Drug & supplement interaction

Strawberry + Rivaroxaban

Rivaroxaban brand name: Xarelto.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Rivaroxaban falls into 2 drug categories that Strawberry can interact with; the most serious is rated moderate. In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Strawberry and Rivaroxaban

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Strawberry interacts with whole categories of medication. Rivaroxaban falls into 2 of those categories, so it can interact with Strawberry in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 2

Why this applies to Rivaroxaban

Rivaroxaban falls under P-GLYCOPROTEIN SUBSTRATES — the group Strawberry interacts with.

In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
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 Xarelto (rivaroxaban) and strawberry. Your body uses a transporter called p-glycoprotein to pump rivaroxaban back out, which helps keep its levels in check. In lab tests, strawberry extract appeared to slow that pump down. In theory, that could let a little more rivaroxaban hang around in your blood, and since this is a blood thinner, the main worry would be easier bruising or bleeding (think nosebleeds, bleeding gums, or blood that takes longer to stop).

The honest part: this is based only on test-tube work, not on real people, so it's a theoretical concern. Eating strawberries as food is very unlikely to cause trouble. Concentrated strawberry supplements are the bigger question mark. Before adding one, just run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Van Gelder, J., Deferme, S., Naesens, L., De Clercq, E., van den, Mooter G., Kinget, R., and Augustijns, P. Intestinal absorption enhancement of the ester prodrug tenofovir disoproxil fumarate through modulation of the biochemical barrier by defined este
  2. Deferme, S., Van Gelder, J., and Augustijns, P. Inhibitory effect of fruit extracts on P-glycoprotein-related efflux carriers: an in-vitro screening. J Pharm Pharmacol 2002;54(9):1213-1219.
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Rivaroxaban also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content. Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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: Xarelto (rivaroxaban) already thins your blood to keep clots from forming. The concern with strawberry is that, in test tube and animal studies, its plant compounds (the polyphenols) seemed to make platelets a little less sticky. Stacked on top of rivaroxaban, the worry is a slightly higher bleeding risk, meaning easier bruising, nosebleeds, bleeding gums, or bleeding that takes longer to stop.

The good news: this is theoretical and based only on lab and animal research, not human studies. Eating strawberries as a normal food is very unlikely to cause a problem. A concentrated strawberry extract supplement is a different story, so I'd run that by your pharmacist or doctor first before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Dutta-Roy, A. K., Crosbie, L., and Gordon, M. J. Effects of tomato extract on human platelet aggregation in vitro. Platelets. 2001;12(4):218-227. PubMed
  2. Naemura, A., Mitani, T., Ijiri, Y., Tamura, Y., Yamashita, T., Okimura, M., and Yamamoto, J. Anti-thrombotic effect of strawberries. Blood Coagul.Fibrinolysis 2005;16(7):501-509. 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

Strawberry Also Interacts With Other Medications

Strawberry has 315 moderate known drug interactions in our database — the Rivaroxaban one above is among them. If you take anything else, check it against the full list below.

Moderate 315 No known interaction 2,515 (incl. Rivaroxaban)
Taking anything else?

Check Another of Your Medications Against Strawberry

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

From our Q&A

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

We hold 2,806 real supplement products containing Strawberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Strawberry. Your product may carry other ingredients that interact with Rivaroxaban too, on top of Strawberry — 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 Strawberry 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 Strawberry
Top 10%

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

29 days ago today
Medication Rivaroxaban
Top 10

#9 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 Strawberry

What is Strawberry?

  • General antioxidant support
  • Heart and blood vessel health
  • Blood sugar support
  • Skin and oral health
  • Source of vitamin C and fiber

Strawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but concentrated supplement forms have only limited research behind specific health claims. If you have allergies or take it as a supplement, check with your pharmacist or doctor.

Read the full Strawberry 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 & Strawberry

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

0Major
315Moderate
0Minor
2,514No known interaction
315 Moderate 2,514 No interaction
Moderate

315 interactions

Showing 60 of 315 moderate interactions — see all 315 on the Strawberry page.

No interaction 2,514 drugs checked — show the list

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

Showing the 60 most looked-up of 2,514 medications checked with no known interaction — see the full Strawberry list.

See the full Strawberry interactions page
See every supplement checked against Rivaroxaban, ranked by severity
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
Strawberry monograph › Uses, safety, and every drug interaction in one place Rivaroxaban supplement interactions › Every supplement checked against Rivaroxaban, ranked by severity Rivaroxaban drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Strawberry and Rivaroxaban Together: Common Questions

Can you take Strawberry with Rivaroxaban?
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 2 interactions listed for Strawberry and Rivaroxaban?
Rivaroxaban belongs to more than one drug category, and Strawberry 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 Strawberry and Rivaroxaban 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 Rivaroxaban and Strawberry?

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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.