Drug & supplement interaction

Tinospora Cordifolia + Warfarin Sodium

Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.

Moderate Interaction
The bottom line Moderate

Warfarin Sodium falls into 3 drug categories that Tinospora Cordifolia can interact with; the most serious is rated moderate. Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C19.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Tinospora Cordifolia and Warfarin Sodium

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Tinospora Cordifolia interacts with whole categories of medication. Warfarin Sodium falls into 3 of those categories, so it can interact with Tinospora Cordifolia in 3 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 3

Why this applies to Warfarin Sodium

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

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C19.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2C19 at high concentrations. 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 quick picture with warfarin. Your liver uses an enzyme called CYP2C19 to help clear part of this medication. In lab dishes, Tinospora cordifolia (Giloy) has slowed that enzyme down at high concentrations. If that same effect happened in your body, warfarin could build up a little, which in theory could thin your blood more than intended and raise your risk of bruising, nosebleeds, or other bleeding.

The honest truth is this is theoretical, based only on test-tube research, and hasn't been reported in real people. Still, warfarin is a finicky drug where even small shifts matter, and your INR is the number that tells the story. Please don't start or stop anything on your own. Just loop in your pharmacist or doctor first so they can watch your INR if needed.

References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

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

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that Tinospora cordifolia extract inhibits CYP1A2 at high concentrations. 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 for warfarin and Giloy (Tinospora cordifolia). Warfarin is partly cleared by a liver enzyme called CYP1A2. In test-tube studies, Tinospora can slow that enzyme down, and slowing it could let warfarin build up a little. With a blood thinner, that potentially means more thinning than intended, which can show up as easy bruising, nosebleeds, bleeding gums, or blood in your urine or stool.

I want to be honest about the evidence, though. This is only lab data at high concentrations and has not been seen in real people. Still, warfarin is a tricky drug where small shifts matter, so don't add Giloy on your own. Loop in your pharmacist or doctor first, and keep up your regular INR checks.

References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 3

Warfarin Sodium also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2C9. Animal research shows that Tinospora cordifolia extract 400 mg/kg twice daily for 14 days reduces the clearance and increases plasma levels of glyburide, a CYP2C9 substrate. 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 concern with mixing Giloy (Tinospora cordifolia) and your warfarin. Your body relies on a liver enzyme called CYP2C9 to break warfarin down and clear it out. In lab and animal studies, Tinospora appears to slow that enzyme. If it does the same in people, warfarin could build up and thin your blood more than intended, which raises the chance of bruising, nosebleeds, bleeding gums, or more serious bleeding.

I want to be honest though: this is only seen in test-tube and animal work, not in real patients, so it's theoretical for now. But warfarin has a very narrow safe range, so even small shifts matter. Please check with your pharmacist or doctor before adding Giloy, and don't change your warfarin on your own.

References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. 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

Tinospora Cordifolia Also Interacts With Other Medications

Tinospora Cordifolia has 613 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 Tinospora Cordifolia

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

From our Q&A

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

We hold 393 real supplement products containing Tinospora Cordifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tinospora Cordifolia. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Tinospora Cordifolia — 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 Tinospora Cordifolia 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 Tinospora Cordifolia
Top 25%

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

29 days ago today
Medication Warfarin Sodium
Top 1%

#22 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 Tinospora Cordifolia

What is Tinospora Cordifolia?

  • Immune support
  • Fever
  • Blood sugar support
  • General wellness and 'rejuvenation'
  • Allergic rhinitis
  • Inflammation

Tinospora cordifolia, known as Guduchi or Giloy in Ayurvedic medicine, is a climbing plant traditionally used to support immunity and treat fevers. Early laboratory and small human studies suggest possible immune and blood sugar effects, but high-quality evidence is limited, and there have been reports of liver injury. Talk with your pharmacist or doctor before using it.

Read the full Tinospora Cordifolia monograph & all interactions
Medication

About Warfarin

What Is Warfarin Used For?

Brand names: Coumadin, Panwarfin, Sofarin

Warfarin helps prevent and treat harmful blood clots. The label lists these uses for both Warfarin Sodium tablets and Jantoven tablets:

  • Preventing and treating venous thrombosis (clots in the veins) and pulmonary embolism (clots in the lungs).
  • Preventing and treating clot-related complications of atrial fibrillation and/or heart valve replacement.
  • Lowering the risk of death, another heart attack, and clot-related events such as stroke after a heart attack.

Warfarin does not dissolve a clot that has already formed. It helps stop the clot from growing and prevents further clot-related complications.

See full Warfarin drug information
Keep checking

Other Drugs & Tinospora Cordifolia

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

0Major
613Moderate
0Minor
2,216No known interaction
Moderate

613 interactions

Showing 60 of 613 moderate interactions — see all 613 on the Tinospora Cordifolia page.

No interaction 2,216 drugs checked — show the list

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

Showing the 60 most looked-up of 2,216 medications checked with no known interaction — see the full Tinospora Cordifolia 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 Tinospora Cordifolia and Warfarin Sodium Together: Common Questions

Can you take Tinospora Cordifolia 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 3 interactions listed for Tinospora Cordifolia and Warfarin Sodium?
Warfarin Sodium belongs to more than one drug category, and Tinospora Cordifolia 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 Tinospora Cordifolia 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.