Ginger Root Interaction with Eliquis

Mechanism of Interaction

Ginger contains constituents that have antiplatelet effects, with 5 of 20 constituents shown to inhibit platelet aggregation in vitro 1, 2
Ginger may slow blood clotting, creating potential drug-drug interactions with anticoagulants like apixaban 3, 4

The Society for Perioperative Assessment and Quality Improvement recommends holding ginger supplements for 2 weeks before surgery due to laboratory evidence of inhibition of thromboxane synthetase with decreased platelet aggregation 5

Patients taking Eliquis should avoid ginger supplements due to the increased risk of bleeding complications 1, 5
If a patient has been taking both ginger and Eliquis, they should be monitored for signs of increased bleeding such as unusual bruising or petechiae 1
If a patient has been taking both ginger and Eliquis, they should be monitored for signs of increased bleeding such as prolonged bleeding from cuts 1
If a patient has been taking both ginger and Eliquis, they should be monitored for signs of increased bleeding such as nosebleeds or gum bleeding 1

Acetaminophen is generally considered a safe pain reliever option for patients on anticoagulants like Eliquis, as it does not have antiplatelet effects 6
Patients should limit daily acetaminophen intake to a maximum of 4 g per day to prevent liver toxicity 6

Healthcare providers should specifically ask about ginger consumption, including ginger tea, supplements, and foods with high ginger content 1, 5

In case of significant bleeding, temporary discontinuation of Eliquis and supportive care may be necessary 5
Patients should always inform healthcare providers about all supplements they are taking before any surgical or dental procedures 6

The additive antiplatelet effect of ginger can enhance the anticoagulant action of Eliquis, which works by inhibiting factor Xa and preventing the conversion of prothrombin to thrombin 7

While some studies suggest ginkgo and ginger do not appear to interact with warfarin at modest doses, the interaction between ginger and Eliquis represents a clinically significant risk that warrants careful consideration in anticoagulant management, with evidence from Circulation: Arrhythmia and Electrophysiology 7