Drug & supplement interaction

Wasabi + Inotersen

Inotersen brand name: Tegsedi.

Moderate Interaction
The bottom line Moderate

Wasabi has a moderate interaction with Inotersen. Theoretically, wasabi might increase the risk of bleeding 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

Wasabi and Inotersen

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Inotersen

Inotersen falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Wasabi interacts with.

Theoretically, wasabi might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
In vitro research shows that 6-(methylsulfinyl) hexyl isothiocyanate, a constituent of wasabi, 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 connection worth knowing. Inotersen (Tegsedi) treats a rare nerve condition caused by hereditary transthyretin amyloidosis, and one of its known side effects is a drop in your platelet count (sometimes a serious one), which on its own can raise bleeding risk. Wasabi contains compounds that, in test-tube studies only, seem to make platelets a little less sticky.

Stacked together, the theory is that both could nudge bleeding risk upward. But please don't lose sleep over this. The wasabi data is purely lab-based, and the small dab on your sushi is very unlikely to matter. Concentrated wasabi supplements are a different story. Since Inotersen already needs regular blood monitoring, just mention any wasabi supplement to your doctor or pharmacist.

References
  1. Morimitsu, Y., Hayashi, K., Nakagawa, Y., Fujii, H., Horio, F., Uchida, K., and Osawa, T. Antiplatelet and anticancer isothiocyanates in Japanese domestic horseradish, Wasabi. Mech Ageing Dev 2000;116(2-3):125-134. 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

Wasabi Also Interacts With Other Medications

Wasabi has 121 moderate known drug interactions in our database — the Inotersen 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 Wasabi

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

Everything else you take

See Every Supplement That Interacts With Inotersen

This page covers Wasabi only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Inotersen page lists 208 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Danshen (major), Piracetam (major), Siberian Cocklebur (major) and Aconite (moderate).

By severity: 4 major · 186 moderate · 18 minor.

From our pharmacist’s overview on the Inotersen page

“Danshen is the entry I would flag first for anyone taking inotersen (Tegsedi). Inotersen can drive platelet counts dangerously low, and 202 of the 208 supplements on this page add some blood-thinning or antiplatelet effect on top of that.”

Reviewed by 2 · Jul 18, 2026

Open the Inotersen interaction page

How much people look this up

Where Wasabi and Inotersen 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 Wasabi
Steady interest

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

29 days ago today
Medication Inotersen
Steady interest

#2,549 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 Wasabi

What is Wasabi?

Wasabi
  • Flavoring for sushi and other foods
  • Antimicrobial support
  • Anti-inflammatory support
  • Antioxidant support
  • General immune support

Wasabi is best known as the pungent green condiment served with sushi, made from a Japanese plant in the cabbage family. Its natural compounds (isothiocyanates) show antimicrobial and antioxidant activity in lab studies, but there is very little human research to support taking it as a supplement. As a food it is generally safe; as a concentrated supplement, talk with your pharmacist or doctor first.

Read the full Wasabi monograph & all interactions
Keep checking

Other Drugs & Wasabi

Browse every other medication we’ve checked against Wasabi — 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
Moderate

121 interactions

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

No interaction 2,708 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 Wasabi and Inotersen Together: Common Questions

Can you take Wasabi with Inotersen?
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 Wasabi and Inotersen 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.