Drug & supplement interaction

Tocotrienols + Bivalirudin

Bivalirudin brand names: Angiomax, Angiox, Angiomax Rtu.

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

Tocotrienols has a minor interaction with Bivalirudin. Concomitant use of tocotrienols with anticoagulant or antiplatelet agents might increase the risk of bleeding.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Tocotrienols and Bivalirudin

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

Minor

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Bivalirudin

Bivalirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Tocotrienols interacts with.

Concomitant use of tocotrienols with anticoagulant or antiplatelet agents might increase the risk of bleeding. However, this has not been reported in humans.
Taking tocotrienols orally inhibits experimentally-induced platelet aggregation in humans. Theoretically tocotrienols might increase the risk of bleeding if taken with antiplatelet or anticoagulant drugs. However, tocotrienols 400-800 mg daily have been used with aspirin and/or clopidogrel for 1 year with no clear cumulative antiplatelet effects and no reports of bleeding.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to know about bivalirudin (Angiomax): it's a powerful blood thinner given through an IV, usually in a hospital during procedures like a cardiac catheterization or angioplasty. Tocotrienols, a form of vitamin E, can lightly discourage your platelets from clumping together. On paper, stacking that mild effect on top of a strong anticoagulant could add up to a bit more bleeding risk, such as easier bruising or oozing at an IV or catheter site.

In real life, this concern is very theoretical. It hasn't actually been reported in people, and studies using tocotrienols alongside aspirin or clopidogrel for a full year showed no clear extra bleeding. Still, since bivalirudin is handled by your hospital care team, just let them know about any supplements you take so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mensink RP, van Houwelingen AC, Kromhout D, Hornstra G. A vitamin E concentrate rich in tocotrienols had no effect on serum lipids, lipoproteins, or platelet function in men with mildly elevated serum lipid concentrations. Am J Clin Nutr 1999;69:213-9. PubMed
  2. Slivka A, Rink C, Paoletto D, Sen CK. Platelet function in stroke/transient ischemic attack patients treated with tocotrienol. FASEB J. 2020;34(9):11838-11843. 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

Tocotrienols Also Interacts With Other Medications

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

Minor 121 No known interaction 2,709 (incl. Bivalirudin)
Taking anything else?

Check Another of Your Medications Against Tocotrienols

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

Everything else you take

See Every Supplement That Interacts With Bivalirudin

This page covers Tocotrienols only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bivalirudin page lists 202 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 2 major · 183 moderate · 17 minor.

From our pharmacist’s overview on the Bivalirudin page

“Bivalirudin (Angiomax) is a strong intravenous blood thinner used during heart procedures like angioplasty, and because bleeding is already its main built-in danger, this list deserves genuine care. All 202 supplements on it interact the same basic way: they thin the blood or blunt platelets themselves, stacking bleeding risk on top of…”

Reviewed by 2 · Jul 18, 2026

Open the Bivalirudin interaction page

One more smart check

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

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

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

29 days ago today
Medication Bivalirudin
Steady interest

#1,828 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 Tocotrienols

What is Tocotrienols?

Tocotrienols
  • Heart and cholesterol support
  • Antioxidant support
  • Liver health (fatty liver)
  • Bone health
  • Brain and nerve protection

Tocotrienols are a less common form of vitamin E with strong antioxidant activity studied mostly for cholesterol, liver, and heart health. Early research is interesting but far from conclusive, and a standard dose is not established. They are generally well tolerated, but talk with your pharmacist or doctor before using them, especially during pregnancy or if you take blood thinners.

Read the full Tocotrienols monograph & all interactions
Keep checking

Other Drugs & Tocotrienols

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

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

121 interactions

Showing 60 of 121 minor interactions — see all 121 on the Tocotrienols page.

No interaction 2,708 drugs checked — show the list

We also checked Tocotrienols 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 Tocotrienols list.

See the full Tocotrienols interactions page
See every supplement checked against Bivalirudin, 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
Tocotrienols monograph › Uses, safety, and every drug interaction in one place Bivalirudin supplement interactions › Every supplement checked against Bivalirudin, ranked by severity 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 Tocotrienols and Bivalirudin Together: Common Questions

Can you take Tocotrienols with Bivalirudin?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Tocotrienols and Bivalirudin interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Bivalirudin and Tocotrienols?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.