Drug & supplement interaction

Vitamin K + Warfarin Sodium

Warfarin Sodium brand names: Coumadin, Panwarfin, Sofarin.

Major Interaction
The bottom line Major

Vitamin K has a major interaction with Warfarin Sodium. Vitamin K can antagonize and reverse the therapeutic effects of warfarin.

Read the full interaction report
SeverityMajor
LikelihoodLikely
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Vitamin K and Warfarin Sodium

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

Major

WARFARIN (Coumadin)

Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Vitamin K antagonizes the effects of warfarin. Excessive vitamin K intake, either from supplements or from changes in the diet, can reduce the anticoagulant effect of warfarin.
Severity Major Likelihood Likely Evidence C

Well-controlled human studies have demonstrated the likely existence of this interaction.

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

Here's the simple version: warfarin works by blocking vitamin K, which your body needs to make clotting factors. So when you take extra vitamin K, you're essentially giving warfarin more of the very thing it's trying to hold back. The result is that warfarin gets weaker, your blood may clot more easily, and you lose some of the protection you're counting on against clots like a stroke or a clot in the leg or lung.

Warfarin is a narrow-margin drug, so even small swings matter. The key isn't avoiding vitamin K (greens, broccoli, supplements), it's keeping your intake steady day to day. Don't suddenly start or stop a vitamin K supplement without checking with your pharmacist or doctor first, since your dose and INR are balanced around your usual habits.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Crowther MA, Ageno W, Garcia D, et al. Oral vitamin K versus placebo to correct excessive anticoagulation in patients receiving warfarin: a randomized trial. Ann Intern Med. 2009;150(5):293-300. PubMed
  3. Dietary vitamin K guidance: an effective strategy for stable control of oral anticoagulation? Nutr Rev. 2010;68(3):178-81. PubMed
  4. Kim JS, Nafziger AN, Gaedigk A, et al. Effects of oral vitamin K on S- and R-warfarin pharmacokinetics and pharmacodynamics: enhanced safety of warfarin as a CYP2C9 probe. J Clin Pharmacol. 2001 Jul;41(7):715-22. PubMed
  5. Dezee, K. J., Shimeall, W. T., Douglas, K. M., Shumway, N. M., and O'malley, P. G. Treatment of excessive anticoagulation with phytonadione (vitamin K): a meta-analysis. Arch.Intern.Med. 2-27-2006;166(4):391-397. DOI
  6. Dentali, F., Ageno, W., and Crowther, M. Treatment of coumarin-associated coagulopathy: a systematic review and proposed treatment algorithms. J.Thromb.Haemost. 2006;4(9):1853-1863. 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

Vitamin K Also Interacts With Other Medications

Vitamin K has 1 major, known drug interaction in our database — the Warfarin Sodium one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Vitamin K

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

From our Q&A

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

We hold 5,292 real supplement products containing Vitamin K, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Vitamin K. Your product may carry other ingredients that interact with Warfarin Sodium too, on top of Vitamin K — 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 Vitamin K 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 Vitamin K
Top 5%

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

29 days ago today
Medication Warfarin Sodium
Top 1%

#18 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 Vitamin K

What is Vitamin K?

  • Supporting normal blood clotting
  • Bone health
  • Heart and vascular health
  • Correcting vitamin K deficiency
  • Newborn bleeding prevention (medical injection)

Vitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but supplements are sometimes used for deficiency or bone and heart health, where evidence is mixed. If you take a blood thinner, talk to your pharmacist or doctor before changing your vitamin K intake.

Read the full Vitamin K monograph & all interactions
Medication

About Warfarin

What Is Warfarin Used For?

Brand names: Coumadin, Panwarfin, Sofarin

Warfarin sodium tablets and Jantoven tablets are both used to prevent and treat venous thrombosis (blood clots in the veins) and pulmonary embolism (a clot in the lungs). They are also used to prevent clot-related complications in people with atrial fibrillation (an irregular heart rhythm) or who have had a heart valve replaced.

In people who have had a heart attack, warfarin is used to reduce the risk of death, another heart attack, stroke, or other clotting events. It does not dissolve an existing clot, but it helps prevent the clot from growing and stops new dangerous clots from forming.

See full Warfarin drug information
Keep checking

Other Drugs & Vitamin K

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

1Major
0Moderate
0Minor
2,828No known interaction
Major

1 interaction

No interaction 2,828 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 Vitamin K and Warfarin Sodium Together: Common Questions

Can you take Vitamin K with Warfarin Sodium?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Vitamin K and Warfarin Sodium interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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

Still Have a Question About Warfarin Sodium and Vitamin K?

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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.