NutriStack
Clopidogrel and Fish Oil, a caution.
Fish oil has antiplatelet properties that may add to clopidogrel's platelet inhibition, increasing the overall bleeding risk. While moderate fish oil doses are generally well-tolerated, the additive antiplatelet effect may be clinically significant, especially with other bleeding risk factors.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Clopidogrel and Fish Oil
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 5 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Fish oil has antiplatelet properties that may add to clopidogrel's platelet inhibition, increasing the overall bleeding risk. While moderate fish oil doses are generally well-tolerated, the additive antiplatelet effect may be clinically significant, especially with other bleeding risk factors.
Mechanism. Clopidogrel irreversibly inhibits the P2Y12 ADP receptor on platelets. Fish oil's EPA/DHA reduce thromboxane A2 production and alter platelet membrane composition, providing additional antiplatelet effect through a different mechanism. The combined dual-pathway platelet inhibition increases bleeding risk.
Recommendation. Use moderate fish oil doses (1-2g/day) cautiously with clopidogrel. Higher doses may increase bleeding risk. Report any unusual bleeding, bruising, or prolonged bleeding from cuts to your healthcare provider.
Sources (5)
- Bays HE. Safety considerations with omega-3 fatty acid therapy. Am J Cardiol. 2007;99(6A):35C-43C. PMID 17368277
- Lun R, Dhaliwal S, Zitikyte G, Roy DC et al.. Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack: A Network Meta-analysis. JAMA Neurology. 2022. PMID 34870698
- Liao Y, Xie B, Zhang H et al.. Efficacy of omega-3 PUFAs in depression: A meta-analysis.. Translational Psychiatry. 2019. PMID 31383846
- Wei BZ, Li L, Dong CW et al.. The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers.. American Journal of Clinical Nutrition. 2023. PMID 37028557
- Uchida Y, Tsuji K, Ochi E. Effects of Omega-3 fatty acids supplementation and resistance training on skeletal muscle.. Clinical Nutrition ESPEN. 2024. PMID 38777432
Stack Score
How this pair moves the number.
Effect on the composite score
If both Clopidogrel and Fish Oil are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
Check your full routine
One pair was the worked example. NutriStack runs every pair in your stack at once.
Drop in your supplements and prescriptions and the public database surfaces every interaction, synergy, timing rule, and contraindication, every one linked to its primary source.