{"id":632751,"date":"2025-07-07T09:42:20","date_gmt":"2025-07-07T13:42:20","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=632751"},"modified":"2026-01-28T14:10:41","modified_gmt":"2026-01-28T19:10:41","slug":"xarelto-interactions-with-supplements","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/xarelto-interactions-with-supplements\/","title":{"rendered":"Xarelto interactions with supplements"},"content":{"rendered":"

Xarelto (rivaroxaban) is a prescription blood thinner that can interact with several supplements, such as St. John\u2019s wort (which may reduce its effectiveness), and Ginkgo biloba or turmeric (which may increase bleeding risk).<\/span><\/p>\n

\u00a0If you\u2019re taking Xarelto, it\u2019s crucial to be aware of its interactions with other drugs and how they can impact its effectiveness or worsen side effects.<\/span><\/p>\n

Xarelto supplement interactions<\/span><\/h2>\n

Like any medication, there are a few drugs that, if taken together, can cause an interaction. Xarelto\u2019s most serious interactions often occur when it is mixed with certain supplements.<\/span><\/p>\n

\u201cApproximately one-third of the drug\u2019s concentration in the body is removed by the kidneys through two transport proteins, P-gp and BCRP,\u201d says Jerome Enad<\/a>, MD, FAANA, ACSM-CEP \u00a0a board-certified orthopedic surgeon in Pensacola, Florida. \u201cAnother one-third is broken up in the liver (or metabolized) by cytochrome p-450 (CYP450) enzymes. Therefore, any supplement that affects the activity of these transport proteins or p-450 enzymes can potentially alter (increase or decrease) the effectiveness of Xarelto.\u201d<\/span><\/p>\n

Here\u2019s a look at common Xarelto supplement interactions:<\/span><\/p>\n\n\n\n\n\n\n
Supplement<\/b><\/td>\nInteractions\/side effects<\/b><\/td>\n<\/tr>\n
St. John\u2019s wort<\/span><\/td>\nMay reduce Xarelto\u2019s effectiveness and increase risk of clots.<\/span><\/td>\n<\/tr>\n
Ginkgo biloba<\/span><\/td>\nMay increase bleeding risk<\/span><\/td>\n<\/tr>\n
Turmeric<\/span><\/td>\nMay increase bleeding risk<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

St. John\u2019s wort<\/span><\/h3>\n

St. John\u2019s wort<\/span><\/a> (hypericum perforatum) is a flowering plant that many people use as a supplement to treat mild to moderate depression, menopausal symptoms, and minor cuts and burns. However, the U.S. Food and Drug Administration (FDA) has not approved nor regulated its use for these medical problems.<\/span><\/p>\n

St. John\u2019s wort can significantly reduce Xarelto\u2019s effectiveness in your body and potentially lead to serious side effects. \u201cSt. John\u2019s Wort is known to increase the function of a specific enzyme (CYP3A4) needed to break down Xarelto in the body,\u201d says <\/span>Stephanie Prozora, MD<\/span><\/a>, a pediatric hematologist-oncologist and Assistant Professor of Pediatrics at Yale Pediatric Hematology & Oncology in New Haven, Connecticut. \u201cWhen taken together, the increased function of CYP3A4 results in Xarelto being cleared faster than it should, making it less effective. Decreasing the effect of Xarelto may increase the risk of developing blood clots.\u201d<\/span><\/p>\n

Research supports<\/span><\/a> Dr. Prozora\u2019s claims. An open-label, non-randomized, sequential treatment interaction study found that taking St. John\u2019s wort can reduce rivaroxaban\u2019s effectiveness by activating the CYP3A4 enzyme. This enzyme breaks down the drug more rapidly than necessary and reduces its blood-thinning effect.<\/span><\/p>\n

The reduction of Xarelto\u2019s effectiveness can increase the risk of blood clots, which can lead to <\/span>symptoms<\/span><\/a> of deep vein thrombosis (DVT), such as:<\/span><\/p>\n