Warfarin and Mango Interaction
Introduction to Mango-Warfarin Interaction
- The American Heart Association suggests that mango can potentiate warfarin's anticoagulant effect and increase bleeding risk, so clinicians should inquire about mango consumption in patients on warfarin and advise limiting intake to less than one whole fruit per day 1
Evidence Quality and Clinical Significance
- The American College of Cardiology identifies mango among several fruits that have been reported to interact with warfarin, based on evidence from case reports rather than controlled trials, which limits definitive conclusions about the magnitude and consistency of this interaction 1
Mechanism of Interaction
- Mango likely interacts with warfarin through pharmacokinetic effects, including potential inhibition of CYP2C9 or CYP3A4 enzymes that metabolize warfarin 1
Clinical Management Algorithm
- The American Heart Association recommends that when taking a medication history, clinicians should specifically ask about mango consumption frequency and quantity, and include recent mango consumption in the differential diagnosis for elevated INR 1
- Clinicians should assess dietary history for other interacting fruits, such as pomegranate, avocado, grapefruit, and papaya, in patients with INR instability 1