Drug & supplement interaction

Uva Ursi + Rivaroxaban

Rivaroxaban brand name: Xarelto.

Moderate Interaction
The bottom line Moderate

Rivaroxaban falls into 2 drug categories that Uva Ursi can interact with; the most serious is rated moderate. Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.

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

Uva Ursi and Rivaroxaban

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Rivaroxaban

Rivaroxaban falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Uva Ursi interacts with.

Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
In vitro, uva ursi appears to inhibit CYP3A4. This effect 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 idea behind this one. Your body relies on a liver enzyme called CYP3A4 to help clear Xarelto (rivaroxaban) out of your system. In lab dish studies, uva ursi seemed to slow that enzyme down. If that were to happen in a real person, rivaroxaban could build up a bit more than expected, and since this is a blood thinner, that could mean a higher chance of bruising or bleeding (think nosebleeds, bleeding gums, or blood in the urine or stool).

I want to be honest, though: this has only been seen in test tubes, never in actual patients, so it's a theoretical concern. Still, because bleeding is serious, I'd run uva ursi past your pharmacist or doctor before combining it, rather than starting or stopping anything on your own.

References
  1. Chauhan B, Yu C, Krantis A, et al. In vitro activity of uva-ursi against cytochrome P450 isoenzymes and P-glycoprotein. Can J Physiol Pharmacol. 2007;85(11):1099-107.
Minor

P-GLYCOPROTEIN SUBSTRATES

2 of 2

Rivaroxaban also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, uva ursi may alter the levels of drugs transported by P-glycoprotein.
In vitro, uva ursi appears to inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.
Severity Minor 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 Xarelto (rivaroxaban) and uva ursi. Your body uses a tiny pump called P-glycoprotein to help move rivaroxaban along. In lab dish studies, uva ursi seemed to slow that pump down. If that were to happen in real people, slightly more rivaroxaban could hang around in your blood, which in theory could nudge up your bleeding risk (think easier bruising, nosebleeds, or bleeding that's slow to stop).

The important part: this has only been seen in test tubes, never confirmed in humans, so it's considered a minor, mostly theoretical concern. Still, since rivaroxaban is a blood thinner, it's worth a quick chat with your pharmacist or doctor before adding uva ursi, especially at concentrated supplement doses.

References
  1. Chauhan B, Yu C, Krantis A, et al. In vitro activity of uva-ursi against cytochrome P450 isoenzymes and P-glycoprotein. Can J Physiol Pharmacol. 2007;85(11):1099-107.

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

Uva Ursi Also Interacts With Other Medications

Uva Ursi has 739 moderate, 63 minor 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.

Taking anything else?

Check Another of Your Medications Against Uva Ursi

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

From our Q&A

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

We hold 1,423 real supplement products containing Uva Ursi, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Uva Ursi. Your product may carry other ingredients that interact with Rivaroxaban too, on top of Uva Ursi — 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 Uva Ursi 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 Uva Ursi
Top 25%

#158 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 Uva Ursi

What is Uva Ursi?

Uva Ursi
  • Urinary tract infections
  • Urinary discomfort
  • Mild diuretic
  • Kidney stones
  • Skin conditions

Uva ursi is a traditional herb used mainly for urinary tract infections, and its leaves contain a compound called arbutin that may have antimicrobial effects in the urine. Evidence in people is limited, and because high doses or long-term use may be harmful to the liver and could be toxic, it should only be used short-term and with guidance from a healthcare professional. Avoid it during pregnancy and breastfeeding.

Read the full Uva Ursi 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 & Uva Ursi

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

0Major
739Moderate
63Minor
2,027No known interaction
Moderate

739 interactions

Showing 60 of 739 moderate interactions — see all 739 on the Uva Ursi page.

Minor

63 interactions

Showing 60 of 63 minor interactions — see all 63 on the Uva Ursi page.

No interaction 2,027 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 Uva Ursi and Rivaroxaban Together: Common Questions

Can you take Uva Ursi 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 Uva Ursi and Rivaroxaban?
Rivaroxaban belongs to more than one drug category, and Uva Ursi 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 Uva Ursi 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 Uva Ursi?

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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.