Warfarin Institute of America

DEDICATED TO YOUR HEALTH

INR Self-Testing from Raytel

GARLIC INTERACTIONS WITH WARFARIN (Coumadin, Jantoven)

Garlic is used as a hypotensive, hypocholestrolemic, antispasmodic, antiseptic and antiviral. (3)  It contains methyl allyl trisulfide and allicin, which have been shown to inhibit platelet aggregation. Additionally, a direct interaction with fibrinogen receptors of platelets by ligand induced conformational changes of a hemoprotein or by intraplatelet mobilization of calcium is proposed.(1,4)

Case reports:

Several reports of increased INR and PT in patients previously stable on warfarin. (3)

 An 87 year-old male, took 4 cloves/day (2000 mg) of garlic to protect against heart disease; admitted for complete bilateral paralysis of lower extremities, bleeding time was prolonged at 11.5 min (RR 3 min); denied taking any other meds that may have interacted.(1)

  A 200 cc hematoma was removed from a breast after surgery, pt admitted to heavy garlic intake, clotting time was prolonged to 15 minutes; after garlic was discontinued clotting time decreased to 6 minutes. (2)

References:

1. Rose KD, Croissant PD, Parliament CF, Levin MB. Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: a case report. Neurosurgery 1990; 26: 880-2.

2. Burnham BE. Garlic as a possible risk for postoperative bleeding. Plast Reconstruc Surg 1995; 95: 213.

3. Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 1998; 158: 2200-9.

4. Srivastava KC. Aqueous extracts of onion, garlic and ginger inhibit platelet aggregation and alter arachadonic acid metabolism. Biomed Biochim Acta 1984; 43:S335-346.

© 2001 Patricia Chuong Used by permission

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Last updated October 24, 2005