MODERATE — Monitor Closely
🟡 CAUTION — Licorice root causes pseudoaldosteronism (sodium retention, potassium wasting, blood pressure elevation) that directly opposes Warfarin. Avoid licorice root if taking antihypertensive medications, or use DGL (deglycyrrhizinated licorice) which lacks this effect.
Evidence level: MODERATE
Licorice root can deplete potassium and cause fluid retention, which may unpredictably alter how warfarin works in your body. Your INR may become unstable.
Licorice root causes pseudoaldosteronism (glycyrrhizin mimics aldosterone), leading to potassium depletion and sodium/water retention. Hypokalemia can affect vitamin K-dependent clotting factor activity and alter warfarin sensitivity. Additionally, licorice may affect CYP enzymes involved in warfarin metabolism.
Avoid licorice root supplements while on warfarin. If you consume any, monitor INR more frequently. Small amounts of licorice candy (which often contains no real licorice) are generally fine.
Be consistent with Licorice Root intake. If on warfarin, vitamin K-rich foods (leafy greens, broccoli, Brussels sprouts) affect clotting — don't avoid them, but eat consistent amounts week to week. Cranberry juice, grapefruit, and alcohol can amplify anticoagulant effects. Warfarin at the same time daily.
Higher risk for: elderly patients, those with liver disease, history of GI bleeding, concurrent use of multiple blood thinners, recent surgery, vitamin K intake changes, alcohol use, or low body weight.
Unusual bruising, bleeding, muscle weakness, irregular heartbeat, swelling in legs/ankles.
No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.
This medication combination requires careful medical oversight. Your doctor or anticoagulation clinic can adjust doses or select alternatives with fewer bleeding risks. Frequent INR monitoring is essential.
Licorice root can deplete potassium and cause fluid retention, which may unpredictably alter how warfarin works in your body. Your INR may become unstable.
Be consistent with Licorice Root intake. If on warfarin, vitamin K-rich foods (leafy greens, broccoli, Brussels sprouts) affect clotting — don't avoid them, but eat consistent amounts week to week. Cranberry juice, grapefruit, and alcohol can amplify anticoagulant effects. Warfarin at the same time daily.
Unusual bruising, bleeding, muscle weakness, irregular heartbeat, swelling in legs/ankles.
This medication combination requires careful medical oversight. Your doctor or anticoagulation clinic can adjust doses or select alternatives with fewer bleeding risks. Frequent INR monitoring is essential.
No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.
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