Berberine and Warfarin
Supplement–drug interaction evidence from the TruthStack database.
| Severity | HIGH |
|---|---|
| Evidence Tier | Moderate |
| Interaction Type | BLEEDING RISK |
| Mechanism | METABOLISM |
| Last Reviewed | 2026-02-24 |
Summary
Berberine inhibits CYP2C9 and CYP3A4, key warfarin metabolic pathways. May increase warfarin plasma levels and INR. Monitor INR closely.
Higher-Concern Contexts
This interaction may be of particular concern in the following contexts:
- anticoagulant use
CYP Enzyme Pathway Overlap
Berberine and Warfarin share activity on the following CYP enzymes:
| Enzyme | Berberine | Warfarin |
|---|---|---|
| CYP1A2 | INHIBITOR (WEAK) | SUBSTRATE (WEAK) |
| CYP2C9 | INHIBITOR (MODERATE) | SUBSTRATE (STRONG) |
| CYP3A4 | INHIBITOR (STRONG) | SUBSTRATE (MODERATE) |
API Reference
GET https://api.truthstack.co/v1/check?c1=Berberine&c2=Warfarin
Open, unauthenticated. Returns JSON. Developer documentation
Sources
Primary: 23590177
Related Interactions
What this page is and is not. TruthStack is an informational reference database that describes published pharmacological findings. It does not provide medical advice, diagnosis, or treatment recommendations. The information on this page reflects flags in our database and should not replace consultation with a qualified healthcare provider. Always discuss supplement-drug combinations with your prescriber or pharmacist.