Drug & supplement interaction

Papain + Warfarin

Warfarin brand name: Warfarin.

Moderate Interaction
The bottom line Moderate

Papain has a moderate interaction with Warfarin. Theoretically, papain might increase the effects and side effects of warfarin.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Papain and Warfarin

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

Moderate

WARFARIN (Coumadin)

Theoretically, papain might increase the effects and side effects of warfarin.
In one case report, a patient previously stable on warfarin was found to have an international normalization ratio (INR) of 7.4, which was attributed to ingestion of a supplement containing papain from papaya extract.
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 gist with warfarin and papain. Warfarin is a tricky blood thinner where small changes really matter, and the concern here is that papain may boost warfarin's effect, thinning your blood more than intended. That can raise your risk of bleeding problems like easy bruising, nosebleeds, bleeding gums, or blood in your urine or stool.

I want to be honest about how solid this is: it's mostly theoretical, backed by a single case report where someone's INR jumped to 7.4 after a papaya papain supplement. That's weak evidence, and the tiny amounts in food are unlikely to matter. Still, because warfarin leaves so little room for error, please check with your pharmacist or doctor before adding a concentrated papain supplement.

References
  1. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.

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

Papain Also Interacts With Other Medications

Papain has 1 moderate known drug interaction in our database — the Warfarin 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 Papain

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

From our Q&A

Questions About Papain or Warfarin

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

This page covers Papain only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Warfarin 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).

By severity: 16 major · 301 moderate · 44 minor.

From our pharmacist’s overview on the Warfarin page

“People take warfarin to prevent dangerous clots, and many are the same people reaching for glucosamine for sore joints or a multivitamin containing vitamin K, which makes this a list that deserves genuine respect. Of the 361 supplements on file for warfarin, 16 carry a major rating, and the danger runs in both directions: some add to w…”

Reviewed by 2 · Jul 18, 2026

Open the Warfarin interaction page

One more smart check

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

We hold 3,790 real supplement products containing Papain, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Papain. Your product may carry other ingredients that interact with Warfarin too, on top of Papain — 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 Papain and Warfarin 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 Papain
Top 5%

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

29 days ago today
Medication Warfarin
Top 10

#7 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 Papain

What is Papain?

Papain
  • Digestive support for protein digestion
  • Wound cleaning (debridement of dead tissue)
  • Sore throat and inflammation
  • Sports injuries such as sprains
  • Skin conditions

Papain is a protein-digesting enzyme from the papaya plant that is used in digestive supplements and some topical products. While it has clear food and laboratory uses, strong human evidence for most health claims is limited, and it can cause allergic reactions or throat irritation. Check with a pharmacist or doctor before using it, especially if you have a latex or papaya allergy.

Read the full Papain monograph & all interactions
Medication

About Warfarin

What Is Warfarin Used For?

Brand name: Warfarin

Warfarin helps prevent and treat harmful blood clots. The label lists these uses for both Warfarin Sodium tablets and Jantoven tablets:

  • Preventing and treating venous thrombosis (clots in the veins) and pulmonary embolism (clots in the lungs).
  • Preventing and treating clot-related complications of atrial fibrillation and/or heart valve replacement.
  • Lowering the risk of death, another heart attack, and clot-related events such as stroke after a heart attack.

Warfarin does not dissolve a clot that has already formed. It helps stop the clot from growing and prevents further clot-related complications.

See full Warfarin drug information
Keep checking

Other Drugs & Papain

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

0Major
1Moderate
0Minor
2,828No known interaction
Moderate

1 interaction

No interaction 2,828 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

Keep exploring
Pharmacist Counseling Corner

Taking Papain and Warfarin Together: Common Questions

Can you take Papain with Warfarin?
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 Papain and Warfarin 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 Warfarin and Papain?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.