Drug & supplement interaction

Mastic + Rivaroxaban

Rivaroxaban brand name: Xarelto.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Mastic and Rivaroxaban in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Mastic and Rivaroxaban

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Rivaroxaban and Mastic in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Mastic at all — not against Rivaroxaban, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Mastic safety at a glance

Mastic overall Use caution Generally well tolerated in food and traditional amounts, but supplement-strength data are limited.
Pregnancy Avoid Not enough safety information; best to avoid medicinal amounts during pregnancy.
Breastfeeding Avoid Not enough safety information; best to avoid medicinal amounts while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Rivaroxaban and Mastic? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Mastic and Rivaroxaban May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Bleeding or bruising Worth acting on reported in 17.6% of FDA reports for Rivaroxaban Additional detail

    Mastic

    “Subcutaneously, administration of a specific mastic extract (RPh201, Regenera Pharma) has been most commonly reported to cause injection site pain and erythema. Pruritus, rash, and ecchymosis have also been reported with this extract.

    Topically, use of a specific mastic gum- and storax gum-containing product (Mastisol Liquid Adhesive, Ferndale Laboratories) has been associated with cases of allergic contact dermatiti…”

    Mastic · Natural Medicines adverse-effect record, reported in dermatitis.

    2 sources cited
    1. 103266. Hazan Z, Adamsky K, Lucassen A, Levin LA. A first-in-human phase 1 randomized single and multiple ascending dose study of RPh201 in healthy volunteers. Clin Pharmacol Drug Dev. 2020;9(3):366-74. PubMed
    2. 106467. Moraschini V, Kischinhevsky ICC, Calasans-Maia MD, et al. Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials. Clin Oral Investig 2020;24(6):1877-1888. PubMed

    Rivaroxaban

    Listed in the ADVERSE REACTIONS section of the FDA label for Rivaroxaban, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Mastic but not commonly for Rivaroxaban: constipation, a skin rash, dizziness and diarrhea.

Effects for Rivaroxaban come from the ADVERSE REACTIONS section of its FDA label; effects for Mastic come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 205,037 voluntary FDA FAERS reports for Rivaroxaban that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Mastic or Rivaroxaban

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Mastic or Rivaroxaban, 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 Rivaroxaban

This page covers Mastic only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rivaroxaban page lists 285 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 · 240 moderate · 40 minor.

From our pharmacist’s overview on the Rivaroxaban page

“Grapefruit is the interaction I would flag first for anyone taking rivaroxaban (Xarelto). It slows how the body clears this blood thinner, and higher levels mean more bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Rivaroxaban interaction page

One more smart check

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

We hold 104 real supplement products containing Mastic, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Mastic. Even though Mastic itself has no known interaction with Rivaroxaban, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Mastic and Rivaroxaban 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 Mastic
Top half

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

29 days ago today
Medication Rivaroxaban
Top 10

#10 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Mastic reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Mastic and Rivaroxaban records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Mastic

What is Mastic?

Mastic
  • Indigestion and stomach upset
  • Stomach ulcers and H. pylori support
  • Oral and gum health
  • Bad breath
  • General antioxidant/anti-inflammatory support

Mastic is a resin from the mastic tree that has a long history of use for digestive complaints and oral health. Some small studies suggest it may help with indigestion, stomach ulcers, and dental hygiene, but the evidence is limited and not conclusive. It is generally well tolerated in food amounts, but talk to your pharmacist or doctor before using it as a supplement, especially if you are pregnant or breastfeeding.

Pistacia lentiscus · Anacardiaceae · Resin (gum) from the tree; sometimes the essential oil · Capsules, chewable gum/resin tears, powder, essential oil, mouthwash, toothpaste

An interaction check asks whether these two react with each other — it does not ask whether Mastic is a good idea for someone in your situation. Here is what our Mastic record says about it on its own.

Mastic: dosing

There is no official or standardized dose of mastic. Studies have used different forms and amounts, so it is hard to recommend one exact dose. The strength of capsules, powders, and chewing products can vary a lot between brands.The safest approach is to follow the directions on the product label and not exceed the suggested amount. Because supplements are not tightly regulated, choose a reputable brand when possible.

From our Mastic monograph — the full record covers uses, side effects and every documented interaction.

Read the full Mastic monograph & all interactions
Medication

About Rivaroxaban

What Is Rivaroxaban Used For?

Brand name: Xarelto

Rivaroxaban tablets are used to reduce the risk of stroke in adults with nonvalvular atrial fibrillation (an irregular heart rhythm), treat deep vein thrombosis (DVT, a blood clot in a vein) and pulmonary embolism (PE, a blood clot in the lungs), and lower the chances of these clots coming back. They also help prevent clots after hip or knee replacement surgery, protect hospitalized patients at risk for clots, and — in combination with aspirin — reduce the risk of major cardiovascular events in adults with coronary artery disease (CAD) or peripheral artery disease (PAD).

Rivaroxaban tablets are also approved for treating VTE (venous thromboembolism, blood clots in veins) and preventing recurrence in pediatric patients from birth to under 18 years, and for preventing clots in children aged 2 and older with congenital heart disease after the Fontan procedure. Rivaroxaban for oral suspension (available as Rivaroxaban Granule and Xarelto oral suspension) is specifically indicated for these two pediatric uses.

See full Rivaroxaban drug information
Keep checking

Other Drugs & Mastic

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Mastic References

The 5 references that drive our Mastic monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Kaliora, A. C., Stathopoulou, M. G., Triantafillidis, J. K., Dedoussis, G. V., and Andrikopoulos, N. K. Chios mastic treatment of patients with active Crohn's disease. World J Gastroenterol. 2-7-2007;13(5):748-753. PubMed
  2. Dabos, K. J., Sfika, E., Vlatta, L. J., and Giannikopoulos, G. The effect of mastic gum on Helicobacter pylori: a randomized pilot study. Phytomedicine. 2010;17(3-4):296-299. PubMed
  3. Dabos, K. J., Sfika, E., Vlatta, L. J., Frantzi, D., Amygdalos, G. I., and Giannikopoulos, G. Is Chios mastic gum effective in the treatment of functional dyspepsia? A prospective randomised double-blind placebo controlled trial. J Ethnopharmacol. 2-3-20 PubMed
  4. Hazan Z, Adamsky K, Lucassen A, Levin LA. A first-in-human phase 1 randomized single and multiple ascending dose study of RPh201 in healthy volunteers. Clin Pharmacol Drug Dev. 2020;9(3):366-74. PubMed
  5. Moraschini V, Kischinhevsky ICC, Calasans-Maia MD, et al. Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials. Clin Oral Investig 2020;24(6):1877-1888. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Mastic and Rivaroxaban Together: Common Questions

Is it safe to take Mastic with Rivaroxaban?
We do not list a known interaction between Mastic and Rivaroxaban. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Mastic and Rivaroxaban have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Rivaroxaban interact with any supplements?
Yes. Rivaroxaban has documented interactions with 285 supplements in our database — Mastic is not one of them. The Rivaroxaban interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Rivaroxaban and Mastic?

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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.