Drug & supplement interaction

Hawthorn + Diclofenac Sodium

Diclofenac Sodium brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, and others.

Moderate Interaction
The bottom line Moderate

Hawthorn has a moderate interaction with Diclofenac Sodium. Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Hawthorn and Diclofenac Sodium

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Diclofenac Sodium

Diclofenac Sodium falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Hawthorn interacts with.

Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that hawthorn can inhibit platelet aggregation. However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract. However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy 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 connection worth knowing about: diclofenac is an NSAID, and like other drugs in that family it can thin the blood a little and irritate the stomach lining, which raises the chance of bleeding (think bruising more easily, or in some cases stomach bleeding). Hawthorn, in lab and animal studies, appears to make platelets a bit less sticky too. Stack the two and, in theory, you could nudge that bleeding risk up.

I want to be honest that this is mostly theoretical. The human evidence is thin and even mixed, with one study finding no real effect on platelets. So it's not a reason to panic, but it is a reason to mention hawthorn to your pharmacist or doctor, especially if you have surgery coming up or already notice easy bruising.

References
  1. Dalli, E., Valles, J., Cosin-Sales, J., Santos, M. T., Moscardo, A., Milara, J., and Sotillo, J. F. Effects of hawthorn (Crataegus laevigata) on platelet aggregation in healthy volunteers. Thromb.Res 2011;128(4):398-400. PubMed
  2. Rababa'h AM, Altarabsheh SE, Haddad O, Deo SV, Obeidat Y, Al-Azzam S. Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach. Heart Surg Forum 2016;19(4):E175-9. PubMed
  3. Shatoor AS, Soliman H, Al-Hashem F, Gamal BE, Othman A, El-Menshaw N. Effect of hawthorn (Crataegus aronia syn. Azarolus (L)) on platelet function in albino wistar rats. Thromb Res 2012;130(1):75-80. PubMed
  4. Vibes J, Lasserre B, Gleye J, Declume C. Inhibition of thromboxane A2 biosynthesis in vitro by the main components of Crataegus oxyacantha (hawthorn) flower heads. Prostaglandins Leukot Essent Fatty Acids 1994;50(4):173-5. PubMed
  5. Rogers KL, Grice ID, Griffiths LR. Inhibition of platelet aggregation and 5-HT release by extracts of Australian plants used traditionally as headache treatments. Eur J Pharm Sci 2000;9(4):355-63. PubMed
  6. Zhou CC, Huang XX, Gao PY, et al. Two new compounds from Crataegus pinnatifida and their antithrombotic activities. J Asian Nat Prod Res 2014;16(2):169-74.

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

Hawthorn Also Interacts With Other Medications

Hawthorn has 14 major, 176 moderate known drug interactions in our database — the Diclofenac Sodium 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 Hawthorn

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

From our Q&A

Questions About Hawthorn or Diclofenac Sodium

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

This page covers Hawthorn only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diclofenac Sodium page lists 308 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Piracetam (major).

By severity: 7 major · 266 moderate · 35 minor.

From our pharmacist’s overview on the Diclofenac Sodium page

“Diclofenac (Voltaren), a daily mainstay for arthritis and joint pain, comes with a supplement list that calls for real vigilance. Of the 308 ingredients on file, 7 rate major, and roughly two hundred entries share a single theme: anything with blood-thinning activity adds to diclofenac's own bleeding risk, especially in the stomach.”

Reviewed by 2 · Jul 18, 2026

Open the Diclofenac Sodium interaction page

One more smart check

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

We hold 2,624 real supplement products containing Hawthorn, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hawthorn. Your product may carry other ingredients that interact with Diclofenac Sodium too, on top of Hawthorn — 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 Hawthorn and Diclofenac Sodium 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 Hawthorn
Top 10%

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

29 days ago today
Medication Diclofenac Sodium
Top 25%

#321 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 Hawthorn

What is Hawthorn?

Hawthorn
  • Heart failure symptoms
  • High blood pressure
  • Chest pain (angina)
  • Irregular heartbeat
  • Digestive upset
  • Anxiety

Hawthorn is a plant traditionally used for heart-related complaints, and some studies suggest it may modestly help symptoms of mild heart failure when added to standard care. However, the evidence is mixed and it should never replace prescribed heart medicines. Always talk to your pharmacist or doctor before using hawthorn, especially if you have a heart condition.

Read the full Hawthorn monograph & all interactions
Medication

About Diclofenac

What Is Diclofenac Used For?

Brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, Diclo SR, Voltarol, Acoflam, Defenac, Dicloflex, Diclovol, Diclozip, Fenactol, Flamrase, Volraman, Diclomax SR, Diclomax Retard, Motifene 75 mg, Voltarol 75 mg SR, Acoflam 75 SR, Defenac SR, Dexomon 75 SR, Dicloflex 75 SR, Diclovol SR, Fenactol 75 mg SR, Flamatak 75 MR, Flamrase SR, Flexotard MR 75, Rheumatac Retard 75, Rhumalgan CR, Slofenac SR, Volsaid Retard 75, Voltarol Retard, Acoflam Retard, Defenac Retard, Dexomon Retard 100, Dicloflex Retard, Diclovol Retard, Fenactol Retard 100 mg, Flamatak 100 MR, Volsaid Retard 100, Voltarol Ophtha Multidose, Voltarol Ophtha, Pennsaid, Voltaren Emulgel, Dyloject

Diclofenac sodium topical gel is used to treat actinic keratoses (AK) — rough, scaly skin patches that form after years of sun exposure. These patches are considered precancerous, meaning they can develop into skin cancer if left untreated.

This is a topical gel, meaning it is applied directly to the skin over the affected area rather than taken by mouth. It belongs to the NSAID (nonsteroidal anti-inflammatory drug) family.

See full Diclofenac drug information
Keep checking

Other Drugs & Hawthorn

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

14Major
176Moderate
0Minor
2,639No known interaction
Major

14 interactions

Moderate

176 interactions

Showing 60 of 176 moderate interactions — see all 176 on the Hawthorn page.

No interaction 2,639 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 Hawthorn and Diclofenac Sodium Together: Common Questions

Can you take Hawthorn with Diclofenac Sodium?
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 Hawthorn and Diclofenac Sodium 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.