Drug & supplement interaction

Indole-3-carbinol + Warfarin Sodium

Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.

Moderate Interaction
The bottom line Moderate

Warfarin Sodium falls into 2 drug categories that Indole-3-carbinol can interact with; the most serious is rated moderate. Theoretically, indole-3-carbinol might increase the metabolism of CYP1A2 substrates and lower serum concentrations.

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

Indole-3-carbinol and Warfarin Sodium

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

Why Are There 2 Interactions?

Indole-3-carbinol interacts with whole categories of medication. Warfarin Sodium falls into 2 of those categories, so it can interact with Indole-3-carbinol in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Warfarin Sodium

Warfarin Sodium falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Indole-3-carbinol interacts with.

Theoretically, indole-3-carbinol might increase the metabolism of CYP1A2 substrates and lower serum concentrations.
Animal research shows that indole-3-carbinol induces CYP1A2 enzymes.
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 idea with this pairing. Your liver uses several enzymes to clear warfarin, and one of them is called CYP1A2. In lab and animal studies, indole-3-carbinol (I3C) seems to speed up that enzyme. If that held true in people, your body might break warfarin down a bit faster, which could lower its blood-thinning effect and theoretically let a clot form. I want to be honest though: this is based only on test-tube and animal data, so it's a possibility, not something proven in humans.

Because warfarin is one of those drugs where small shifts really matter, your INR is the thing to watch. Please don't start, stop, or change anything on your own. Just loop in your pharmacist or the clinic managing your warfarin before adding an I3C supplement.

References
  1. He YH, Friesen MD, Ruch RJ, Schut HA. Indole-3-carbinol as a chemopreventive agent in 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) carcinogenesis: inhibition of PhIP-DNA adduct formation, acceleration of PhIP metabolism, and induction of cytoch
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Warfarin Sodium also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, indole-3-carbinol might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
In vitro research shows that indole-3-carbinol inhibits platelet aggregation.
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 with warfarin and indole-3-carbinol (I3C). Warfarin already keeps your blood from clotting easily, and lab research suggests I3C may slow how your platelets stick together. Put those two together, in theory, and you could lean further toward easy bleeding. Think more bruising, nosebleeds, bleeding gums, or cuts that take longer to stop.

I want to be honest about the evidence though: this concern comes from test-tube studies, not from real people taking both. It's a theoretical caution, not a proven problem. Still, warfarin is a finicky drug where small shifts matter, so don't add an I3C supplement without checking with your pharmacist or doctor first. Broccoli or cabbage on your plate is a different story and generally fine.

References
  1. Paliwal P, Chauhan G, Gautam D, Dash D, Patne SCU, Krishnamurthy S. Indole-3-carbinol improves neurobehavioral symptoms in a cerebral ischemic stroke model. Naunyn Schmiedebergs Arch Pharmacol. 2018;391(6):613-625. 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

Indole-3-carbinol Also Interacts With Other Medications

Indole-3-carbinol has 293 moderate 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 Indole-3-carbinol

Covers the 2,830 medications we’ve checked against Indole-3-carbinol. Pick one to open its full report.

From our Q&A

Questions About Indole-3-carbinol 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 Indole-3-carbinol 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 Indole-3-carbinol 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 Indole-3-carbinol as Part of a Dietary Supplement Product? Check It for Interactions

We hold 287 real supplement products containing Indole-3-carbinol, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indole-3-carbinol. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Indole-3-carbinol — 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 Indole-3-carbinol 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 Indole-3-carbinol
Top 25%

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

29 days ago today
Medication Warfarin Sodium
Top 1%

#18 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 Indole-3-carbinol

What is Indole-3-carbinol?

  • Estrogen and hormone balance support
  • Breast and cervical health
  • Prostate health
  • Antioxidant and 'detox' support
  • General cancer-prevention interest

Indole-3-carbinol (I3C) is a compound formed when you eat cruciferous vegetables like broccoli and cabbage, and it is sold as a supplement mainly for hormone-related and cell-protective effects. Most human evidence is preliminary or comes from lab and animal studies, so it should not be relied on to prevent or treat any disease. Talk to your pharmacist or doctor before using it, and avoid it in pregnancy and breastfeeding.

Read the full Indole-3-carbinol 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 & Indole-3-carbinol

Browse every other medication we’ve checked against Indole-3-carbinol — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
293Moderate
0Minor
2,536No known interaction
Moderate

293 interactions

Showing 60 of 293 moderate interactions — see all 293 on the Indole-3-carbinol page.

No interaction 2,536 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 Indole-3-carbinol and Warfarin Sodium Together: Common Questions

Can you take Indole-3-carbinol with Warfarin Sodium?
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 Indole-3-carbinol and Warfarin Sodium?
Warfarin Sodium belongs to more than one drug category, and Indole-3-carbinol 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 Indole-3-carbinol and Warfarin Sodium 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

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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.