Herb & supplement monograph

Wintergreen Drug Interactions, Uses, Effectiveness, Safety & More

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Reviewed by licensed pharmacists Sourced from Natural Medicines

Wintergreen Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Because wintergreen oil delivers an aspirin-like compound through the skin, the overall risk of a clinically significant Wintergreen drug interaction is moderate for most people, and it deserves real caution with blood thinners. A couple of interactions are rated major and nearly all of the rest are moderate, with none rated minor.

Interactions deserving the most attention

The interaction that matters most is with warfarin, where human case reports show that applying wintergreen oil products to the skin can raise INR and increase bleeding risk, because the methyl salicylate in the oil is absorbed into the body. There is also a documented concern with aspirin, since wintergreen's methyl salicylate is closely related to aspirin and using large amounts, covering treated skin, or applying it for long periods could add to salicylate levels. Both of these have human evidence behind them, so they should be taken seriously rather than treated as theory.

What the rest of the list means

Wintergreen's long interaction list does not mean every combination is dangerous. Most concerns trace back to one thing: the oil contains a salicylate that can pass through the skin, so risk depends heavily on how much is applied, over how much skin, and for how long. Occasional light use is a different situation from heavy or prolonged application.

Check your medications against Wintergreen

Based on HelloPharmacist’s Wintergreen interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Wintergreen

37 medications have a known interaction with Wintergreen, graded by severity. Select any drug for the full evidence-based detail.

2 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Wintergreen.

2,830 drugs
WarfarinWarfarin› Warfarin SodiumCoumadin, Panwarfin, Sofarin› Acetaminophen, AspirinGemnisyn› Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine› Acetylsalicylic AcidEntrophen› Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2› Aluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin› AspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more› Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3› Aspirin, ButalbitalAxotal› Aspirin, Butalbital, CaffeineFiorinal› Aspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine› Aspirin, Butalbital, Caffeine, PhenacetinMarnal› Aspirin, CaffeineAnacin› Aspirin, Caffeine, Codeine PhosphateAnacin w/ Codeine› Aspirin, Caffeine, Dihydrocodeine BitartrateSynalgos DC› Aspirin, Caffeine, Dover's PwdAcedoval, Dovacet› Aspirin, Caffeine, HydrocodoneDamason-P› Aspirin, Caffeine, Isobutylallylbarbituric Acid, PhenacetinLanorinal› Aspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte› Aspirin, Caffeine, Phenacetin, PropoxypheneMargesic Comp. 65› Aspirin, Calcium Carbonate, Magnesium Carbonate, Magnesium OxideBufferin› Aspirin, CarisoprodolSoma Compound› Aspirin, Carisoprodol, Codeine PhosphateSoma Compound w/ Codeine› Aspirin, Chlorpheniramine, PhenylpropanolamineAlka-Seltzer Plus Cold› Aspirin, Citric Acid, Sodium BicarbonateAlka-Seltzer Pain Reliever and Antacid› Aspirin, Codeine PhosphateAspirin w/ Codeine› Aspirin, Codeine Phosphate, MethocarbamolRobaxisal C› Aspirin, Codeine Phosphate, PhenobarbitalPhenaphen› Aspirin, Diphenhydramine, PhenylpropanolamineAlka Seltzer Plus Night Time Effervescent›
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Wintergreen combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Wintergreen affects

Every type of medication (drug category) Wintergreen is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 2 drug categories Wintergreen interacts with
Warfarin (coumadin)Aspirin
Warfarin (Coumadin)

Using wintergreen oil topically might increase the effects and adverse effects of warfarin.
Several case reports show that concomitant use of topical wintergreen oil-containing products and warfarin can increase INR and bleeding risk due to systemic absorption of the methyl salicylate contained in wintergreen oil. Topical analgesic gels, lotions, creams, ointments, liniments, and sprays can contain up to 55% methyl salicylate.

Likelihood Probable Evidence D
Aspirin

Using wintergreen oil topically in large amounts, with occlusive dressings, or for prolonged periods of time might increase the risk of additive salicylate toxicity when used with aspirin.
Wintergreen oil contains methyl salicylate. Topical analgesic gels, lotions, creams, ointments, liniments, and sprays can contain up to 55% methyl salicylate.

Likelihood Probable Evidence D
Monograph

Wintergreen: Uses, Safety & Side Effects

The bottom line

Wintergreen is a low-growing North American plant whose oil is rich in methyl salicylate, an aspirin-like compound used in topical pain rubs. While it may help ease minor muscle and joint pain when applied to the skin, the concentrated oil is highly toxic if swallowed and should never be taken by mouth. Talk with a pharmacist or doctor before using wintergreen products, especially around children.

Scientific name
Gaultheria procumbens
Family
Ericaceae
Part used
Leaves and essential oil
Common forms
Essential oil, topical creams and ointments, liniments, tea, lozenges, flavoring
People commonly use it for
  • Muscle and joint pain (topical)
  • Arthritis discomfort
  • Headaches
  • Sore throat and oral care
  • Flavoring agent

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Topical use may be acceptable for adults, but the essential oil is extremely toxic if swallowed.

PregnancyInsufficient reliable information

Insufficient reliable information is available; avoid using in amounts greater than those found in foods.

Read the full pregnancy detail
BreastfeedingLikely Unsafe

When used orally or topically. Wintergreen products are likely toxic to nursing infants.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Wintergreen (Gaultheria procumbens) is a small, creeping evergreen shrub native to the woodlands of eastern North America. It has glossy leaves and bright red berries, and it gives off a distinctive minty, sweet smell that many people recognize from candy, gum, and toothpaste.

The plant's leaves and the oil pressed or distilled from them have a long history of traditional use. Native American and early settler remedies used wintergreen for aches, pains, and fevers. Today, most wintergreen on the market is either a natural essential oil or a synthetic version of its main active compound, methyl salicylate.

Wintergreen is most commonly found in topical pain-relief rubs, liniments, and ointments, as well as in flavorings and oral care products.

How it works

The main active ingredient in wintergreen oil is methyl salicylate. In the body, methyl salicylate is closely related to salicylic acid, the active part of aspirin. This is why wintergreen is thought to have pain-relieving and anti-inflammatory effects.

When applied to the skin, methyl salicylate is believed to act as a counterirritant, creating a warm or cool sensation that can distract from underlying pain. It may also reduce inflammation in the area where it is applied.

Much of what we know about these mechanisms comes from laboratory studies and from research on salicylates in general. Because the compound is absorbed through the skin and acts like aspirin in the body, large amounts can cause aspirin-like toxicity.

Effectiveness

Does Wintergreen work?

Evidence overview · 3 uses evaluated
3 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.

For Wintergreen, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 3 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Back pain
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using topical wintergreen oil for back pain, there is insufficient reliable information about the clinical effects of wintergreen for this purpose.

Insufficient Reliable Evidence To Rate Joint pain
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using topical wintergreen oil for joint pain, including in those with osteoarthritis or rheumatoid arthritis, there is insufficient reliable information about the clinical effects of wintergreen for this purpose.

Insufficient Reliable Evidence To Rate Muscle soreness
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using topical wintergreen oil for muscle soreness, there is insufficient reliable information about the clinical effects of wintergreen for this purpose.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

The single most important safety point: wintergreen essential oil must never be swallowed. It is extremely concentrated, and even a small amount (as little as a teaspoon) can cause serious or fatal salicylate poisoning, especially in children. Keep all wintergreen oil tightly closed and far out of reach of children and pets.

People who are allergic or sensitive to aspirin or other salicylates should avoid wintergreen. Those with bleeding disorders, kidney problems, or who are scheduled for surgery should also be cautious because of its aspirin-like activity.

Do not apply wintergreen products to broken, irritated, or large areas of skin, and do not use heating pads or tight wraps over the treated area, since this can increase how much is absorbed. Pregnant and breastfeeding people should avoid wintergreen because of its salicylate content and the lack of safety data. Because of the risk of Reye's syndrome and salicylate toxicity, it should not be used on children.

Side effects

When used on the skin, wintergreen may cause local reactions such as redness, burning, stinging, rash, or skin irritation. Some people develop an allergic skin reaction.

More serious problems usually occur when too much is absorbed through the skin or when the oil is swallowed. Signs of salicylate toxicity can include ringing in the ears, nausea, vomiting, rapid breathing, confusion, and in severe cases, seizures or collapse. If wintergreen oil is swallowed, seek emergency medical help or call a poison control center right away.

Wintergreen: Reported Adverse Effects

Documented safety reports on Wintergreen from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, wintergreen leaf seems to be well tolerated, while wintergreen oil may be unsafe. Topically, wintergreen oil seems to be well tolerated.

Serious Adverse Effects (Rare):

Orally: Salicylate poisoning due to methyl salicylate in wintergreen oil.

Reports by condition
Cluster headache Neurologic/CNS

Orally, wintergreen oil can result in symptoms of salicylate poisoning, including headache, tinnitus, and confusion.

  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
Dermatitis Dermatologic

Wintergreen oil can cause contact dermatitis, which can be irritant or allergic in nature. When the oil is applied topically it should not be covered with an occlusive dressing because this could result in absorption of toxic amounts of methyl salicylate.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Chan TY. Potential dangers from topical preparations containing methyl salicylate. Hum Exp Toxicol 1996;15:747-50.
  3. Franceschi J, Darrigade AS, Jegou MH, Milpied B. First report of allergic contact dermatitis caused by Gaultheria procumbens (wintergreen) essential oil. Contact Dermatitis 2022;87(2):193-195.
  4. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
Diarrhea Gastrointestinal

Orally, wintergreen oil can result in symptoms of salicylate poisoning, including nausea, vomiting, diarrhea, and stomach pain. Wintergreen causes gastrointestinal irritation.

  1. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no well-established standardized dose for wintergreen. For topical products, follow the directions on the package and apply only a thin layer to the affected area as directed, no more than the label allows.

Avoid taking wintergreen oil or large amounts of the herb by mouth. Because product strengths vary widely and the oil is dangerous if misused, talk with a pharmacist or doctor before starting any wintergreen product, especially if you take other medicines or have health conditions.

Pregnancy & Breastfeeding

Wintergreen & Pregnancy

Insufficient reliable information

Insufficient reliable information is available; avoid using in amounts greater than those found in foods.

Wintergreen & Breastfeeding

Likely Unsafe

When used orally or topically. Wintergreen products are likely toxic to nursing infants.

  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 7 references that drive our Wintergreen monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Gossel TA, Bricker JD. Principles of Clinical Toxicology. New York, NY:Raven Press, 1994.
  4. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  5. Chan TY. Potential dangers from topical preparations containing methyl salicylate. Hum Exp Toxicol 1996;15:747-50.
  6. Joss JD, LeBlond RF. Potentiation of warfarin anticoagulation associated with topical methyl salicylate. Ann Pharmacother 2000;34:729-33. PubMed
  7. Franceschi J, Darrigade AS, Jegou MH, Milpied B. First report of allergic contact dermatitis caused by Gaultheria procumbens (wintergreen) essential oil. Contact Dermatitis 2022;87(2):193-195.
Keep reading

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.

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

Product directory

Supplement products with Wintergreen

49 products in our database contain Wintergreen. Open any to see its full ingredient list and every drug interaction we check.

BCT Herbal Oil by Professional Botanicals Liquid 4 Dram(s) View ingredients & interactions Blue Ice Fermented Cod Liver Oil Arctic Mint by Green Pasture Liquid 8 fl. Oz. · 237 mL View ingredients & interactions Calm by OL Olympian Labs Capsule 90 Vegetarian Capsule(s) View ingredients & interactions Cascara Sagrada 5,000 mg by Nature's Answer Liquid 3 fl. Oz. · 90 mL View ingredients & interactions Fem Balance by D'Adamo Personalized Nutrition Capsule 90 Veggiecap(s) View ingredients & interactions Five Oils by Pure Herbs Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Five Oils by Pure Herbs Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Green 33 by 4 Organics Tablet Or Pill 90 Vegetarian Tablet(s) View ingredients & interactions Green 33 by 4 Organics Tablet Or Pill 45 Vegetarian Tablet(s) View ingredients & interactions Immune Support by Crystal Star Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Loki 2000 Drops Wintergreen Mint Flavor by Sun God Medicinals Liquid 1 Fluid Ounce(s) · 30 Milliliter(s) View ingredients & interactions Ramp Up by Force Factor Capsule 60 Capsule(s) View ingredients & interactions Total Comfort by Professional Botanicals Capsule 60 Veg. Capsule(s) View ingredients & interactions Total Comfort by Professional Botanicals Capsule 60 Veg. Capsule(s) View ingredients & interactions Ultimate Daily Greens with MSM by Daily Health Powder 8 Ounce(s) · 226 Gram(s) View ingredients & interactions Ultimate Daily Greens with MSM by Daily Health Capsule 180 Capsule(s) View ingredients & interactions Wintergreen by Herbal Terra Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions Wintergreen by Hawaii Pharm Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Wintergreen by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Wintergreen by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Wintergreen Alcohol Free by Herbal Terra Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions Wintergreen Alcohol Free by Hawaii Pharm Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Wintergreen Herb by TerraVita Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Wintergreen Herb 450 mg by TerraVita Premium Collection Capsule 100 Capsule(s) View ingredients & interactions
Pharmacist Counseling Corner

Wintergreen: Common Questions

What is Wintergreen used for, and does it work?
People use Wintergreen for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Wintergreen interact with prescription medications?
Yes. We list 37 medications with a known interaction with Wintergreen, including 2 rated major. Use the checker above to see how Wintergreen interacts with a specific drug.
How are Wintergreen interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Wintergreen with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Wintergreen interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Wintergreen used for?
It is most commonly used in topical rubs for minor muscle and joint pain and arthritis discomfort. It is also used as a flavoring in candy, gum, and oral care products.
Is it safe to swallow Wintergreen oil?
No. Wintergreen essential oil is extremely concentrated and can cause serious or even fatal poisoning if swallowed, even in small amounts. Keep it away from children and never take it by mouth.
Can I use Wintergreen while pregnant or breastfeeding?
It's best to avoid it. Wintergreen contains an aspirin-like compound, and there isn't enough safety information to consider it safe during pregnancy or breastfeeding.
Why does Wintergreen act like aspirin?
Its main ingredient, methyl salicylate, is closely related to the active component of aspirin. This is why it can cause aspirin-like effects and toxicity if too much is absorbed or swallowed.

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

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