NutriStack
Ginger Extract and Warfarin, a caution.
Ginger extract inhibits platelet aggregation via thromboxane synthase suppression and may potentiate warfarin. Case reports describe supratherapeutic INRs and bleeding (one patient developed epistaxis with an INR >10 after starting ginger tea and dried ginger). A longitudinal cohort of warfarin patients found ginger use was independently associated with a ~3.2-fold increase in bleeding events.
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
- Ginger Extract and Warfarin
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 3 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. Ginger extract inhibits platelet aggregation via thromboxane synthase suppression and may potentiate warfarin. Case reports describe supratherapeutic INRs and bleeding (one patient developed epistaxis with an INR >10 after starting ginger tea and dried ginger). A longitudinal cohort of warfarin patients found ginger use was independently associated with a ~3.2-fold increase in bleeding events.
Mechanism. Gingerols and shogaols inhibit cyclooxygenase and thromboxane A2 synthesis in platelets, reducing aggregation. This pharmacodynamic antiplatelet effect adds to warfarin's anticoagulation, raising bleeding risk without necessarily changing the INR.
Recommendation. Avoid concentrated ginger extract while taking warfarin. Culinary amounts in food are generally safe, but tell your anticoagulation clinic before starting any ginger supplement and ask for an INR check within 1-2 weeks.
Sources (3)
- Lesho EP, Saullo L, Udvari-Nagy S. A 76-year-old woman with erratic anticoagulation. Cleve Clin J Med. 2004;71(8):651-6. PMID 15449760
- Shalansky S, Lynd L, Richardson K, Ingaszewski A, Kerr C. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27(9):1237-47. PMID 17723077
- Marx W, McKavanagh D, McCarthy AL, et al. The Effect of Ginger (Zingiber officinale) on Platelet Aggregation: A Systematic Literature Review. PLoS One. 2015;10(10):e0141119. PMID 26488162
Stack Score
How this pair moves the number.
Effect on the composite score
If both Ginger Extract and Warfarin 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.
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