Drug & supplement interaction

Rosemary + Lepirudin

Lepirudin brand name: Refludan.

Moderate Interaction
The bottom line Moderate

Rosemary has a moderate interaction with Lepirudin. Theoretically, rosemary may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Rosemary and Lepirudin

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Lepirudin

Lepirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Rosemary interacts with.

Theoretically, rosemary may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that rosemary inhibits platelet aggregation.
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

Lepirudin is a powerful injectable blood thinner, usually given in the hospital for a condition called heparin-induced thrombocytopenia. It works by directly blocking thrombin, a key step in clotting. Here's the concern with rosemary: in lab and animal studies, some of its plant compounds appear to make platelets (the tiny cells that help form clots) a little less sticky. If that effect carried over into people, stacking it on top of a strong anticoagulant could nudge your bleeding risk higher.

I want to be honest, though: this is theoretical, based only on test-tube and animal data, not human studies. Cooking with rosemary is not a worry. Concentrated rosemary supplements are the question mark. Since Lepirudin is closely monitored in a hospital setting, just let your care team know about any supplements you take.

References
  1. Lee JJ, Jin YR, Lee JH, et al. Antiplatelet activity of carnosic acid, a phenolic diterpene from Rosmarinus officinalis. Planta Med 2007;73(2):121-7.
  2. Yamamoto J, Yamada K, Naemura A, et al. Testing various herbs for antithrombotic effect. Nutrition 2005;21(5):580-7. PubMed
  3. Naemura A, Ura M, Yamashita T, et al. Long-term intake of rosemary and common thyme herbs inhibits experimental thrombosis without prolongation of bleeding time. Thromb Res 2008;122(4):517-22. PubMed
  4. Lee JJ, Jin YR, Lim Y, et al. Antiplatelet activity of carnosol is mediated by the inhibition of TXA2 receptor and cytosolic calcium mobilization. Vascul Pharmacol 2006;45:148-53. 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

Rosemary Also Interacts With Other Medications

Rosemary has 211 moderate, 160 minor known drug interactions in our database — the Lepirudin 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 Rosemary

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

Everything else you take

See Every Supplement That Interacts With Lepirudin

This page covers Rosemary only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lepirudin page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Lepirudin page

“Lepirudin (Refludan) is a potent injectable blood thinner, typically given when heparin has caused a dangerous platelet reaction, and that makes this a list to read with real care. Of the 218 supplements and herbs with interactions on file, 202 can slow clotting on their own, piling extra bleeding risk onto a drug whose chief hazard is…”

Reviewed by 2 · Jul 18, 2026

Open the Lepirudin interaction page

One more smart check

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

We hold 1,786 real supplement products containing Rosemary, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rosemary. Your product may carry other ingredients that interact with Lepirudin too, on top of Rosemary — 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 Rosemary and Lepirudin 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 Rosemary
Top 25%

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

29 days ago today
Medication Lepirudin
Steady interest

#2,417 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 Rosemary

What is Rosemary?

Rosemary
  • Memory and concentration
  • Digestive upset
  • Hair growth
  • Anxiety and stress (aromatherapy)
  • Muscle and joint discomfort
  • Antioxidant support

Rosemary is a fragrant Mediterranean herb that is safe and flavorful in normal food amounts. Some early research suggests possible benefits for memory, mood, and hair growth, but the evidence is limited and far from conclusive. Concentrated supplements and the essential oil should be used carefully, and the essential oil should never be swallowed.

Read the full Rosemary monograph & all interactions
Keep checking

Other Drugs & Rosemary

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

0Major
211Moderate
160Minor
2,458No known interaction
Moderate

211 interactions

Showing 60 of 211 moderate interactions — see all 211 on the Rosemary page.

Minor

160 interactions

Showing 60 of 160 minor interactions — see all 160 on the Rosemary page.

No interaction 2,458 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 Rosemary and Lepirudin Together: Common Questions

Can you take Rosemary with Lepirudin?
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 Rosemary and Lepirudin 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.