Drug & supplement interaction

Germanium + Rivaroxaban

Rivaroxaban brand name: Xarelto.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Germanium and Rivaroxaban in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Germanium and Rivaroxaban

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Rivaroxaban and Germanium in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Germanium at all — not against Rivaroxaban, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Germanium safety at a glance

Germanium overall Avoid Germanium supplements have caused serious kidney damage and deaths and should be avoided.
Pregnancy Likely Unsafe When used orally due to reported toxicity; avoid using. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally due to reported toxicity; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Rivaroxaban and Germanium? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Germanium Itself Has Been Linked To

This is not an interaction — nothing below involves Rivaroxaban. It is the side-effect record for Germanium on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Germanium, this list is the first place to look. 7 entries are worth acting on rather than waiting out — marked below.

  • Muscle weakness Worth acting on Additional detail

    “Orally, germanium is well tolerated in amounts typically found in the diet, 0.4-3.4 mg daily. However, there have been more than 30 reports of renal tubular cell damage with renal failure, hepatic steatosis, lactic acidosis, myopathy, peripheral neuropathy, cerebellar ataxia, and degeneration of the dorsal column of the spinal cord, in some cases leading to death, when organic or inorganic germanium compounds are tak…”

    Germanium · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    6 sources cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    2. 51753. Schauss, A. G. Nephrotoxicity in humans by the ultratrace element germanium. Ren Fail. 1991;13(1):1-4. PubMed
    3. 10040. Higuchi I, Izumo S, Kuriyama M, et al. Germanium myopathy: clinical and experimental pathological studies. Acta Neuropathol (Berl) 1989;79:300-4.. PubMed
    4. 10041. Matsusaka T, Fujii M, Nakano T, et al. Germanium-induced nephropathy: report of two cases and review of the literature. Clin Nephrol 1988;30:341-5..
    5. 10042. Hess B, Raisin J, Zimmermann A, et al. Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. Am J Kidney Dis 1993;21:548-52.. PubMed
    6. 10043. Luck BE, Mann H, Melzer H, et al. Renal and other organ failure caused by germanium intoxication. Nephrol Dial Transplant 1999;14:2464-8. PubMed

    “Orally, muscle weakness or myopathy are among the most common symptoms of germanium toxicity. In one case report, a 38-year-old woman presented with myopathy after taking 600 mg of a germanium preparation daily for 18 months as an elixir. The preparation was found to be mainly germanium dioxide with some organic compound present.”

    Germanium · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    1 source cited
    1. 51762. Nagata, N., Yoneyama, T., Yanagida, K., Ushio, K., Yanagihara, S., Matsubara, O., and Eishi, Y. Accumulation of germanium in the tissues of a long-term user of germanium preparation died of acute renal failure. J.Toxicol.Sci. 1985;10(4):333-341. PubMed
  • Unsteadiness Worth acting on Additional detail

    “Orally, germanium has caused peripheral neuropathy. Intravenously, transient lethargy, dizziness, visual blurring, and ataxia were the main adverse effects to the organic compound, spirogermanium. Less common adverse effects were persistent loss of taste and weakness, and a seizure. At doses above 250 mg/m2 daily tremors and mental confusion are more severe.”

    Germanium · Natural Medicines adverse-effect record, reported in epilepsy.

    4 sources cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    2. 10038. Vogelzang NJ, Gesme DH, Kennedy BJ. A phase II study of spirogermanium in advanced human malignancy. Am J Clin Oncol 1985;8:341-4.. PubMed
    3. 10049. Schein PS, Slavik M, Smythe T, et al. Phase I clinical trial of spirogermanium. Cancer Treat Rep 1980;64:1051-6..
    4. 51770. Woolley, P. V., Ahlgren, J. D., Byrne, P. J., Priego, V. M., and Schein, P. S. A Phase I trial of spirogermanium administered on a continuous infusion schedule. Invest New Drugs 1984;2(3):305-309. PubMed
  • Confusion / Seizures Worth acting on Additional detail

    Recorded for Germanium in the same Natural Medicines adverse-effect record shown under Unsteadiness above.

  • Low mood Worth acting on Additional detail

    “Orally, depression occurred in two patients receiving an organometallic preparation of germanium called propagermanium 30 mg daily.”

    Germanium · Natural Medicines adverse-effect record, reported in depression.

    1 source cited
    1. 51746. Tsutsumi, Y., Tanaka, J., Kanamori, H., Musashi, M., Minami, H., Fukushima, A., Yamato, H., Ehira, N., Kawamura, T., Obara, S., Ogura, N., Asaka, M., Imamura, M., and Masauzi, N. Effectiveness of propagermanium treatment in multiple myeloma patients. Eur. PubMed
  • Kidney problems Worth acting on Additional detail

    “Orally, germanium can cause renal tubular degeneration and renal failure. In one case report, a 38-year-old woman presented with renal failure eventually leading to death after taking 600 mg of a germanium preparation daily for 18 months as an elixir. The preparation was found to be mainly germanium dioxide with some organic compound present.”

    Germanium · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    6 sources cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    2. 10041. Matsusaka T, Fujii M, Nakano T, et al. Germanium-induced nephropathy: report of two cases and review of the literature. Clin Nephrol 1988;30:341-5..
    3. 10042. Hess B, Raisin J, Zimmermann A, et al. Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. Am J Kidney Dis 1993;21:548-52.. PubMed
    4. 10044. Schauss AG. Nephrotoxicity and neurotoxicity in humans from organogermanium compounds and germanium dioxide. Biol Trace Elem Res 1991;29:267-80.. PubMed
    5. 10073. Krapf R, Schaffner T, Iten PX. Abuse of germanium associated with fatal lactic acidosis. Nephron 1992;62:351-6.. PubMed
    6. 10074. Takeuchi A, Yoshizawa N, Oshima S, et al. Nephrotoxicity of germanium compounds: report of a case and review of the literature. Nephron 1992;60:436-42.. PubMed
  • Anemia Worth acting on Additional detail

    “Orally, germanium can cause anemia.”

    Germanium · Natural Medicines adverse-effect record, reported in anemia.

    1 source cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
  • Liver problems Worth acting on Additional detail

    “Orally, germanium has caused hepatic steatosis.”

    Germanium · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    3 sources cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    2. 10042. Hess B, Raisin J, Zimmermann A, et al. Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. Am J Kidney Dis 1993;21:548-52.. PubMed
    3. 10073. Krapf R, Schaffner T, Iten PX. Abuse of germanium associated with fatal lactic acidosis. Nephron 1992;62:351-6.. PubMed
  • A change in taste Additional detail

    Recorded for Germanium in the same Natural Medicines adverse-effect record shown under Unsteadiness above.

  • Numbness or tingling Additional detail

    Recorded for Germanium in the same Natural Medicines adverse-effect record shown under Muscle weakness above.

Showing the 10 most notable of 13 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Germanium — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Rivaroxaban’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Rivaroxaban column appears here.

Special populations

Germanium in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally due to reported toxicity; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

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

We hold 41 real supplement products containing Germanium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Germanium. Even though Germanium itself has no known interaction with Rivaroxaban, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Germanium 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 Germanium
Steady interest

#1,154 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Rivaroxaban
Top 10

#10 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Germanium reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Germanium and Rivaroxaban records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Germanium

What is Germanium?

  • Immune support
  • Cancer (unproven, alternative therapy)
  • Antioxidant claims
  • Pain relief
  • General wellness/anti-aging

Germanium is a chemical element sometimes sold as a dietary supplement, but there is no reliable evidence it treats any disease. More importantly, germanium supplements have been linked to serious and sometimes fatal kidney damage, so health authorities have warned against their use. We do not recommend taking germanium supplements.

Not a plant; germanium is a chemical element (mineral) · Capsules, tablets, powders (often as germanium-132 / organic germanium or inorganic germanium salts)

An interaction check asks whether these two react with each other — it does not ask whether Germanium is a good idea for someone in your situation. Here is what our Germanium record says about it on its own.

Germanium: dosing

There is no safe or established dose of germanium as a dietary supplement, and we do not recommend taking it at all.

From our Germanium monograph — the full record covers uses, side effects and every documented interaction.

Read the full Germanium 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 & Germanium

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Germanium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Germanium list.

See the full Germanium interactions page
See every supplement checked against Rivaroxaban, ranked by severity
Evidence & sources

Germanium References

The 30 references that drive our Germanium monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
  2. Budman DR, Schulman P, Vinciguerra V, Degnan TJ. Phase I trial of spirogermanium given by infusion in a multiple-dose schedule. Cancer Treat Rep 1982;66:173-5..
  3. Mainwaring MG, Poor C, Zander DS, Harman E. Complete remission of pulmonary spindle cell carcinoma after treatment with oral germanium sesquioxide. Chest 2000;117:591-3.. PubMed
  4. Vogelzang NJ, Gesme DH, Kennedy BJ. A phase II study of spirogermanium in advanced human malignancy. Am J Clin Oncol 1985;8:341-4.. PubMed
  5. Ettinger DS, Finkelstein DM, Donehower RC, et al. Phase II study of N-methylformamide, spirogermanium, and 4-demethoxydaunorubicin in the treatment of non-small cell lung cancer (EST 3583): an Eastern Cooperative Oncology Group study. Med Pediatr Oncol 1 PubMed
  6. Higuchi I, Izumo S, Kuriyama M, et al. Germanium myopathy: clinical and experimental pathological studies. Acta Neuropathol (Berl) 1989;79:300-4.. PubMed
  7. Matsusaka T, Fujii M, Nakano T, et al. Germanium-induced nephropathy: report of two cases and review of the literature. Clin Nephrol 1988;30:341-5..
  8. Hess B, Raisin J, Zimmermann A, et al. Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. Am J Kidney Dis 1993;21:548-52.. PubMed
  9. Luck BE, Mann H, Melzer H, et al. Renal and other organ failure caused by germanium intoxication. Nephrol Dial Transplant 1999;14:2464-8. PubMed
  10. Schauss AG. Nephrotoxicity and neurotoxicity in humans from organogermanium compounds and germanium dioxide. Biol Trace Elem Res 1991;29:267-80.. PubMed
  11. Schein PS, Slavik M, Smythe T, et al. Phase I clinical trial of spirogermanium. Cancer Treat Rep 1980;64:1051-6..
  12. Trope C, Mattsson W, Gynning I, et al. Phase II study of spirogermanium in advanced ovarian malignancy. Cancer Treat Rep 1981;65:119-20..
  13. Gerber GB, Leonard A. Mutagenicity, carcinogenicity and teratogenicity of germanium compounds. Mutat Res 1997;387:141-6.. PubMed
  14. Asaka T, Nitta E, Makifuchi T, et al. Germanium intoxication with sensory ataxia. J Neurol Sci 1995;130:220-3.. PubMed
  15. Sanai T, Okuda S, Onoyama K, et al. Germanium dioxide-induced nephropathy: a new type of renal disease. Nephron. 1990;54:53-60.. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Germanium and Rivaroxaban Together: Common Questions

Is it safe to take Germanium with Rivaroxaban?
We do not list a known interaction between Germanium and Rivaroxaban. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Does Rivaroxaban interact with any supplements?
Yes. Rivaroxaban has documented interactions with 285 supplements in our database — Germanium is not one of them. The Rivaroxaban interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Germanium monograph Uses, safety profile, and every drug interaction in one place Rivaroxaban drug information The full plain-English guide to this medication Rivaroxaban supplement interactions Every supplement checked against Rivaroxaban, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 30 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Rivaroxaban and Germanium?

Our pharmacists answer your medication & supplement questions — free.

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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.