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Cautions about taking blood thinners with St. John's Wort!


Staff member
Hi everyone,

I learned something new this week - St. John's Wort should not be taken with blood thinners! My wife, who is a physician and a PhD, suspected that St. John Wort could interact with blood thinners and told me to stop taking it - stop the SJW, not the blood thinners, which can be live-saving medication for some people. I had this confirmed recently by contacting my provincial PADIS (Poison And Drug Information Service), who looked up the interactions and told me I should definitely not take the two together.

For reference, common blood thinners include:
  • Rivaroxaban (Xarelto)
  • Dabigatran (Pradaxa)
  • Apixaban (Eliquis)
  • Heparin (various)
  • Warfarin (Coumadin)
Anyone who has had surgery recently or are taking blood thinners for any other reason should stop taking St. John's Wort.

I had surgery recently, as well as serious trauma. I'm taking Rivaroxaban, a powerful and expensive anticoagulant used to treat a Pulmonary Embolism (PE) that I have - blood clots in my lungs - which is an unfortunate complication from a serious accident I was in six weeks ago. These blood clots are serious and potentially fatal, so I was prescribed Rivaroxaban and will be on it for another three months at least. As it's a life-saving medication for me and when I found out it can interact with St. John's Wort I stopped taking the SJW immediately.

Just for reference, and not for sympathy: six weeks ago I had a serious accident while tobogganing with my daughter that required a 911 call, an ambulance and put me in the trauma unit of the hospital for almost a week. I broke 10 bones in my body including my back in four places, three ribs, my hip, my left arm and my right elbow, and I was on heavy doses of hydromorphone (a morphine-based drug). Recovery has been long, very difficult and painful beyond words. Now I know what it's like to be disabled and also in extreme pain. Honestly I am happy to be alive and very lucky I was not paralyzed, so I expect to make a full recovery one day on this long road of healing that I'm on. Every single day I thank God that things aren't worse. More than that, every day I am so thankful that my daughter, a beautiful and smart 9-year-old, was not injured in my accident!

When I get some time I'll update the main part of this website with new cautions about blood thinners - it's not something I remember reading about anywhere, but it's a potentially serious interaction when the blood thinners are a life-saving medication.