MODERATE — Monitor Closely
CAUTION — additive bleeding risk
Evidence level: MODERATE
Dong quai has mild blood-thinning properties that add to Eliquis effects, increasing bleeding risk.
Dong quai has antiplatelet activity from natural coumarins. May add to anticoagulant effect of apixaban.
Avoid combining or use with caution. Inform prescriber about dong quai use.
Use caution. Many botanicals affect blood clotting — ginkgo, garlic, ginger, turmeric, and dong quai all have antiplatelet activity that can amplify Apixaban. St. John's Wort can REDUCE anticoagulant effectiveness. Take at separate times and inform your prescriber about all herbal supplements. Request more frequent INR monitoring if on warfarin.
Concurrent anticoagulants, bleeding history, surgery planned
Unusual bruising, prolonged bleeding, blood in stool/urine
Inform prescriber about all herbal supplements with blood-thinning properties.
Blood thinners have narrow safety margins. Instead of Dong Quai, consider safer options: CoQ10 (with INR monitoring), vitamin D3, or probiotics — these have minimal anticoagulant interactions. Always inform your anticoagulation clinic about any supplements.
Dong quai has mild blood-thinning properties that add to Eliquis effects, increasing bleeding risk.
Use caution. Many botanicals affect blood clotting — ginkgo, garlic, ginger, turmeric, and dong quai all have antiplatelet activity that can amplify Apixaban. St. John's Wort can REDUCE anticoagulant effectiveness. Take at separate times and inform your prescriber about all herbal supplements. Request more frequent INR monitoring if on warfarin.
Unusual bruising, prolonged bleeding, blood in stool/urine
Blood thinners have narrow safety margins. Instead of Dong Quai, consider safer options: CoQ10 (with INR monitoring), vitamin D3, or probiotics — these have minimal anticoagulant interactions. Always inform your anticoagulation clinic about any supplements.
Inform prescriber about all herbal supplements with blood-thinning properties.
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