Drug & supplement interaction

Honey + Warfarin Sodium

Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.

Minor Interaction
The bottom line Minor

Warfarin Sodium 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?
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Interaction report

Honey and Warfarin Sodium

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. Warfarin Sodium 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 Warfarin Sodium

Warfarin Sodium 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 honest picture with honey and warfarin. The idea is that honey might speed up an enzyme called CYP3A4, which is one of the pathways your body uses to break down warfarin. If that were to happen consistently, your warfarin could clear a little faster and work slightly less, which in theory could nudge your INR down and make a clot more likely. But the research here is genuinely mixed. Some studies say honey revs up that enzyme, others found no effect at all, and different honey types behave differently.

Because warfarin is a narrow-therapeutic-index drug where even small shifts matter, I wouldn't panic, but I would keep things steady. Normal amounts of honey in tea or on toast are very unlikely to cause trouble. If you plan to take concentrated honey supplements daily, mention it to your pharmacist or doctor so they can watch your INR.

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

Warfarin Sodium 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

Good question to ask, since warfarin is one of those medicines where small shifts can matter. The concern here is purely theoretical. In lab dishes and in mice fed very large amounts, honey slowed down how platelets clump and stretched out clotting time a little. On paper, that could nudge warfarin's blood-thinning effect in the same direction, meaning a slightly higher chance of bleeding signs like easy bruising, nosebleeds, bleeding gums, or blood in your urine or stool.

The reassuring part: this has never actually been reported in people, and normal food amounts of honey (a spoon in tea or on toast) are very unlikely to cause trouble. If you plan to use large or daily medicinal doses, just mention it to your pharmacist or doctor, and keep up your regular INR checks.

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 Warfarin Sodium 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 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 Warfarin 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 Honey or Warfarin 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 Warfarin Sodium

This page covers Honey only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Warfarin Sodium page lists 361 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Alfalfa (major), American Ginseng (major), Beer (major) and Cannabis (major).

Open the Warfarin Sodium 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 Warfarin Sodium 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 Warfarin 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 Honey
Top 25%

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

29 days ago today
Medication Warfarin Sodium
Top 1%

#20 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 Warfarin

What Is Warfarin Used For?

Brand names: Coumadin, Panwarfin, Sofarin

Warfarin sodium tablets and Jantoven tablets are both used to prevent and treat venous thrombosis (blood clots in the veins) and pulmonary embolism (a clot in the lungs). They are also used to prevent clot-related complications in people with atrial fibrillation (an irregular heart rhythm) or who have had a heart valve replaced.

In people who have had a heart attack, warfarin is used to reduce the risk of death, another heart attack, stroke, or other clotting events. It does not dissolve an existing clot, but it helps prevent the clot from growing and stops new dangerous clots from forming.

See full Warfarin 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
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
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 Honey and Warfarin Sodium Together: Common Questions

Can you take Honey with Warfarin Sodium?
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 Warfarin Sodium?
Warfarin Sodium 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 Warfarin Sodium 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

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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.