Drug & supplement interaction

Japanese Persimmon + Vorapaxar

Vorapaxar brand name: Zontivity.

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

Japanese Persimmon has a moderate interaction with Vorapaxar. 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 Vorapaxar

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Vorapaxar

Vorapaxar 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

Here's the basic idea: Vorapaxar (Zontivity) is already a powerful blood thinner that keeps your platelets from clumping, and it's usually taken alongside aspirin and clopidogrel. The concern is that Japanese persimmon leaf may have its own mild blood-thinning activity, so stacking it on top could, in theory, add to that effect and raise your bleeding risk. Think easy bruising, nosebleeds, bleeding gums, or bleeding that's slow to stop.

I want to be honest about the strength of this, though. This is purely theoretical, based on lab (test tube) studies of persimmon leaf extracts, not anything seen in real people. Eating the fruit as food is unlikely to be a problem. Concentrated leaf extracts or supplements are the part to be cautious with, so please run those by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Vorapaxar one above is one of them. If you take anything else, check it against the full list below.

Moderate 288 No known interaction 2,542 (incl. Vorapaxar)
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 Vorapaxar

This page covers Japanese Persimmon only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Vorapaxar page lists 282 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 · 236 moderate · 41 minor.

From our pharmacist’s overview on the Vorapaxar page

“Vorapaxar (Zontivity) keeps platelets from clumping after a heart attack or clogged leg arteries, so it raises bleeding risk by design, and adding supplements calls for real caution. Of the 282 ingredients on file, 202 can thin the blood further, stacking their antiplatelet effects on the drug's.”

Reviewed by 2 · Jul 18, 2026

Open the Vorapaxar 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 Vorapaxar 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 Vorapaxar 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

#1,198 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Vorapaxar
Steady interest

#2,466 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
Medication

About Vorapaxar

What Is Vorapaxar Used For?

Brand name: Zontivity

Zontivity (vorapaxar) is used to lower the risk of heart attack, stroke, cardiovascular death, and the need for urgent procedures to open blocked arteries. It is prescribed for people who have already had a heart attack or who have peripheral arterial disease (PAD) — a condition where arteries outside the heart become narrowed or blocked.

Zontivity is not used alone. It is given alongside aspirin and/or clopidogrel as part of a broader antiplatelet treatment plan.

See full Vorapaxar drug information
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
288 Moderate 2,541 No 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

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

Showing the 60 most looked-up of 2,541 medications checked with no known interaction — see the full Japanese Persimmon list.

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

Can you take Japanese Persimmon with Vorapaxar?
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 Vorapaxar 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 Vorapaxar and Japanese Persimmon?

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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.