Check Your Supplements Against Eliquis
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Supplements to avoid with Eliquis (apixaban) fall into two camps: St. John’s Wort, which speeds the drug’s elimination and quietly weakens your clot protection, and bleeding-risk boosters — high-dose fish oil, ginkgo biloba, and high-dose vitamin E — that stack on top of an anticoagulant.
The best-documented supplement interactions with Eliquis: St. John’s Wort (induces the enzymes that clear apixaban, reducing its protective effect — avoid), plus supplements with antiplatelet or blood-thinning activity: high-dose fish oil, ginkgo biloba, and vitamin E above recommended amounts, all of which can add bleeding risk. Unlike warfarin, Eliquis is not destabilized by dietary vitamin K.
This page is for informational purposes only and is not medical advice. The interactions listed here are well-documented but not exhaustive — no list can cover every product or personal situation. Always consult your doctor or pharmacist before combining any supplement with prescription medication, and never start or stop a medication or supplement based on what you read online.
Eliquis (apixaban) is a direct oral anticoagulant: it blocks clotting factor Xa directly, without routine INR monitoring and without the vitamin K sensitivity that makes warfarin so finicky. That is genuine progress, but it removes a safety net too — with no monthly blood test, a supplement that quietly lowers your apixaban levels has no lab value to expose it.
That is exactly what St. John’s Wort can do. It is a strong inducer of CYP3A4 and P-glycoprotein, the enzyme and transporter that clear apixaban, and strong inducers are specifically cautioned against in apixaban prescribing information. The other rule is simpler: you are on a blood thinner, so supplements with their own antiplatelet effects add bleeding risk.
| Supplement | Risk | What to do |
|---|---|---|
| St. John’s Wort | Strongly induces CYP3A4 and P-gp, which can lower apixaban levels and reduce protection against stroke and clots — with no routine lab test to catch it. | Avoid entirely while on Eliquis. |
| Fish oil (high-dose omega-3s) | Mild antiplatelet effect; NIH notes high doses may add to bleeding risk with anticoagulant drugs. | Discuss dose with your prescriber; keep it modest if approved. |
| Ginkgo biloba | Associated with bleeding events and generally cautioned against alongside anticoagulants. | Avoid while on Eliquis. |
| Vitamin E (above recommended intake) | High doses inhibit platelet function and may increase bleeding risk on anticoagulants, per NIH. | Stay at or below standard multivitamin amounts; skip high-dose vitamin E products. |
Standard multivitamins, vitamin D, calcium, and magnesium at label doses have no well-documented interaction with apixaban — and unlike warfarin, you do not need to micromanage vitamin K in your diet or supplements. The watchlist for Eliquis is specific: metabolic inducers (St. John’s Wort) and anything marketed for “blood flow” or “circulation,” which often means antiplatelet activity.
Before any planned surgery or dental work, tell the clinician about every supplement you take alongside Eliquis — bleeding-risk combinations matter most exactly then.
A list like this covers the best-documented supplement interactions with Eliquis, but it cannot cover every product on the shelf. Multi-ingredient formulas — greens powders, sleep blends, pre-workouts, “hormone support” capsules — often bury a risky ingredient halfway down the label where nobody looks.
Suppi solves this the practical way: scan the label, and the app cross-checks every ingredient against your medications and the rest of your supplement stack using a database built on 500+ peer-reviewed clinical studies. You can also start with our free supplement interaction checker overview to see how it works, then bring your full list to your doctor or pharmacist for the final word.
Sources used for this guide. These are stable, authoritative pages from the U.S. National Institutes of Health, the National Library of Medicine, and the FDA.
This page is for informational purposes only and is not medical advice. The interactions listed here are well-documented but not exhaustive — no list can cover every product or personal situation. Always consult your doctor or pharmacist before combining any supplement with prescription medication, and never start or stop a medication or supplement based on what you read online.
Scan any supplement label and see bleeding-risk flags for your anticoagulant in seconds. Free on iOS.
Download Free on iOSPrefer to read first? See how the supplement interaction checker works.