefully (and tracked with INR blood tests), please loop in your pharmacist or doctor before adding feverfew so they can watch your numbers.

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

5 of 6

Warfarin 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: warfarin already lowers your blood's ability to clot, and feverfew may gently nudge in the same direction. Lab studies suggest feverfew can make platelets (the cells that help form clots) a little less sticky, so stacking the two could add up and raise your bleeding risk. Think easy bruising, nosebleeds, bleeding gums, or heavier-than-usual periods.

Now, the honest part: this is mostly theoretical, based on lab work and a single case report, not strong human trials. But warfarin is a narrow-margin drug where small shifts matter and your INR is watched closely. Please don't start or stop feverfew on your own. Just check with your pharmacist or doctor first so they can keep an eye on your numbers.

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.
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

6 of 6

Warfarin also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C8.
Laboratory research shows that feverfew might inhibit CYP2C8. 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 gist for warfarin: lab studies hint that feverfew might slow down a liver enzyme called CYP2C8, which is one of the pathways that helps clear warfarin from your body. In theory, if that pathway slows, warfarin could build up a bit and thin your blood more than intended. That matters because warfarin is a narrow-window drug, meaning even small shifts can tip you toward bruising, nosebleeds, or harder-to-stop bleeding.

That said, this is only a test-tube finding so far, and it hasn't actually been seen in people. Still, since warfarin needs careful balancing, I'd loop in your pharmacist or doctor before adding feverfew. If you do start it, they may simply want to check your INR a little more closely.

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

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 Warfarin 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 Warfarin

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 Warfarin, 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 Warfarin

This page covers Feverfew only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Warfarin 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).

By severity: 16 major · 301 moderate · 44 minor.

From our pharmacist’s overview on the Warfarin page

“People take warfarin to prevent dangerous clots, and many are the same people reaching for glucosamine for sore joints or a multivitamin containing vitamin K, which makes this a list that deserves genuine respect. Of the 361 supplements on file for warfarin, 16 carry a major rating, and the danger runs in both directions: some add to w…”

Reviewed by 2 · Jul 18, 2026

Open the Warfarin 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 Warfarin 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 Warfarin 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%

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

29 days ago today
Medication Warfarin
Top 10

#4 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 Warfarin

What Is Warfarin Used For?

Brand name: Warfarin

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.

See full Warfarin 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

Keep exploring
Pharmacist Counseling Corner

Taking Feverfew and Warfarin Together: Common Questions

Can you take Feverfew with Warfarin?
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 6 interactions listed for Feverfew and Warfarin?
Warfarin 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 Warfarin 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 Warfarin 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.