Drug & supplement interaction

Honey + Rivaroxaban

Rivaroxaban brand name: Xarelto.

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

Rivaroxaban falls into 2 drug categories that Honey can interact with; the most serious is rated minor. Theoretically, honey might decrease levels of drugs metabolized by CYP3A4, but research is conflicting.

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

Honey and Rivaroxaban

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

Why Are There 2 Interactions?

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Rivaroxaban

Rivaroxaban falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Honey interacts with.

Theoretically, honey might decrease levels of drugs metabolized by CYP3A4, but research is conflicting.
Some clinical research shows that honey induces CYP3A4. However, other clinical studies found no effect on CYP3A4 activity. Different honey preparations may have different effects on CYP3A4.
Severity Minor Likelihood Possible Evidence B

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: your body clears rivaroxaban (Xarelto) partly through a liver enzyme called CYP3A4. There's some weak, conflicting research suggesting honey might nudge that enzyme to work a little faster. If that happened, your rivaroxaban could be cleared a bit quicker, which in theory means slightly less blood-thinning protection against clots. I want to stress the word theoretical here, since other studies showed no effect at all, and different honeys behave differently.

The everyday amount of honey in your tea or toast is very unlikely to matter. I wouldn't lose sleep over it. Since rivaroxaban is a drug where getting the dose right is important, just mention any regular honey use to your pharmacist or doctor so they can keep an eye on you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Tushar, T., Vinod, T., Rajan, S., Shashindran, C., and Adithan, C. Effect of honey on CYP3A4, CYP2D6 and CYP2C19 enzyme activity in healthy human volunteers. Basic Clin Pharmacol Toxicol 2007;100(4):269-272. PubMed
  2. Fetzner, L., Burhenne, J., Weiss, J., Völker, M., Unger, M., Mikus, G., and Haefeli, W. E. Daily honey consumption does not change CYP3A activity in humans. J Clin Pharmacol 2011;51(8):1223-1232. PubMed
Minor

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Rivaroxaban also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, honey may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
In vitro, honey inhibits platelet aggregation and increases the time to clotting. Furthermore, animal research suggests that feeding mice large doses of honey for 12 days increases bleeding time when compared with no intervention. However, these effects have not been reported in humans.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: Rivaroxaban (Xarelto) is already a blood thinner that lowers your blood's ability to clot. The concern with honey is that, at least in the lab and in mice, it seemed to slow down platelets and lengthen the time it takes blood to clot. Stack that on top of a drug doing a similar job, and the theory is you could bleed a little more easily.

I want to be honest about how soft this evidence is. These effects have only been seen in test tubes and animals, never reported in people, and the everyday amount of honey you'd drizzle on toast or stir into tea is very unlikely to matter. Still, watch for things like easy bruising, nosebleeds, or bleeding gums, and check with your pharmacist or doctor before using large, concentrated honey supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ahmed, A., Khan, R. A., Azim, M. K., Saeed, S. A., Mesaik, M. A., Ahmed, S., and Imran, I. Effect of natural honey on human platelets and blood coagulation proteins. Pak.J Pharm Sci 2011;24(3):389-397.
  2. Martina SJ, Ramar LAP, Silaban MRI, Luthfi M, Govindan PAP. Antiplatelet Effectivity between Aspirin with Honey on Cardiovascular Disease Based on Bleeding Time Taken on Mice. Open Access Maced J Med Sci. 2019 Oct 14;7(20):3416-3420. 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

Honey Also Interacts With Other Medications

Honey has 5 moderate, 730 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.

Moderate 5 Minor 730 No known interaction 2,095 (incl. Rivaroxaban)
Taking anything else?

Check Another of Your Medications Against Honey

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

From our Q&A

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

We hold 298 real supplement products containing Honey, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Honey. Your product may carry other ingredients that interact with Rivaroxaban too, on top of Honey — 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 Honey 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 Honey
Top 25%

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

29 days ago today
Medication Rivaroxaban
Top 1%

#13 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 Honey

What is Honey?

Honey
  • Cough and sore throat
  • Wound and burn care
  • Soothing minor skin irritation
  • Sweetener and home remedy
  • Digestive upset

Honey is a natural food with some real, modest evidence for easing coughs and helping certain wounds, especially when special medical-grade or Manuka honey is used. It is generally safe for most adults and children over 1 year, but should never be given to infants under 12 months because of the risk of botulism.

Read the full Honey 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 & Honey

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

0Major
5Moderate
730Minor
2,094No known interaction
5 Moderate 730 Minor 2,094 No interaction
Moderate

5 interactions

Minor

730 interactions

Showing 60 of 730 minor interactions — see all 730 on the Honey page.

No interaction 2,094 drugs checked — show the list

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

Showing the 60 most looked-up of 2,094 medications checked with no known interaction — see the full Honey list.

See the full Honey interactions page
See every supplement checked against Rivaroxaban, 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
Honey monograph › Uses, safety, and every drug interaction in one place Rivaroxaban supplement interactions › Every supplement checked against Rivaroxaban, ranked by severity Rivaroxaban 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 Honey and Rivaroxaban Together: Common Questions

Can you take Honey 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 Honey and Rivaroxaban?
Rivaroxaban belongs to more than one drug category, and Honey 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 Honey 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 Honey?

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.