Red Clover + Warfarin Sodium
Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.
Warfarin Sodium falls into 5 drug categories that Red Clover can interact with; the most serious is rated minor. Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
Read the full interaction reportRed Clover and Warfarin Sodium
These two interact in 5 distinct ways. Each one is explained separately below.
Why Are There 5 Interactions?
Red Clover interacts with whole categories of medication. Warfarin Sodium falls into 5 of those categories, so it can interact with Red Clover in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 5Why this applies to Warfarin Sodium
Warfarin Sodium falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Red Clover interacts with.
In vitro evidence shows that red clover inhibits CYP1A2. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine, a CYP1A2 probe substrate.
Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..
Here's the gist with red clover and your warfarin. In a test tube, red clover's isoflavones can block an enzyme called CYP1A2, which is one of the pathways your body uses to break down warfarin. In theory, slowing that pathway could let warfarin build up a bit, nudging your blood thinner toward thinner. That might show up as easy bruising, nosebleeds, or a higher INR on your bloodwork.
But here's the reassuring part: this is lab-only evidence, and a small human study actually found red clover didn't change how a similar drug was processed. So a real-world problem is unlikely. Still, warfarin has a narrow safety window, so please loop in your pharmacist or doctor before starting red clover, and keep up with your INR checks.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
2 of 5Warfarin Sodium also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.
In vitro evidence suggests that red clover weakly inhibits CYP2C19. This interaction has not been reported in humans.
Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..
Here's the honest picture with red clover and warfarin. Warfarin is a true blood thinner (not a prodrug), so anything that slows how your body clears it can let levels creep up. Lab studies hint that red clover may weakly block an enzyme called CYP2C19, which helps process part of your warfarin. In theory that could nudge your warfarin effect higher, meaning a higher INR and more bleeding or bruising.
The reassuring part: this is theoretical, seen only in test-tube work, and has never been reported in real people. Still, because warfarin is so finicky and small shifts matter, I'd loop in your pharmacist or doctor before adding red clover, and keep up with your INR checks.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
3 of 5Warfarin Sodium also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
In vitro evidence suggests that red clover might inhibit CYP2C9. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of tolbutamide, a CYP2C9 probe substrate.
Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..
Here's the short version: warfarin is cleared by a liver enzyme called CYP2C9, and red clover has been shown in test-tube studies to mildly block that enzyme. In theory, blocking it could let warfarin build up a bit, which would push your blood toward being too thin. That can mean easy bruising, nosebleeds, bleeding gums, or more serious bleeding.
But here's the reassuring part: the actual human evidence is weak. A small clinical study using standardized red clover found no real effect on a CYP2C9 drug. So this concern stays mostly theoretical. Still, warfarin is a narrow-margin medicine where small shifts matter, so don't add red clover without telling your doctor or pharmacist first. A quick INR check after starting is a smart, easy safeguard.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
4 of 5Warfarin Sodium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro evidence shows that red clover might inhibit CYP3A4 isoenzymes. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of alprazolam, a CYP3A4 probe substrate.
Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..
Here's the gist with red clover and warfarin. On paper, red clover might block a liver enzyme called CYP3A4, which is one of the pathways your body uses to clear warfarin. If that pathway slowed down, warfarin could build up a little and thin your blood more than intended, raising the chance of bruising, nosebleeds, or harder-to-stop bleeding. But the real-world evidence here is reassuring. A small clinical study using standardized red clover isoflavones found no meaningful change in a similar CYP3A4 drug, so this concern stays mostly theoretical.
Still, warfarin is a finicky medication where small shifts matter, and red clover has mild estrogen-like activity too. Before adding it, check with your pharmacist or doctor and keep up with your regular INR checks.
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed
ANTICOAGULANT/ANTIPLATELET DRUGS
5 of 5Warfarin Sodium also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.
In vitro research suggests that genistein in red clover has antiplatelet effects, and historically, red clover was thought to have anticoagulant effects due to its coumarin content. However, some experts state that this is unlikely as most natural coumarins have not been shown to have anticoagulant effects, and their content in red clover is low. Additionally, some clinical research in postmenopausal patients found no effect on coagulation or prothrombin time with the use of red clover flowering tops 378 mg daily for 12 months or red clover isoflavone (Rimostil) 50 mg daily for 2 years.
Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..
Here's the honest picture for warfarin and red clover. On paper, red clover contains a little coumarin and one of its plant compounds (genistein) showed mild blood-thinning activity in the lab. That raised a fair question, since warfarin itself is a powerful blood thinner. But when researchers actually studied red clover in real people, including postmenopausal women taking it daily for a year or two, they saw no measurable change in clotting or in the prothrombin time (the test behind your INR).
So the worry is mostly theoretical, and the risk is rated minor and unlikely. Still, warfarin is a drug where small shifts matter, so don't add red clover on your own. Let your pharmacist or doctor know first, and keep up your regular INR checks so any change gets caught early.
- Geller SE, Shulman LP, van Breemen RB, et al. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial. Menopause 2009;16:1156-66. PubMed
- Guerrero JA, Lozano ML, Castillo J, et al. Flavonoids inhibit platelet function through binding to the thromboxane A2 receptor. J Thromb Haemost 2005;3(2):369-376. PubMed
- Kondo K, Suzuki Y, Ikeda Y, Umemura K. Genistein, an isoflavone included in soy, inhibits thrombotic vessel occlusion in the mouse femoral artery and in vitro platelet aggregation. Eur J Pharmacol 2002;455(1):53-57. PubMed
- Polini N, Rauschemberger MB, Mendiberri J, et al. Effect of genistein and raloxifene on vascular dependent platelet aggregation. Mol Cell Endocrinol 2007;267(1-2):55-62. PubMed
- Clifton-Bligh PB, et al. Red cover isoflavones enriched with formononetin lower serum LDL cholesterol- a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2015;69(1):134-142.
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.
Red Clover Also Interacts With Other Medications
Red Clover has 44 moderate, 822 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 Red Clover
We haven’t checked that one against Red Clover yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Red Clover. Pick one to open its full report.
Questions About Red Clover 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 Red Clover 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:
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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 Red Clover 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 Red Clover as Part of a Dietary Supplement Product? Check It for Interactions
We hold 1,480 real supplement products containing Red Clover, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Red Clover. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Red Clover — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Red Clover 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.
#161 of 1,452 supplements looked up here in the last 7 days
#18 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 Red Clover
What is Red Clover?
- Menopause symptoms (hot flashes)
- High cholesterol
- Bone health/osteoporosis
- Skin and hair concerns
- Women's health
Red clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot flashes. The evidence is mixed and generally weak, with some studies showing modest benefit and others showing none. Because of its hormone-like effects, it's not for everyone—talk with your pharmacist or doctor before trying it, especially if you have a hormone-sensitive condition.
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 & Red Clover
Browse every other medication we’ve checked against Red Clover — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
44 interactions
- Estradiol ›
- Conjugated Estrogens ›
- Methotrexate ›
- Esterified Estrogens ›
- Estropipate ›
- Tamoxifen Citrate ›
- Estrogen ›
- Estrone ›
- Ethinyl Estradiol ›
- Methotrexate Sodium ›
- Oestrogen ›
- Prasterone (prescription Drug) ›
- Tibolone ›
- Ethinyl Estradiol, Norethindrone ›
- Ethinyl Estradiol, Levonorgestrel ›
- Ethinyl Estradiol, Norgestimate ›
- Ethinyl Estradiol, Desogestrel ›
- Ethinyl Estradiol, Norethindrone, Ferrous Fumarate ›
- Desogestrel, Ethinyl Estradiol ›
- Ethinyl Estradiol, Ethynodiol Diacetate ›
- Levonorgestrel, Ethinyl Estradiol ›
- Ethinyl Estradiol, Norgestrel ›
- Drospirenone, Ethinyl Estradiol ›
- Conjugated Estrogens, Medroxyprogesterone Acetate ›
- Conjugated Estrogens, Meprobamate ›
- Cyproterone Acetate, Ethinyl Estradiol ›
- Ethiny Estradiol, Levonorgestrel ›
- Norelgestromin, Ethinyl Estradiol ›
- Norethindrone Acetate, Ethinyl Estradiol, Ferrous Fumarate ›
- Bazedoxifene Acetate, Conjugated Estrogens ›
- Conjugated Estrogens, Methyltestosterone ›
- Drospirenone, Estetrol ›
- Drospirenone, Ethinyl Estradiol, Levomefolate ›
- Esterified Estrogens, Methyltestosterone ›
- Estradiol, Medroxyprogesterone ›
- Estradiol, Norethindrone Acetate ›
- Estradiol, Norgestimate ›
- Estradiol, Progesterone ›
- Ethinyl Estradiol, Drospirenone ›
- Ethinyl Estradiol, Levonogestrel ›
- Etonogestrel, Ethinyl Estradiol ›
- Medroxyprogesterone Acetate, Oestrogens, Conjugated ›
- Relugolix, Estradiol, Norethindrone Acetate ›
- Segesterone Acetate, Ethinyl Estradiol ›
822 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ketoprofen ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Nortriptyline ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Bendamustine ›
- Bivalirudin ›
- Caffeine (otc Drug) ›
Showing 60 of 822 minor interactions — see all 822 on the Red Clover page.
No interaction 1,963 drugs checked — show the list
We also checked Red Clover against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Metoprolol ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Valacyclovir ›
- Docusate ›
- Hydroxyurea ›
- Methamphetamine ›
- Semaglutide ›
- Sumatriptan ›
- Tirzepatide ›
- Lisdexamfetamine ›
- Bupropion ›
- Metformin ›
- Acyclovir ›
- Amoxicillin ›
- Lisinopril ›
- Doxycycline ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Amphetamine ›
- Isotretinoin ›
- Azithromycin ›
- Dextroamphetamine ›
- Methylene Blue ›
- Duloxetine ›
- Ciprofloxacin ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Daptomycin ›
- Hexobarbitone ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Levetiracetam ›
- Mitomycin ›
- Minoxidil ›
- Cefaclor ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Ezetimibe ›
- Levodopa ›
- Vancomycin ›
- Phenylephrine ›
- Spironolactone ›
- Venlafaxine ›
- Dirithromycin ›
- Procainamide ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
Showing the 60 most looked-up of 1,963 medications checked with no known interaction — see the full Red Clover 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 Red Clover and Warfarin Sodium Together: Common Questions
Can you take Red Clover with Warfarin Sodium?
Why are there 5 interactions listed for Red Clover and Warfarin Sodium?
How serious is the Red Clover 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.