Medication·Interactions·Reviewed June 9, 2026
Rivaroxaban interactions.
Rivaroxaban has 6 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. The full interaction list is below. None of this is a substitute for your prescriber's advice.
Rivaroxaban at a glance.
A quick, data-grounded summary. The full tables are below.
Rivaroxaban has 6 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. The full interaction list is below. None of this is a substitute for your prescriber's advice.
Substances that interact with rivaroxaban.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| St. John's Wort | Conflict | St. John's Wort potently induces CYP3A4 and P-glycoprotein, the primary metabolic pathways for rivaroxaban. This can substantially reduce... details → |
| Fish Oil | Caution | Fish oil has antiplatelet and antithrombotic properties that may increase bleeding risk when combined with rivaroxaban. The combination creates... details → |
| Garlic Extract | Caution | Concentrated garlic extracts inhibit platelet aggregation and have been linked to perioperative bleeding. Added to rivaroxaban's factor Xa... |
| Ginkgo Biloba | Caution | Ginkgo biloba is a potent platelet-activating factor (PAF) antagonist and has been linked in case reports to spontaneous intracranial, ocular, and... details → |
| Nattokinase | Caution | Nattokinase is a direct fibrinolytic enzyme that also reduces clotting factor levels. Combined with rivaroxaban's factor Xa inhibition, the additive... |
| Turmeric/Curcumin | Caution | Curcumin has antiplatelet properties that may increase bleeding risk when combined with rivaroxaban. The additive effect on hemostasis through... |
The full rivaroxaban profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common rivaroxaban questions.
Quick answers drawn from the tables above.
What interacts with Rivaroxaban?
In the NutriStack database, Rivaroxaban has 6 documented interactions. The most notable include St. John's Wort, Fish Oil, Garlic Extract, Ginkgo Biloba, and Nattokinase. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Rivaroxaban?
Rivaroxaban is flagged against 1 substance in the database, including St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Is it safe to take St. John's Wort with Rivaroxaban?
NutriStack classifies the St. John's Wort and Rivaroxaban pairing as conflict: St. John's Wort potently induces CYP3A4 and P-glycoprotein, the primary metabolic pathways for rivaroxaban. This can substantially reduce rivaroxaban plasma... Avoid combining St. John's Wort with rivaroxaban. Strong CYP3A4 inducers are listed as a contraindication in rivaroxaban prescribing information.... Always confirm with your prescriber.
Check your whole stack
See how rivaroxaban fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.