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5426062 
Journal Article 
Review 
Interactions of warfarin with garlic, ginger, ginkgo, or ginseng: Nature of the evidence 
Vaes, LPJ; Chyka, PA 
2000 
Yes 
Annals of Pharmacotherapy
ISSN: 1060-0280
EISSN: 1542-6270 
34 
12 
1478-1482 
English 
11144706 
WOS:000165810800016 
OBJECTIVE: To review and characterize the evidence describing potential interactions between warfarin and garlic, ginger, ginkgo, or ginseng.

DATA SOURCES: Searches of MEDLINE (1966-1999), other bibliographic databases, several abstracting services, and tertiary references were conducted.

STUDY SELECTION AND DATA EXTRACTION: Articles were examined by each author, and additional citations were obtained from the references of these articles. Preference was given to Englishlanguage articles of human studies.

DATA SYNTHESIS: Evidence is lacking for an interaction of warfarin wth galic or ginger. One case report associates ginseng use with decreased warfarin-maintained anticoagulation effect. Another case report links concomitant use of ginkgo and warfarin with the development of intracerebral hemorrhage. Hemorrhage and tendencies were noted in four cases with ginkgo use and in three cases with garlic; in none of these cases were patients receiving warfarin.

CONCLUSIONS: The true risks of these interactions and effects are difficult to characterize due to the limited number and nature of existing reports. 
drug interactions; warfarin; garlic; ginger; ginkgo; ginseng; dietary supplements