Drug & supplement interaction

Hemp + Rivaroxaban

Rivaroxaban brand name: Xarelto.

Minor Interaction
The bottom line Minor

Rivaroxaban falls into 2 drug categories that Hemp can interact with; the most serious is rated minor. Theoretically, hemp seed might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hemp and Rivaroxaban

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Hemp interacts with whole categories of medication. Rivaroxaban falls into 2 of those categories, so it can interact with Hemp in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Rivaroxaban

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

Theoretically, hemp seed might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
In animal research, hemp seed at 5% of the diet inhibits platelet aggregation in vitro. However, in human research, taking hemp seed oil 2 grams daily for 12 weeks does not inhibit the aggregation of platelets in vitro.
Severity Minor 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 short version on hemp and Xarelto (rivaroxaban): this is a very minor, mostly theoretical concern. Rivaroxaban already thins your blood to prevent clots, and there's a thought that hemp seed might gently nudge your blood toward clotting a little less by affecting platelets. If both pushed in that same direction, you could in theory see more bruising or bleeding (think nosebleeds, bleeding gums, or cuts that take longer to stop).

But the evidence here is weak. The platelet effect only showed up in animal and lab studies, and a human study using 2 grams of hemp seed oil daily for 12 weeks did not reduce platelet activity. So eating hemp seeds or oil as food is very unlikely to matter. If you plan to take concentrated hemp supplements, just give your pharmacist or doctor a quick heads-up.

References
  1. Kaul N, Kreml R, Austria JA, et al. A comparison of fish oil, flaxseed oil and hempseed oil supplementation on selected parameters of cardiovascular health in healthy volunteers. J Am Coll Nutr 2008;27:51-8. PubMed
  2. Richard MN, Ganguly R, Steigerwald SN, Al-Khalifa A, Pierce GN. Dietary hempseed reduces platelet aggregation. J Thromb Haemost. 2007;5(2):424-5. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

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

Theoretically, hemp might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that hemp induces CYP3A4 enzymes.
Severity Minor 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 Xarelto (rivaroxaban). Your body clears this blood thinner partly through a liver enzyme called CYP3A4. Lab studies hint that hemp may speed that enzyme up. If that happened in real life, your body could clear rivaroxaban a little faster, which might make it slightly less effective at preventing clots. Since rivaroxaban is the active drug already (not a prodrug), faster clearance means weaker effect, not stronger.

The important thing: this is theoretical, coming only from test-tube research, and it's rated minor. Eating hemp seeds or hemp oil as food is very unlikely to matter. Still, because rivaroxaban protects you from dangerous clots, check with your pharmacist or doctor before using concentrated hemp supplements.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. 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

Hemp Also Interacts With Other Medications

Hemp has 41 moderate, 896 minor known drug interactions in our database — the Rivaroxaban 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 Hemp

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

From our Q&A

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

We hold 720 real supplement products containing Hemp, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hemp. Your product may carry other ingredients that interact with Rivaroxaban too, on top of Hemp — 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 Hemp 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 Hemp
Top 25%

#184 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 Hemp

What is Hemp?

Hemp
  • Plant-based protein source
  • Heart health support
  • Skin and hair health
  • Reducing inflammation
  • General nutrition (omega fatty acids)

Hemp seeds and hemp seed oil are nutritious foods rich in protein, fiber, and healthy omega-3 and omega-6 fatty acids, and they are generally safe for most people as part of the diet. While the nutrition is real, strong human evidence that hemp supplements treat specific medical conditions is limited. Talk with your pharmacist or doctor before using hemp products for a health concern, especially if you are pregnant or breastfeeding.

Read the full Hemp 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 & Hemp

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

0Major
41Moderate
896Minor
1,892No known interaction
Moderate

41 interactions

Minor

896 interactions

Showing 60 of 896 minor interactions — see all 896 on the Hemp page.

No interaction 1,892 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 Hemp and Rivaroxaban Together: Common Questions

Can you take Hemp with Rivaroxaban?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Hemp and Rivaroxaban?
Rivaroxaban belongs to more than one drug category, and Hemp 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 Hemp and Rivaroxaban interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Rivaroxaban and Hemp?

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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.