Drug & supplement interaction

Swallowroot + Rivaroxaban

Rivaroxaban brand name: Xarelto.

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

Swallowroot has a moderate interaction with Rivaroxaban. Theoretically, swallowroot might increase the risk of bleeding when taken 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

Swallowroot and Rivaroxaban

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Rivaroxaban

Rivaroxaban falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Swallowroot interacts with.

Theoretically, swallowroot might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that swallowroot 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

Here's the simple version: Rivaroxaban (Xarelto) is already a powerful blood thinner that slows down your body's clotting process. Swallowroot, in lab studies, appears to make platelets (the cells that help blood clump) less sticky. Stack those two effects together and you could, in theory, tip the balance toward easier bleeding.

What I want you to know is that this concern comes only from test-tube research, not from studies in people, so it's more of a caution than a proven problem. Still, since Xarelto already raises bleeding risk, watch for things like unusual bruising, nosebleeds, bleeding gums, or blood in your urine or stool. Food or pickled amounts are unlikely to matter much, but before using concentrated Swallowroot supplements, please check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Suneetha WJ, Krishnakantha TP. Effect of swallowroot extract on functions of platelets in vitro. J Thromb Thrombolysis 2005;19:133-4. 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

Swallowroot Also Interacts With Other Medications

Swallowroot has 121 moderate known drug interactions in our database — the Rivaroxaban one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Rivaroxaban)
Taking anything else?

Check Another of Your Medications Against Swallowroot

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

From our Q&A

Questions About Swallowroot 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 Swallowroot 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 Swallowroot 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

How much people look this up

Where Swallowroot 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 Swallowroot
Steady interest

#1,133 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.

Supplement

About Swallowroot

What is Swallowroot?

  • Digestive complaints
  • General tonic and appetite stimulant
  • Blood purifier in folk medicine
  • Antimicrobial and food preservative
  • Cooling drink in hot weather

Swallowroot (Decalepis hamiltonii) is a root used in South Indian folk medicine and as a food flavoring, often pickled or made into a cooling drink. Modern scientific evidence for its health benefits in people is very limited, resting mostly on laboratory and animal studies, so its effectiveness is not proven. If you are considering it, talk with your pharmacist or doctor first, especially during pregnancy or breastfeeding.

Read the full Swallowroot 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 & Swallowroot

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Swallowroot page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Swallowroot list.

See the full Swallowroot 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
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Pharmacist Counseling Corner

Taking Swallowroot and Rivaroxaban Together: Common Questions

Can you take Swallowroot 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.
How serious is the Swallowroot 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 Swallowroot?

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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.