The short answer
Feverfew deserves caution with dabigatran etexilate because it has laboratory effects on platelets and limited bleeding reports. These findings do not prove a clinically important interaction with this exact medicine. Discuss the product with your pharmacist before starting it, particularly if other bleeding-risk medicines are also used.
What this answer covers
Oral Tanacetum parthenium (feverfew) supplements with adult oral dabigatran etexilate capsules; extract, leaf and high-dose preparations may differ.
- Supplement or preparation
- Feverfew
- Medication ingredient
- dabigatran etexilate
What supports the bleeding concern?
Laboratory research found that feverfew extracts can inhibit platelet-related processes. A human case report described prolonged vaginal bleeding and abnormal clotting tests during feverfew use, but the patient was not taking dabigatran. These sources justify caution without establishing how often bleeding would occur in people taking both products.
What are the limits of the case report?
The reported feverfew exposure was high and prolonged. Several treatments were used while the supplement was withdrawn, so improvement cannot be attributed to withdrawal alone. One uncontrolled case cannot determine a safe dose, establish a direct anticoagulant interaction or predict the effect of different feverfew extracts.
How does this relate to dabigatran?
Dabigatran etexilate is the swallowed prodrug. The body converts it to dabigatran, which directly inhibits thrombin. The medication already carries a bleeding risk. A platelet effect could be relevant, but it is different from demonstrating increased absorption or blood concentrations of active dabigatran. The inspected evidence does not supply that pharmacokinetic proof or an exact-pair clinical risk estimate.
Can changing the dosing time help?
No validated interval between feverfew and dabigatran etexilate was identified. Review the reason for using feverfew, the exact preparation and other antiplatelet medicines with the treating team. Continue the prescribed anticoagulant unless its prescriber changes the plan. New unusual bleeding needs attention, and severe or continuing bleeding requires urgent care.
Evidence and practical considerations
Side effects & toxicity
Feverfew deserves caution with dabigatran etexilate because it has laboratory effects on platelets and limited bleeding reports. These findings do not prove a clinically important interaction with this exact medicine. Discuss the product with your pharmacist before starting it, particularly if other bleeding-risk medicines are also used.
- Exact scope
- Oral Tanacetum parthenium (feverfew) supplements with adult oral dabigatran etexilate capsules; extract, leaf and high-dose preparations may differ. with adult oral dabigatran etexilate mesylate capsules; active dabigatran produced after absorption
- Medication form and route
- adult oral dabigatran etexilate mesylate capsules; active dabigatran produced after absorption
- Timing or duration
- Concurrent oral use. Source-specific durations are recorded in the evidence entries; no unstudied duration threshold or separation schedule is inferred.
What remains uncertain
- In vitro findings and a feverfew-only case, not a direct dabigatran interaction study. Product variability, high/prolonged exposure and co-treatments limit generalization.
Factors that may matter: Exact supplement preparation, dose and additional ingredients; Kidney function, age, bleeding history and other antiplatelet or anticoagulant medicines; Current medication formulation and recent supplement start or stop.
Read the supporting source summaries
Source 1: current U.S. regulatory prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients receiving oral dabigatran etexilate capsules.
P-gp induction reduces active dabigatran exposure. P-gp inhibition and impaired renal function increase exposure. Capsules must be swallowed intact. RE-LY trough concentrations were not appreciably changed by concomitant PPIs or H2 blockers.
How this applies: Establishes the exact medicine’s mechanism, baseline bleeding precautions and formulation/transport limitations; it does not establish this supplement-specific interaction. Exact scope: Oral Tanacetum parthenium (feverfew) supplements with adult oral dabigatran etexilate capsules; extract, leaf and high-dose preparations may differ.
Named medicine dose adjustments cannot be extrapolated to untested herbs. Label silence about a supplement does not prove compatibility. Capsule results must not be generalized to every formulation.
Source 2: laboratory platelet study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Blood platelets and polymorphonuclear leukocytes studied experimentally.
The extracts inhibited platelet aggregation and release of serotonin in response to several stimuli.
How this applies: Applied only as indirect context; the study or guidance did not establish an interaction with this exact direct oral anticoagulant. It is interpreted only alongside the current dabigatran etexilate label; any source using warfarin or no anticoagulant is indirect for this pair. Exact scope: Oral Tanacetum parthenium (feverfew) supplements with adult oral dabigatran etexilate capsules; extract, leaf and high-dose preparations may differ.
In-vitro exposure, not oral feverfew plus warfarin in patients. Does not quantify bleeding risk or translate into a safe dose.
Source 3: peer-reviewed human case report
europepmc.org · Source check Sep 10, 2026
Population: One 36-year-old woman; warfarin was not among her reported medicines.
Vaginal bleeding and prolonged coagulation tests were reported. Recovery followed feverfew withdrawal together with other treatment.
How this applies: Applied only as indirect context; the study or guidance did not establish an interaction with this exact direct oral anticoagulant. It is interpreted only alongside the current dabigatran etexilate label; any source using warfarin or no anticoagulant is indirect for this pair. Exact scope: Oral Tanacetum parthenium (feverfew) supplements with adult oral dabigatran etexilate capsules; extract, leaf and high-dose preparations may differ.
No warfarin exposure, one uncontrolled case, concurrent treatment and uncertain causal attribution. This is a supplement safety signal, not direct evidence for a warfarin pair.
Source 4: government clinical reference
nccih.nih.gov · Source check Sep 10, 2026
Population: People taking feverfew products.
The reference states that feverfew may slow blood clotting and gives a surgery-related precaution.
How this applies: Applied only as indirect context; the study or guidance did not establish an interaction with this exact direct oral anticoagulant. It is interpreted only alongside the current dabigatran etexilate label; any source using warfarin or no anticoagulant is indirect for this pair. Exact scope: Oral Tanacetum parthenium (feverfew) supplements with adult oral dabigatran etexilate capsules; extract, leaf and high-dose preparations may differ.
Not a direct warfarin interaction study; it does not establish the frequency or size of a combined-use risk.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Current labels and targeted original sources assessed; all current available claims adjudicated and consumer article prepared. Uncertainty and indirect evidence retained. Clinical sign-off not recorded. | |
| Research summary published |
Article revision: 3001b51a57791d1e
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.