Drug & supplement interaction

Resveratrol + Warfarin Sodium

Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.

Moderate Interaction
The bottom line Moderate

Warfarin Sodium falls into 4 drug categories that Resveratrol can interact with; the most serious is rated moderate. Theoretically, resveratrol might increase levels of drugs metabolized by CYP2C19.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Resveratrol and Warfarin Sodium

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Resveratrol interacts with whole categories of medication. Warfarin Sodium falls into 4 of those categories, so it can interact with Resveratrol in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 4

Why this applies to Warfarin Sodium

Warfarin Sodium falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Resveratrol interacts with.

Theoretically, resveratrol might increase levels of drugs metabolized by CYP2C19.
In vitro research shows that resveratrol can inhibit CYP2C19 enzymes. However, this interaction has not been reported in humans.
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 resveratrol. Lab studies suggest resveratrol can slow down an enzyme called CYP2C19, which is one of the pathways your body uses to clear warfarin. In theory, if that pathway slows, warfarin could build up a bit and thin your blood more than intended. That could mean easier bruising, nosebleeds, bleeding gums, or in a worst case, more serious bleeding.

I want to be honest about the strength of this, though. This is only seen in test-tube research, not in real patients, so it's more of a theoretical caution than a proven problem. But because warfarin is a narrow-margin drug where small shifts matter, please check with your doctor or pharmacist before adding resveratrol, and keep up with your INR checks.

References
  1. Yu, C., Shin, Y. G., Kosmeder, J. W., Pezzuto, J. M., and van Breemen, R. B. Liquid chromatography/tandem mass spectrometric determination of inhibition of human cytochrome P450 isozymes by resveratrol and resveratrol-3-sulfate. Rapid Commun.Mass Spectro PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 4

Warfarin Sodium also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, resveratrol might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that resveratrol can inhibit CYP1A2 enzymes. However, this interaction has not been reported in humans.
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 resveratrol. Warfarin is cleared in part by a liver enzyme called CYP1A2, and lab (test tube) studies suggest resveratrol can slow that enzyme down. If that happened in your body, warfarin could build up a bit, which in theory might push your blood toward being too thin. With warfarin that matters, because it's a narrow-window drug where small shifts can mean easy bruising, nosebleeds, bleeding gums, or more serious bleeding.

The honest part: this is only seen in lab studies, not in real patients, so it's theoretical. Food amounts of grapes or berries are very unlikely to do anything. Still, because warfarin is so dose-sensitive, please check with your pharmacist or doctor before adding a resveratrol supplement, and keep up with your INR checks.

References
  1. Chang, T. K., Chen, J., and Lee, W. B. Differential inhibition and inactivation of human CYP1 enzymes by trans-resveratrol: evidence for mechanism-based inactivation of CYP1A2. J.Pharmacol.Exp.Ther. 2001;299(3):874-882.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

Warfarin Sodium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, resveratrol might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that resveratrol can inhibit the CYP3A4 enzyme. However, clinical research shows that taking resveratrol 3000 mg daily for 8 weeks does not necessitate dose adjustments to medications metabolized by CYP3A4.
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 resveratrol. In lab dishes, resveratrol can slow down a liver enzyme called CYP3A4, which is one of the routes your body uses to clear warfarin. In theory, that could let warfarin build up a little, nudging your blood toward being too thin. With warfarin that matters, because it's a narrow-margin drug where small shifts can mean bruising, nosebleeds, or more serious bleeding.

The reassuring part: this is mostly test-tube evidence, and one human study using a high dose (3000 mg daily for 8 weeks) didn't require dose changes. Still, warfarin is closely watched for good reason. If you want to add resveratrol, check with your pharmacist or doctor first so your INR can be monitored.

References
  1. Piver B, Berthou F, Dreano Y, Lucas D. Inhibition of CYP3A, CYP1A and CYP2E1 activities by resveratrol and other non volatile red wine components. Toxicol Lett 2001;125:83-91. PubMed
  2. Yu, C., Shin, Y. G., Kosmeder, J. W., Pezzuto, J. M., and van Breemen, R. B. Liquid chromatography/tandem mass spectrometric determination of inhibition of human cytochrome P450 isozymes by resveratrol and resveratrol-3-sulfate. Rapid Commun.Mass Spectro PubMed
  3. Chachay VS, Macdonald GA, Martin JH, Whitehead JP, O'Moore-Sullivan TM, Lee P, Franklin M, Klein K, Taylor PJ, Ferguson M, Coombes JS, Thomas GP, Cowin GJ, Kirkpatrick CM, Prins JB, Hickman IJ. Resveratrol does not benefit patients with nonalcoholic fatty
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

4 of 4

Warfarin Sodium also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Resveratrol may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Resveratrol seems to have antiplatelet effects.
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 thing to know about pairing resveratrol with warfarin. Warfarin already thins your blood by lowering your clotting ability. Resveratrol seems to work on a different part of clotting, your platelets (the cells that stick together to plug a wound). Stacking the two could, in theory, nudge you toward easier bleeding or bruising.

Warfarin is a narrow therapeutic index drug, meaning small shifts can matter, so this is worth flagging even though the evidence here is weak (mostly lab and animal studies, not solid human data). Watch for things like unusual bruising, nosebleeds, bleeding gums, or dark stools. Small amounts in food like grapes or berries are very unlikely to be an issue. Before starting a concentrated resveratrol supplement, check with your pharmacist or doctor, who may want to watch your INR.

References
  1. Pace-Asciak CR, Rounova O, Hahn SE, et al. Wines and grape juices as modulators of platelet aggregation in healthy human subjects. Clin Chim Acta 1996;246:163-82. PubMed
  2. Bertelli AA, Giovannini L, Bernini W, et al. Antiplatelet activity of cis-resveratrol. Drugs Exp Clin Res 1996;22:61-3.
  3. Pace-Asciak CR, Hahn S, Diamandis EP, et al. The red wine phenolics trans-resveratrol and quercetin block human platelet aggregation and eicosanoid synthesis: implications for protection against coronary heart disease. Clin Chim Acta 1995;235:207-19.
  4. Bertelli A, Bertelli AA, Gozzini A, Giovannini L. Plasma and tissue resveratrol concentrations and pharmacological activity. Drugs Exp Clin Res 1998;24:133-8.
  5. Bertelli AA, Giovannini L, Giannessi D, et al. Antiplatelet activity of synthetic and natural resveratrol in red wine. Int J Tissue React 1995;17:1-3.
  6. Dobrydneva, Y., Williams, R. L., and Blackmore, P. F. trans-Resveratrol inhibits calcium influx in thrombin-stimulated human platelets. Br.J.Pharmacol. 1999;128(1):149-157.
  7. Kirk, R. I., Deitch, J. A., Wu, J. M., and Lerea, K. M. Resveratrol decreases early signaling events in washed platelets but has little effect on platalet in whole food. Blood Cells Mol.Dis. 2000;26(2):144-150.
  8. Zbikowska, H. M. and Olas, B. Antioxidants with carcinostatic activity (resveratrol, vitamin E and selenium) in modulation of blood platelet adhesion. J Physiol Pharmacol. 2000;51(3):513-520.
  9. Olas, B., Wachowicz, B., Saluk-Juszczak, J., and Zielinski, T. Effect of resveratrol, a natural polyphenolic compound, on platelet activation induced by endotoxin or thrombin. Thromb.Res 8-15-2002;107(3-4):141-145. PubMed
  10. Ma, Z. H. and Ma, Q. Y. Resveratrol: a medical drug for acute pancreatitis. World J Gastroenterol. 6-7-2005;11(21):3171-3174. PubMed
  11. Pendurthi, U. R., Williams, J. T., and Rao, L. V. Resveratrol, a polyphenolic compound found in wine, inhibits tissue factor expression in vascular cells : A possible mechanism for the cardiovascular benefits associated with moderate consumption of wine. PubMed

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

Resveratrol Also Interacts With Other Medications

Resveratrol has 821 moderate 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.

Taking anything else?

Check Another of Your Medications Against Resveratrol

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

From our Q&A

Questions About Resveratrol 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 Resveratrol 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:

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 Sodium

This page covers Resveratrol 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).

Open the Warfarin Sodium interaction page

One more smart check

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

We hold 2,939 real supplement products containing Resveratrol, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Resveratrol. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Resveratrol — 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 Resveratrol 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.

Supplement Resveratrol
Top 10%

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

29 days ago today
Medication Warfarin Sodium
Top 1%

#18 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 Resveratrol

What is Resveratrol?

Resveratrol
  • Heart and blood vessel health
  • Antioxidant support
  • Anti-aging
  • Blood sugar and metabolic support
  • General anti-inflammatory support

Resveratrol is a plant compound found in red grapes, berries, and peanuts that is popular for heart health, anti-aging, and antioxidant support. While lab and animal studies are promising, strong human evidence for most uses is still limited. It appears generally well tolerated in supplement doses, but talk with your pharmacist or doctor before starting it.

Read the full Resveratrol monograph & all interactions
Medication

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.

See full Warfarin drug information
Keep checking

Other Drugs & Resveratrol

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

0Major
821Moderate
0Minor
2,008No known interaction
Moderate

821 interactions

Showing 60 of 821 moderate interactions — see all 821 on the Resveratrol page.

No interaction 2,008 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

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Pharmacist Counseling Corner

Taking Resveratrol and Warfarin Sodium Together: Common Questions

Can you take Resveratrol with Warfarin Sodium?
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.
Why are there 4 interactions listed for Resveratrol and Warfarin Sodium?
Warfarin Sodium belongs to more than one drug category, and Resveratrol interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Resveratrol and Warfarin Sodium 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

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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.