Diet & Fitness

Ginseng (Panax ginseng) was associated with a decrease in warfarin activity in a case study. This report suggests that ginseng may affect parameters of bleeding. Therefore, people taking ticlopidine should consult with a physician knowledgeable about botanical medicines before taking Asian ginseng or eleuthero/Siberian ginseng (Eleutherococcus senticosus).

This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

Dan shen (Salvia miltiorrhiza), a Chinese herb, was associated with increased warfarin activity in two cases. Although warfarin acts differently from ticlopidine, both affect parameters of bleeding. Until more is known, people taking ticlopidine should use dan shen only under close medical supervision. Sage (Salvia officinalis), a plant relative of dan shen found in the West, has not been not associated with interactions involving warfarin.

Devil’s claw (Harpagophytum procumbens) was associated with purpura (bleeding under the skin) in a patient treated with warfarin. As with dan shen, until more is known, people taking ticlopidine should avoid taking devil’s claw concurrently.

This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

Ginseng (Panax ginseng) was associated with a decrease in warfarin activity in a case study. This report suggests that ginseng may affect parameters of bleeding. Therefore, people taking ticlopidine should consult with a physician knowledgeable about botanical medicines before taking Asian ginseng or eleuthero/Siberian ginseng (Eleutherococcus senticosus).

Garlic (Allium sativum) has been shown to help prevent atherosclerosis (hardening of the arteries), perhaps by reducing the ability of platelets to stick together. Interfering with the action of platelets results in an increase in the tendency toward bleeding and in theory could dangerously enhance the effect of ticlopidine. Standardized extracts of garlic have been associated with bleeding in people only on rare occasions. People taking ticlopidine should consult with a doctor before taking products containing standardized extracts of garlic or eating more than one clove of garlic daily.

Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding. In a rat study, a high intake of ginkgo increased the action of ticlopidine in a way that could prove dangerous if the same effect occurred in people. Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem. People taking ticlopidine should use ginkgo extracts only under the supervision of a doctor.

Although there are no specific studies demonstrating interactions with platelet inhibitors, the following herbs contain coumarin-like substances that may cause bleeding and therefore interact with ticlopidine. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff.

Like ticlopidine, salicylates interfere with the action of platelets. Various herbs, including meadowsweet (Filipendula ulmaria), poplar (Populus tremuloides),willow (Salix alba), and wintergreen (Gaultheria procumbens) contain salicylates. Though similar to aspirin, plant salicylates have been shown to have different actions in test tube studies. Furthermore, salicylates are poorly absorbed and likely do not build up to levels sufficient to cause negative interactions that aspirin might cause. No reports have been published of negative interactions between salicylate-containing plants and aspirin or aspirin-containing drugs. Therefore concerns about combining salicylate-containing herbs and any drug remain theoretical, and the risk of causing bleeding problems may be low.

This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

As it may increase bleeding time, reishi (Ganoderma lucidum) is not recommended for those taking anticoagulant (blood-thinning) medications.