Drug & supplement interaction

Flaxseed Oil + Rivaroxaban

Rivaroxaban brand name: Xarelto.

Moderate Interaction
The bottom line Moderate

Flaxseed Oil has a moderate interaction with Rivaroxaban. Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.

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

Flaxseed Oil and Rivaroxaban

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Rivaroxaban

Rivaroxaban falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Flaxseed Oil interacts with.

Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Small clinical studies show that consuming flaxseed oil might decrease platelet aggregation and increase 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 the simple version: Xarelto (rivaroxaban) is already a blood thinner, so it slows down your blood's ability to clot. Flaxseed oil, in larger supplement doses, may have a mild blood-thinning effect of its own by making platelets a little less sticky. Put the two together and those effects can stack, which could nudge your bleeding risk a bit higher.

To be fair, this concern is mostly theoretical and based on pharmacology plus a few small studies, not strong proof that it causes real harm. Still, it's worth watching for things like easy bruising, nosebleeds, bleeding gums, or any unusual or prolonged bleeding. Occasional flaxseed in food is unlikely to matter much. Before adding a flaxseed oil supplement, just run it by your pharmacist or doctor first.

References
  1. Nordstrom DC, Honkanen VE, Nasu Y, et al. Alpha-linolenic acid in the treatment of rheumatoid arthritis. A double-blind, placebo-controlled and randomized study: flaxseed vs. safflower seed. Rheumatol Int 1995;14:231-4. PubMed
  2. Allman, M. A., Pena, M. M., and Pang, D. Supplementation with flaxseed oil versus sunflowerseed oil in healthy young men consuming a low fat diet: effects on platelet composition and function. Eur.J Clin.Nutr. 1995;49(3):169-178.

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

Flaxseed Oil Also Interacts With Other Medications

Flaxseed Oil has 292 moderate known drug interactions in our database — the Rivaroxaban 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 Flaxseed Oil

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

From our Q&A

Questions About Flaxseed Oil or Rivaroxaban

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Flaxseed Oil or Rivaroxaban, 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 Rivaroxaban

This page covers Flaxseed Oil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rivaroxaban page lists 285 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 · 240 moderate · 40 minor.

From our pharmacist’s overview on the Rivaroxaban page

“Grapefruit is the interaction I would flag first for anyone taking rivaroxaban (Xarelto). It slows how the body clears this blood thinner, and higher levels mean more bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Rivaroxaban interaction page

One more smart check

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

We hold 1,329 real supplement products containing Flaxseed Oil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Flaxseed Oil. Your product may carry other ingredients that interact with Rivaroxaban too, on top of Flaxseed Oil — 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 Flaxseed Oil and Rivaroxaban 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 Flaxseed Oil
Top 25%

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

29 days ago today
Medication Rivaroxaban
Top 10

#9 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 Flaxseed Oil

What is Flaxseed Oil?

  • Source of omega-3 (ALA) fatty acids
  • Heart and cholesterol health
  • Dry skin and inflammation
  • Constipation
  • General wellness

Flaxseed oil is a plant-based source of the omega-3 fatty acid ALA, which the body can partly convert to the omega-3s found in fish oil. It may help support heart health and provide healthy fats, but evidence for most specific health claims is limited or mixed. It is generally well tolerated, but talk to your pharmacist or doctor before starting, especially if you are pregnant or have a bleeding risk.

Read the full Flaxseed Oil monograph & all interactions
Medication

About Rivaroxaban

What Is Rivaroxaban Used For?

Brand name: Xarelto

Rivaroxaban tablets are used to reduce the risk of stroke in adults with nonvalvular atrial fibrillation (an irregular heart rhythm), treat deep vein thrombosis (DVT, a blood clot in a vein) and pulmonary embolism (PE, a blood clot in the lungs), and lower the chances of these clots coming back. They also help prevent clots after hip or knee replacement surgery, protect hospitalized patients at risk for clots, and — in combination with aspirin — reduce the risk of major cardiovascular events in adults with coronary artery disease (CAD) or peripheral artery disease (PAD).

Rivaroxaban tablets are also approved for treating VTE (venous thromboembolism, blood clots in veins) and preventing recurrence in pediatric patients from birth to under 18 years, and for preventing clots in children aged 2 and older with congenital heart disease after the Fontan procedure. Rivaroxaban for oral suspension (available as Rivaroxaban Granule and Xarelto oral suspension) is specifically indicated for these two pediatric uses.

See full Rivaroxaban drug information
Keep checking

Other Drugs & Flaxseed Oil

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

0Major
292Moderate
0Minor
2,537No known interaction
Moderate

292 interactions

Showing 60 of 292 moderate interactions — see all 292 on the Flaxseed Oil page.

No interaction 2,537 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 Flaxseed Oil and Rivaroxaban Together: Common Questions

Can you take Flaxseed Oil with Rivaroxaban?
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 Flaxseed Oil and Rivaroxaban 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 Rivaroxaban and Flaxseed Oil?

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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.