Licorice + Warfarin Sodium
Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.
Warfarin Sodium falls into 6 drug categories that Licorice can interact with; the most serious is rated moderate. Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
Read the full interaction reportLicorice and Warfarin Sodium
These two interact in 6 distinct ways. Each one is explained separately below.
Why Are There 6 Interactions?
Licorice interacts with whole categories of medication. Warfarin Sodium falls into 6 of those categories, so it can interact with Licorice in 6 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
1 of 6Why this applies to Warfarin Sodium
Warfarin Sodium falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Licorice interacts with.
In vitro, licorice extracts from the species G. glabra and G. uralensis inhibit CYP2C19 isoenzymes in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C19; however, this interaction has not yet been reported in humans.
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.
Here's the situation with licorice and your warfarin. Warfarin is a blood thinner that your liver partly clears using an enzyme called CYP2C19. In lab studies (not in actual people yet), licorice slowed that enzyme down. If that effect held true in the body, your warfarin could build up a little, which might thin your blood more than intended and raise your risk of bruising, nosebleeds, or other bleeding.
I want to be honest: this is theoretical, based only on test-tube data, and it hasn't been seen in real patients. But warfarin is a finicky drug where even small shifts matter, so I wouldn't add a licorice supplement without first checking with your pharmacist or doctor. Occasional culinary amounts are far less concerning than concentrated daily supplements.
- Li G, Simmler C, Chen L, et al. Cytochrome P450 inhibition by three licorice species and fourteen licorice constituents. Eur J Pharm Sci. 2017;109:182-190. PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
2 of 6Warfarin Sodium also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
There is conflicting evidence about the effect of licorice on CYP2C9 enzyme activity. In vitro research shows that extracts from the licorice species G. glabra and G. uralensis moderately inhibit CYP2C9 isoenzymes. However, evidence from an animal model shows that licorice extract from the species G. uralensis can induce hepatic CYP2C9 activity. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates.
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.
Here's the deal with licorice and your warfarin. Warfarin is partly cleared by a liver enzyme called CYP2C9, and licorice may bump that enzyme's activity in either direction. The catch is that this is based only on lab and animal studies, so it's more of a theoretical concern than something we've clearly seen in people. Still, warfarin is one of those drugs where even small shifts matter.
If licorice slowed your warfarin's breakdown, levels could climb and raise bleeding risk (think easy bruising, nosebleeds, blood in urine or stool). If it sped things up, your warfarin could work less well and clots become the worry. Don't change anything on your own. Loop in your pharmacist or doctor, and keep your INR checks on schedule. DGL licorice is also gentler overall.
- Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15.. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Li G, Simmler C, Chen L, et al. Cytochrome P450 inhibition by three licorice species and fourteen licorice constituents. Eur J Pharm Sci. 2017;109:182-190. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 6Warfarin Sodium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
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.
Here's the practical picture with warfarin and licorice. Warfarin is a blood thinner that walks a very tight line. Too much and you risk bleeding (easy bruising, nosebleeds, blood in urine or stool); too little and a clot can slip through. Licorice may nudge a liver enzyme (CYP3A4) that plays a part in clearing warfarin, but the lab and animal data point in both directions depending on the licorice species, so we honestly can't predict which way your INR would move.
Because warfarin is so dose-sensitive, even a small shift matters. Don't start or stop anything on your own. If you're using or considering licorice (DGL is gentler on blood pressure), tell your pharmacist or doctor so they can watch your INR more closely.
- Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15.. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Tu, J. H., He, Y. J., Chen, Y., Fan, L., Zhang, W., Tan, Z. R., Huang, Y. F., Guo, D., Hu, D. L., Wang, D., and Hong-Hao Zhou. Effect of glycyrrhizin on the activity of CYP3A enzyme in humans. Eur J Clin Pharmacol 2010;66(8):805-810. PubMed
- Li G, Simmler C, Chen L, et al. Cytochrome P450 inhibition by three licorice species and fourteen licorice constituents. Eur J Pharm Sci. 2017;109:182-190. PubMed
CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES
4 of 6Warfarin Sodium also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.
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.
Here's the gist for warfarin. In lab dishes, certain licorice species seem to slow down an enzyme called CYP2C8, which is one of the pathways your body uses to clear warfarin. If that pathway slows, warfarin could theoretically build up a bit, and since warfarin already walks a very fine line, even small shifts can nudge you toward easy bruising, nosebleeds, or more serious bleeding. Your INR could climb.
That said, this is only test-tube evidence and hasn't actually been seen in real people yet. Still, warfarin is unforgiving, and regular licorice has its own blood pressure and potassium effects. Before adding any licorice product, please check with your pharmacist or doctor so your INR can be watched.
- Li G, Simmler C, Chen L, et al. Cytochrome P450 inhibition by three licorice species and fourteen licorice constituents. Eur J Pharm Sci. 2017;109:182-190. PubMed
WARFARIN (Coumadin)
5 of 6Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.
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.
Here's the gist for warfarin and licorice. In animal studies, licorice seems to speed up an enzyme in your liver called CYP2C9, which is the main pathway your body uses to clear warfarin. If warfarin gets cleared faster, its blood-thinning effect can weaken, and that raises the worry of clots forming, the very thing warfarin is meant to prevent.
Warfarin is a narrow-window drug, so even small shifts in your INR matter. I'll be honest though: this interaction is theoretical and comes from lab and animal data, not solid human studies. Occasional culinary licorice flavoring is unlikely to be the issue; regular use of licorice supplements is the bigger concern. Please check with your pharmacist or doctor before adding it, and never change your warfarin on your own.
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
6 of 6Warfarin Sodium also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research shows that licorice induces CYP1A2 enzymes.
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.
Here's the gist for warfarin: lab studies suggest licorice may speed up an enzyme called CYP1A2, which is one of the pathways that helps clear warfarin from your body. In theory, that faster clearance could lower your warfarin levels a bit and make it work less strongly, meaning your blood might not be thinned as much as your doctor intended. Warfarin is a narrow-margin drug, so even small shifts can nudge your INR off track.
I want to be honest, though: this is only seen in test-tube research, not real patients, and it's rated as minor. Still, because warfarin needs careful monitoring, please loop in your pharmacist or doctor before adding licorice supplements (DGL is gentler), and keep up with your regular INR checks.
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Licorice Also Interacts With Other Medications
Licorice has 976 moderate, 63 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.
Check Another of Your Medications Against Licorice
We haven’t checked that one against Licorice yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Licorice. Pick one to open its full report.
Questions About Licorice 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 Licorice 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:
- Concerns With Taking Licorice With Metoprolol ›
- Does Ginger Water Interfere With Amoxicillin-Clavulanate? ›
- Can Licorice Or Alfalfa Affect Birth Control Pills? ›
- Can You Take Nattokinase With a 40 mg Statin? ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Warfarin Sodium
This page covers Licorice 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).
Taking Licorice as Part of a Dietary Supplement Product? Check It for Interactions
We hold 4,721 real supplement products containing Licorice, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Licorice. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Licorice — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Licorice 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.
#36 of 1,452 supplements looked up here in the last 7 days
#30 of 2,830 medications looked up here in the last 7 days
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.
About Licorice
What is Licorice?
- Sore throat and cough
- Heartburn and stomach upset
- Mouth ulcers and digestive complaints
- Inflammation
- Traditional tonic/adrenal support
Licorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, which can raise blood pressure and lower potassium when taken in large amounts or for a long time, so deglycyrrhizinated (DGL) products are often preferred. Talk to your pharmacist or doctor before using it, especially if you have high blood pressure, heart, or kidney problems.
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.
Other Drugs & Licorice
Browse every other medication we’ve checked against Licorice — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
976 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Hydrocortisone ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ivermectin ›
- Lofepramine ›
- Medroxyprogesterone ›
Showing 60 of 976 moderate interactions — see all 976 on the Licorice page.
63 interactions
- Theophylline ›
- Acetaminophen ›
- Methotrexate ›
- Nortriptyline ›
- Bendamustine ›
- Riluzole ›
- Asenapine ›
- Clozapine ›
- Propafenone ›
- Ropinirole ›
- Tizanidine ›
- Anagrelide ›
- Bendamustine Hydrochloride ›
- Chlordiazepoxide ›
- Fezolinetant ›
- Fluvoxamine ›
- Grepafloxacin ›
- Methotrexate Sodium ›
- Mexiletine ›
- Olanzapine ›
- Paracetamol ›
- Pentazocine ›
- Pirfenidone ›
- Rasagiline ›
- Ropivacaine ›
- Tacrine ›
- Triclabendazole ›
- Acetaminophen, Butalbital ›
- Acetaminophen, Pseudoephedrine ›
- Guaifenesin, Theophylline ›
- Acetaminophen, Dichloralantipyrine, Isometheptene ›
- Acetaminophen, Oxycodone ›
- Acetaminophen, Propoxyphene ›
- Acetaminophen, Chlorzoxazone ›
- Acetaminophen, Diphenhydramine, Pseudoephedrine ›
- Acetaminophen, Chlorzoxazone, Codeine ›
- Acetaminophen, Codeine ›
- Acetaminophen, Codeine, Methocarbamol ›
- Acetaminophen, Diphenhydramine ›
- Acetaminophen, Phenyltoloxamine ›
- Ephedrine, Hydroxyzine, Theophylline ›
- Acetaminophen, Aspirin ›
- Acetaminophen, Brompheniramine, Phenylpropanolamine ›
- Acetaminophen, Butalbital, Codeine ›
- Acetaminophen, Butalbital, Codeine Phosphate ›
- Acetaminophen, Codeine, Doxylamine ›
- Acetaminophen, Dexbrompheniramine, Pseudoephedrine ›
- Acetaminophen, Dichloralphenazone, Isometheptene ›
- Acetaminophen, Dichlorophenazone, Isometheptane ›
- Acetaminophen, Doxylamine, Pseudoephedrine ›
- Acetaminophen, Meperidine ›
- Acetaminophen, Methocarbamol ›
- Acetaminophen, Pentazocine ›
- Acetaminophen, Phenylpropanolamine ›
- Acetaminophen, Phenylpropanolamine, Phenyltoloxamine ›
- Acetaminophen, Phenyltoloxamine, Salicylamide ›
- Acetaminophen, Pseudoephedrine, Triprolidine ›
- Aspirin, Pentazocine ›
- Chlordiazepoxide, Clidinium Bromide ›
- Codeine, Paracetamol ›
Showing 60 of 63 minor interactions — see all 63 on the Licorice page.
No interaction 1,790 drugs checked — show the list
We also checked Licorice against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Tirzepatide ›
- Methamphetamine ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Lisdexamfetamine ›
- Metformin ›
- Amoxicillin ›
- Amphetamine ›
- Acyclovir ›
- Azithromycin ›
- Lamotrigine ›
- Pregabalin ›
- Dextroamphetamine ›
- Gabapentin ›
- Levothyroxine, Liothyronine ›
- Duloxetine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Amoxicillin, Clavulanate Potassium ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Cephalexin ›
- Cyclopentolate ›
- Ezetimibe ›
- Roxithromycin ›
- Acetylsalicylic Acid ›
- Levetiracetam ›
- Carbidopa, Levodopa ›
- Phentermine, Topiramate ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Thyroid Hormone ›
- Levodopa ›
- Pizotifen ›
- Venlafaxine ›
- Daptomycin ›
- Canagliflozin, Metformin ›
- Lenvatinib ›
- Hexobarbitone ›
- Flutemetamol F-18 ›
- Magnesium Hydroxide (otc Drug) ›
- Mitomycin ›
- Cefaclor ›
- Insulin Degludec, Liraglutide ›
- Pegunigalsidase Alfa-iwxj ›
- Bentoquatam ›
- Alglucosidase Alpha ›
- Salbutamol Sulfate ›
- Amobarbital, Ephedrine Sulfate ›
- Hethylphenidate Hcl ›
- Factor 7a ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Vancomycin ›
Showing the 60 most looked-up of 1,790 medications checked with no known interaction — see the full Licorice list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Taking Licorice and Warfarin Sodium Together: Common Questions
Can you take Licorice with Warfarin Sodium?
Why are there 6 interactions listed for Licorice and Warfarin Sodium?
How serious is the Licorice and Warfarin Sodium interaction?
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.