Drug & supplement interaction

Japanese Persimmon + Lepirudin

Lepirudin brand name: Refludan.

Moderate Interaction
The bottom line Moderate

Japanese Persimmon has a moderate interaction with Lepirudin. There is concern that Japanese persimmon leaf constituents might potentiate effects of anticoagulant and antiplatelet drugs.

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

Japanese Persimmon 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 Japanese Persimmon interacts with.

There is concern that Japanese persimmon leaf constituents might potentiate effects of anticoagulant and antiplatelet drugs. In vitro research shows that certain Japanese persimmon leaf extract protein fractions have anticoagulant activity. These fractions are thought to bind fibrinogen leading to thrombin inactivation. This effect has not been shown in humans.
Some anticoagulant and antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopidine (Ticlid), warfarin (Coumadin), and others.
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 is a powerful injectable blood thinner. It works as a direct thrombin inhibitor, meaning it blocks the clotting enzyme thrombin so your blood doesn't clot as easily. It's usually given in a hospital to people who can't safely use heparin.

Here's the concern with persimmon: in lab dish studies, certain protein pieces from persimmon leaf extracts also showed blood-thinning activity, partly by interfering with the same clotting steps. In theory, stacking that on top of Lepirudin could nudge your bleeding risk higher (think easy bruising, nosebleeds, or harder-to-stop bleeding). But this has never been shown in people, and eating the fruit as food is a different story from concentrated leaf supplements. Since Lepirudin is closely monitored anyway, just tell your care team about any persimmon products before using them.

References
  1. Sa YS, Kim SJ, Choi HS. The anticoagulant fraction from the leaves of Diospyros kaki L. has an antithrombotic activity. Arch Pharm Res. 2005;28(6):667-74.

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

Japanese Persimmon Also Interacts With Other Medications

Japanese Persimmon has 288 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.

Taking anything else?

Check Another of Your Medications Against Japanese Persimmon

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

Everything else you take

See Every Supplement That Interacts With Lepirudin

This page covers Japanese Persimmon 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 Japanese Persimmon as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1 real supplement products containing Japanese Persimmon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Japanese Persimmon. Your product may carry other ingredients that interact with Lepirudin too, on top of Japanese Persimmon — 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 Japanese Persimmon 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 Japanese Persimmon
Steady interest

#1,448 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Lepirudin
Steady interest

#2,661 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 Japanese Persimmon

What is Japanese Persimmon?

  • High blood pressure
  • Cough and hiccups (traditional use)
  • Antioxidant support
  • Digestive health and fiber
  • Skin and general wellness

Japanese persimmon is a nutritious fruit rich in fiber, vitamins, and antioxidant plant compounds, and its leaves and calyx are used in traditional medicine. While eating the fruit as food is generally safe and healthy, the evidence for concentrated supplements or leaf extracts treating specific conditions is limited. Talk to your pharmacist or doctor before using persimmon products medicinally.

Read the full Japanese Persimmon monograph & all interactions
Keep checking

Other Drugs & Japanese Persimmon

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

0Major
288Moderate
0Minor
2,541No known interaction
Moderate

288 interactions

Showing 60 of 288 moderate interactions — see all 288 on the Japanese Persimmon page.

No interaction 2,541 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 Japanese Persimmon and Lepirudin Together: Common Questions

Can you take Japanese Persimmon 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 Japanese Persimmon 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

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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.