Drug & supplement interaction

Holy Basil + Acenocoumarol

Acenocoumarol brand name: Sintrom.

Moderate Interaction
The bottom line Moderate

Holy Basil has a moderate interaction with Acenocoumarol. Theoretically, holy basil seed oil might increase the risk of bleeding when 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

Holy Basil and Acenocoumarol

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Acenocoumarol

Acenocoumarol falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Holy Basil interacts with.

Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Animal research shows that holy basil seed oil can prolong bleeding time, possibly due to inhibition of platelet aggregation. However, it is not known if this occurs 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

Acenocoumarol (Sintrom) is a blood thinner with a narrow safety window, meaning small shifts in its effect can tip you toward too much bleeding or too little protection. The concern here is that holy basil seed oil may slow down how platelets clump together, which could add to the blood-thinning you already get from your medication. Stacked together, the theoretical worry is more bleeding, things like easy bruising, nosebleeds, bleeding gums, or blood in your urine or stool.

I want to be honest about the evidence though: this comes only from animal studies, and we simply do not know if it happens in people. Culinary amounts of tulsi tea are far less concerning than concentrated supplement doses. Before starting holy basil, check in with your pharmacist or doctor so your INR can be watched closely.

References
  1. Singh S, Rehan HM, Majumdar DK. Effect of Ocimum sanctum fixed oil on blood pressure, blood clotting time and pentobarbitone-induced sleeping time. J Ethnopharmacol 2001;78:139-43. 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

Holy Basil Also Interacts With Other Medications

Holy Basil has 211 moderate known drug interactions in our database — the Acenocoumarol 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 Holy Basil

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

From our Q&A

Questions About Holy Basil or Acenocoumarol

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

This page covers Holy Basil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acenocoumarol page lists 221 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Acetyl-l-carnitine (moderate) and Aconite (moderate).

By severity: 3 major · 193 moderate · 25 minor.

From our pharmacist’s overview on the Acenocoumarol page

“Acenocoumarol (Sintrom) is a blood thinner in the warfarin family, and it lives in a narrow zone where a little too much means bleeding and a little too little means clots. So treat its 221 supplement interactions as a real safety issue, not fine print.”

Reviewed by 2 · Jul 18, 2026

Open the Acenocoumarol interaction page

One more smart check

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

We hold 1,867 real supplement products containing Holy Basil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Holy Basil. Your product may carry other ingredients that interact with Acenocoumarol too, on top of Holy Basil — 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 Holy Basil and Acenocoumarol 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 Holy Basil
Top 25%

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

29 days ago today
Medication Acenocoumarol
Top 25%

#574 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 Holy Basil

What is Holy Basil?

Holy Basil
  • Stress and anxiety
  • Blood sugar support
  • Respiratory complaints
  • General immune and wellness support
  • Inflammation

Holy basil (tulsi) is a traditional Ayurvedic herb most often used today for stress and general wellness, but the human evidence is mostly small and preliminary. It is generally well tolerated by most adults, but it should be avoided in pregnancy and used cautiously by anyone with health conditions or taking medications. Talk to your pharmacist or doctor before starting it.

Read the full Holy Basil monograph & all interactions
Keep checking

Other Drugs & Holy Basil

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

0Major
211Moderate
0Minor
2,618No known interaction
Moderate

211 interactions

Showing 60 of 211 moderate interactions — see all 211 on the Holy Basil page.

No interaction 2,618 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 Holy Basil and Acenocoumarol Together: Common Questions

Can you take Holy Basil with Acenocoumarol?
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 Holy Basil and Acenocoumarol 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 Acenocoumarol and Holy Basil?

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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.