Drug & supplement interaction

Inositol Nicotinate + Lepirudin

Lepirudin brand name: Refludan.

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

Inositol Nicotinate has a moderate interaction with Lepirudin. Theoretically, concomitant use of inositol nicotinate with anticoagulant or antiplatelet drugs might increase the risk of bleeding.

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

Inositol Nicotinate and Lepirudin

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Lepirudin

Lepirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Inositol Nicotinate interacts with.

Theoretically, concomitant use of inositol nicotinate with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
Inositol nicotinate has fibrinolytic effects, which may increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
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

Lepirudin (Refludan) is a powerful injectable blood thinner. It directly blocks thrombin, a key clotting protein, so its whole job is to make your blood less likely to clot. Inositol nicotinate, a 'no-flush' niacin product, is thought to have mild fibrinolytic (clot-dissolving) and blood-vessel-widening effects. Stacking the two could, in theory, push your bleeding risk higher.

I want to be honest about how strong this concern is: it's based on pharmacology and theory, not solid human studies, so it may never cause a problem for you. Still, with a drug as potent as lepirudin, watch for easy bruising, nosebleeds, bleeding gums, pink urine, or dark stools, and tell your care team right away. Never start or stop either one on your own. Run it by your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.
  2. Holti G. An experimentally controlled evaluation of the effect of inositol nicotinate upon the digital blood flow in patients with Raynaud's phenomenon. J Int Med Res 1979;7:473-83. 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

Inositol Nicotinate Also Interacts With Other Medications

Inositol Nicotinate has 222 moderate known drug interactions in our database — the Lepirudin one above is one of them. If you take anything else, check it against the full list below.

Moderate 222 No known interaction 2,608 (incl. Lepirudin)
Taking anything else?

Check Another of Your Medications Against Inositol Nicotinate

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

Everything else you take

See Every Supplement That Interacts With Lepirudin

This page covers Inositol Nicotinate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lepirudin page lists 218 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), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Lepirudin page

“Lepirudin (Refludan) is a potent injectable blood thinner, typically given when heparin has caused a dangerous platelet reaction, and that makes this a list to read with real care. Of the 218 supplements and herbs with interactions on file, 202 can slow clotting on their own, piling extra bleeding risk onto a drug whose chief hazard is…”

Reviewed by 2 · Jul 18, 2026

Open the Lepirudin interaction page

One more smart check

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

We hold 202 real supplement products containing Inositol Nicotinate, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Inositol Nicotinate. Your product may carry other ingredients that interact with Lepirudin too, on top of Inositol Nicotinate — 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 Inositol Nicotinate and Lepirudin 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 Inositol Nicotinate
Top half

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

29 days ago today
Medication Lepirudin
Steady interest

#1,897 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 Inositol Nicotinate

What is Inositol Nicotinate?

Inositol Nicotinate
  • Cholesterol support
  • Improving circulation
  • Raynaud's phenomenon
  • Intermittent claudication (leg pain with walking)
  • A 'no-flush' niacin alternative

Inositol nicotinate is a 'no-flush' form of niacin marketed for cholesterol and circulation. Evidence that it works as well as regular niacin is weak and inconsistent, and it is not a proven replacement for prescription cholesterol treatment. Talk to your pharmacist or doctor before using it, especially if you have liver problems or take other medicines.

Read the full Inositol Nicotinate monograph & all interactions
Keep checking

Other Drugs & Inositol Nicotinate

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

0Major
222Moderate
0Minor
2,607No known interaction
222 Moderate 2,607 No interaction
Moderate

222 interactions

Showing 60 of 222 moderate interactions — see all 222 on the Inositol Nicotinate page.

No interaction 2,607 drugs checked — show the list

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

Showing the 60 most looked-up of 2,607 medications checked with no known interaction — see the full Inositol Nicotinate list.

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

Can you take Inositol Nicotinate with Lepirudin?
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 Inositol Nicotinate and Lepirudin 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 Lepirudin and Inositol Nicotinate?

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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.