NAD+ and Warfarin
Supplement–drug interaction evidence from the TruthStack database.
| Severity | MODERATE |
|---|---|
| Evidence Tier | Limited |
| Interaction Type | SAFETY CONCERN |
| Mechanism | METABOLISM |
| Last Reviewed | 2026-02-24 |
Summary
High-dose niacin (NAD+ precursor pathway) can alter hepatic function and potentially affect warfarin metabolism. IV NAD+ may still affect coagulation parameters. Limited data. Monitor INR.
Higher-Concern Contexts
This interaction may be of particular concern in the following contexts:
- hepatic impairment
- anticoagulant use
CYP Enzyme Profiles
Published CYP enzyme data for compounds in this interaction:
Warfarin: CYP1A2 substrate (weak), CYP2C9 substrate (strong), CYP3A4 substrate (moderate)
What We Don't Know
This interaction has limited evidence. Key gaps may include: direct clinical trial data for this specific combination, dose-response relationships, and long-term outcome data. Absence of evidence is not evidence of absence.
API Reference
Open, unauthenticated. Returns JSON. Developer documentation