[ Pharmaceutical Sciences Asia - ONLINE ]
E-ISSN 2586-8470
[ Journal Abbreviation: Pharm.Sci.Asia ]
Mahidol University Journal of Pharmaceutical Sciences
  FORMER NAME   "Mahidol University Journal of Pharmaceutical Sciences" Published Since 1974


DOI: https://doi.org/10.29090/psa.2017.04.173Pharm Sci Asia 2017; 44(4), 173-189

Warfarin-chlorophyll products, herb-drug interactions

N. Siriwatanametanon*

- Department of Pharmaceutical Botany, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand

Warfarin is one of the most commonly prescribed anticoagulants for preventing the formation of blood clots to reduce the risk of heart attack, stroke, deep vein thrombosis, and other serious conditions. Warfarin belongs to a group of vitamin K antagonists that has a narrow therapeutic index, slow onset of action and significant drug-drug, herb-drug interactions. Its unpredictable dose-response relationship can increase risks of bleeding complications or inadequate anticoagulation. Consumption of foods and nutritional supplements rich in vitamin K can interfere with warfarin treatment because vitamin K can reduce the warfarins effectiveness and potentially increase the risk of blood clots. There are chlorophyll products that are claimed to be beneficial to health when taken as a supplement in solid or liquid forms. Chlorophyll products are now increasingly distributed all over the world. These products make patients and healthcare providers confused about how they affect the effectiveness of warfarin treatment because they are derived from green vegetables, which have been known to cause significant herb-drug interactions. This review provides some information about chlorophylls and chlorophyll products that can potentially interact with warfarin, and some forms, such as chlorophyll drops or chlorophyll water, that can be taken safely because they contain the lowest amount of vitamin K.


Warfarin, Herb-drug interaction, Chlorophyll, Chlorophyllin, Vitamin K

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