Drug & supplement interaction

Pennyroyal + Rivaroxaban

Rivaroxaban brand name: Xarelto.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Pennyroyal 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

Pennyroyal 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 Pennyroyal 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.

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.

Pennyroyal safety at a glance

Pennyroyal overall Avoid Pennyroyal oil is highly toxic and has caused liver failure and death.
Pregnancy Likely Unsafe When used orally or topically. Pennyroyal essential oil has been used traditionally as an abortifacient. Pennyroyal leaf tea is reported to cause onset of mense... Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally or topically; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Rivaroxaban and Pennyroyal? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Rivaroxaban

Interactions in our licensed database are recorded against drug classes, not just single drug names. Rivaroxaban is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Pennyroyal has documented interactions with 1 drug class — the most serious being acetaminophen (tylenol, others) (moderate) — and none of Rivaroxaban’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Pennyroyal Does Interact With Other Medications

Pennyroyal has 69 moderate known drug interactions in our database — Rivaroxaban isn’t one of them. If you take anything else, check it against the full list below.

Moderate 69 No known interaction 2,761 (incl. Rivaroxaban)
Taking anything else?

Check Another of Your Medications Against Pennyroyal

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

What to actually watch for

No Interaction Found — But Data Suggests Pennyroyal and Rivaroxaban May Share Several of the Same Side Effects

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.

  • An irregular heartbeat Worth acting on Additional detail

    Pennyroyal

    “The main constituent of pennyroyal essential oil, pulegone, and its metabolite menthofuran, are hepatotoxic (12). Orally, pennyroyal essential oil can cause liver failure (12,5601). A case report describes a 76-year-old adult who developed liver failure with duodenitis, hypotension, and cardiac arrhythmias after taking pennyroyal and acetaminophen concurrently.”

    Pennyroyal · Natural Medicines adverse-effect record, reported in arrhythmia.

    3 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI
    3. 101477. Fozard J, Hieger M. Hepatic failure from pennyroyal tea interaction with medications metabolized by the cytochrome P450 enzymes. Am J Ther 2019 Aug 13. doi: 10.1097/MJT.0000000000001052. [Epub ahead of print]. PubMed

    Rivaroxaban

    Listed in the ADVERSE REACTIONS section of the FDA label for Rivaroxaban. Read the label on DailyMed ›

  • Vomiting Additional detail

    Pennyroyal

    “Orally, herbal teas prepared with pennyroyal leaves can cause nausea and abdominal cramping (12). Pennyroyal essential oil causes more severe gastrointestinal effects, including abdominal pain, burning of the throat, and vomiting (12,5601).”

    Pennyroyal · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    2 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI

    Rivaroxaban

    Listed in the ADVERSE REACTIONS section of the FDA label for Rivaroxaban. Read the label on DailyMed ›

Reported for Pennyroyal but not commonly for Rivaroxaban: hallucinations, stomach pain, kidney problems and anxiety or restlessness.

Effects for Rivaroxaban come from the ADVERSE REACTIONS section of its FDA label; effects for Pennyroyal 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.

Special populations

Pennyroyal in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally or topically. Pennyroyal essential oil has been used traditionally as an abortifacient. Pennyroyal leaf tea is reported to cause onset of menses.

Lactation Likely Unsafe

When used orally or topically; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Pennyroyal 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 Pennyroyal 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 Pennyroyal 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 Pennyroyal as Part of a Dietary Supplement Product? Check It for Interactions

We hold 11 real supplement products containing Pennyroyal, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Pennyroyal. Even though Pennyroyal 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 Pennyroyal 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 Pennyroyal
Steady interest

#1,120 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 Pennyroyal reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Pennyroyal and Rivaroxaban records this page draws on were last updated July 11, 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 Pennyroyal

What is Pennyroyal?

  • Digestive upset
  • Menstrual cramps
  • Inducing menstruation or abortion (dangerous)
  • Colds and coughs
  • Insect repellent

Pennyroyal is a mint-family plant whose essential oil is highly toxic and has caused serious poisonings and deaths, especially when used to try to bring on a period or end a pregnancy. There is no reliable evidence that it safely treats any condition, and the oil should never be swallowed. Avoid pennyroyal and talk to your pharmacist or doctor about safer options.

Mentha pulegium · Lamiaceae · Leaves, flowering tops, and essential oil · Tea, dried herb, tincture, essential oil

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

Pennyroyal: dosing

There is no established safe dose for pennyroyal, and health experts generally advise against using it at all because of its toxicity.The essential oil should never be swallowed, and even teas made from the herb carry risk. Because of these dangers, we do not recommend a dose.

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

Read the full Pennyroyal 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 & Pennyroyal

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

0Major
69Moderate
0Minor
2,760No known interaction
69 Moderate 2,760 No interaction
Moderate

69 interactions

Showing 60 of 69 moderate interactions — see all 69 on the Pennyroyal page.

No interaction 2,760 drugs checked — show the list

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

Showing the 60 most looked-up of 2,760 medications checked with no known interaction — see the full Pennyroyal list.

See the full Pennyroyal interactions page
See every supplement checked against Rivaroxaban, ranked by severity
Evidence & sources

Pennyroyal References

The 8 references that drive our Pennyroyal 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. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Bakerink JA, Gospe SM Jr, Dimand RJ, Eldridge MW. Multiple organ failure after ingestion of pennyroyal oil from herbal tea in two infants. Pediatrics 1996;98:944-7. DOI
  5. Sudekum M, Poppenga RH, Raju N, Braselton WE Jr. Pennyroyal oil toxicosis in a dog. J Am Vet Med Assoc 1992;200:817-8.. DOI
  6. Anderson IB, Mullen WH, Meeker JE, et al. Pennyroyal toxicity: measurement of toxic metabolite levels in two cases and review of the literature. Ann Intern Med 1996;124:726-34. PubMed
  7. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI
  8. Fozard J, Hieger M. Hepatic failure from pennyroyal tea interaction with medications metabolized by the cytochrome P450 enzymes. Am J Ther 2019 Aug 13. doi: 10.1097/MJT.0000000000001052. [Epub ahead of print]. 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 Pennyroyal and Rivaroxaban Together: Common Questions

Is it safe to take Pennyroyal with Rivaroxaban?
We do not list a known interaction between Pennyroyal 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 Pennyroyal and Rivaroxaban have any of the same side effects?
Yes — our sources link each of them separately to 2 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.
How was the Pennyroyal and Rivaroxaban combination checked?
Interactions in our licensed database are recorded against drug classes. Rivaroxaban is filed under 5 classifications, and Pennyroyal has documented interactions with 1 drug class — none of Rivaroxaban's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Pennyroyal interact with any other medications?
Yes. Pennyroyal has 69 documented drug interactions in our database — Rivaroxaban is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Rivaroxaban interact with any supplements?
Yes. Rivaroxaban has documented interactions with 285 supplements in our database — Pennyroyal 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

Where next

Keep Exploring

Pennyroyal monograph Uses, safety profile, and every drug interaction in one place Rivaroxaban drug information The full plain-English guide to this medication Rivaroxaban supplement interactions Every supplement checked against Rivaroxaban, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 8 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Rivaroxaban and Pennyroyal?

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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.