Does Berberine Interact With Xarelto?

Answer

Thank you for contacting us! There is a potential interaction between berberine and Xarelto, so it's important to consult your doctor before combining them.

Our 'Drug-Herbal Interaction Checker' provides detailed information on the interaction between Berberine and Xarelto. I've shared some of the key details in the sections below.

Interaction Details

Several factors contribute to the interaction between berberine and Xarelto.

First, research indicates that berberine moderately inhibits CYP3A4, an enzyme involved in metabolizing various drugs, including Xarelto. This inhibition can lead to increased levels of Xarelto in the body, potentially raising the risk of adverse effects like bleeding.

The prescribing information for Xarelto states this clearly:

Concomitant use of drugs that are known combined P-gp and strong CYP3A inhibitors increases rivaroxaban exposure and may increase bleeding risk

Additionally, berberine itself has been associated with anticoagulant effects, inhibiting platelet aggregation in animal studies. While evidence of berberine's blood-thinning effects in humans is lacking, the risk is plausible.

Xarelto already carries a bleeding risk on its own, which is why it's often recommended to avoid other drugs that carry a bleeding risk too, like NSAIDs (e.g., ibuprofen) and aspirin.

While berberine is not typically linked to a bleeding risk like NSAIDs and aspirin, it should still be used cautiously with blood-thinning medications such as Xarelto for similar reasons.

Final Words

Given the potential interaction between berberine and Xarelto, it's advisable to consult with your doctor before taking them together so you can be appropriately monitored.

The combination may be safe for some individuals but it is important to know of the potential risks.