Drug & supplement interaction

Hesperidin + Apixaban

Apixaban brand name: Eliquis.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Apixaban falls into 2 drug categories that Hesperidin can interact with; the most serious is rated moderate. Theoretically, hesperidin might inhibit P-glycoprotein-mediated drug efflux and potentially increase levels of drugs that are substrates of P-glycoprotein.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Hesperidin and Apixaban

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

Why Are There 2 Interactions?

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

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 2

Why this applies to Apixaban

Apixaban falls under P-GLYCOPROTEIN SUBSTRATES — the group Hesperidin interacts with.

Theoretically, hesperidin might inhibit P-glycoprotein-mediated drug efflux and potentially increase levels of drugs that are substrates of P-glycoprotein.
In vitro research shows that hesperidin can inhibit P-glycoprotein efflux. This effect 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 Eliquis (apixaban). Your body relies on a little cellular pump called P-glycoprotein to help move apixaban along and clear it. Lab studies suggest hesperidin may slow that pump down. If that happened in people, a bit more apixaban could linger in your system, and since apixaban is a blood thinner, that could mean a higher chance of bruising or bleeding (think nosebleeds, bleeding gums, or blood in the urine or stool).

I'll be honest though: this is theoretical, seen only in test-tube research and never confirmed in humans, so I wouldn't lose sleep over it. Casual citrus in your diet is no concern. Before starting a concentrated hesperidin supplement, just give your pharmacist or doctor a heads-up so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. El-Readi, M. Z., Hamdan, D., Farrag, N., El-Shazly, A., and Wink, M. Inhibition of P-glycoprotein activity by limonin and other secondary metabolites from Citrus species in human colon and leukaemia cell lines. Eur.J.Pharmacol. 1-25-2010;626(2-3):139-145 PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Apixaban also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, hesperidin may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Animal research suggests that hesperetin, a bioflavonoid aglycone derivative of hesperidin, may have antiplatelet activity.
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

Eliquis (apixaban) is already a blood thinner, so it lowers your blood's ability to clot to help prevent strokes and dangerous clots. The concern here is that hesperidin may have a mild blood-thinning effect of its own. Put them together and, in theory, you could lean a little more toward bleeding.

I want to be honest about how soft this evidence is. This warning comes from lab and animal studies on a hesperidin-related compound, not from real people taking it with apixaban. It is a theoretical caution, not a proven problem. Still, watch for things like easy bruising, nosebleeds, bleeding gums, or unusually heavy bleeding, and call your doctor right away for any black stools or blood you cannot explain. Before adding a hesperidin supplement, just run it past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jin, Y. R., Han, X. H., Zhang, Y. H., Lee, J. J., Lim, Y., Chung, J. H., and Yun, Y. P. Antiplatelet activity of hesperetin, a bioflavonoid, is mainly mediated by inhibition of PLC-gamma2 phosphorylation and cyclooxygenase-1 activity. Atherosclerosis 200

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

Hesperidin Also Interacts With Other Medications

Hesperidin has 701 moderate known drug interactions in our database — the Apixaban one above is among them. If you take anything else, check it against the full list below.

Moderate 701 No known interaction 2,129 (incl. Apixaban)
Taking anything else?

Check Another of Your Medications Against Hesperidin

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

From our Q&A

Questions About Hesperidin or Apixaban

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

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

“St. John's wort can weaken apixaban (Eliquis), speeding how the body clears this blood thinner and leaving you less protected from the strokes and clots it is prescribed to prevent.”

Reviewed by 2 · Jul 18, 2026

Open the Apixaban interaction page

One more smart check

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

We hold 1,895 real supplement products containing Hesperidin, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hesperidin. Your product may carry other ingredients that interact with Apixaban too, on top of Hesperidin — 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 Hesperidin and Apixaban 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 Hesperidin
Top 25%

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

29 days ago today
Medication Apixaban
Most looked up

#1 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 Hesperidin

What is Hesperidin?

Hesperidin
  • Hemorrhoids
  • Varicose veins and poor circulation
  • Leg swelling (venous insufficiency)
  • High blood pressure
  • Antioxidant support

Hesperidin is a flavonoid found in citrus fruits that is often combined with diosmin and used for vein and circulation problems like hemorrhoids and varicose veins. Some evidence supports these uses, but data for many other claims is limited. It is generally well tolerated, but pregnant and breastfeeding people should avoid it because safety has not been established.

Read the full Hesperidin monograph & all interactions
Medication

About Apixaban

What Is Apixaban Used For?

Brand name: Eliquis

Apixaban is used to reduce the risk of stroke and dangerous clots traveling through the body in adults with nonvalvular atrial fibrillation (an irregular heart rhythm not caused by a heart valve problem). It is also used to prevent deep vein thrombosis (DVT — a blood clot in the leg) in adults after hip or knee replacement surgery, and to treat DVT and pulmonary embolism (PE — a blood clot in the lungs) in adults, including reducing the risk of those clots coming back.

Eliquis (the brand-name tablet and kit) is additionally approved to treat venous thromboembolism (VTE — blood clots in the veins) and reduce the risk of recurrent VTE in pediatric patients from birth and older, after at least 5 days of initial anticoagulant treatment. The generic apixaban tablet carries the adult indications only.

See full Apixaban drug information
Keep checking

Other Drugs & Hesperidin

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

0Major
701Moderate
0Minor
2,128No known interaction
701 Moderate 2,128 No interaction
Moderate

701 interactions

Showing 60 of 701 moderate interactions — see all 701 on the Hesperidin page.

No interaction 2,128 drugs checked — show the list

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

Showing the 60 most looked-up of 2,128 medications checked with no known interaction — see the full Hesperidin list.

See the full Hesperidin interactions page
See every supplement checked against Apixaban, ranked by severity
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
Hesperidin monograph › Uses, safety, and every drug interaction in one place Apixaban supplement interactions › Every supplement checked against Apixaban, ranked by severity Apixaban drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Hesperidin and Apixaban Together: Common Questions

Can you take Hesperidin with Apixaban?
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 2 interactions listed for Hesperidin and Apixaban?
Apixaban belongs to more than one drug category, and Hesperidin 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 Hesperidin and Apixaban 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 Apixaban and Hesperidin?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.