ModerateLipid-modifying agents. Omega-3 polyunsaturated fatty acids×Vitamin K antagonist anticoagulants
Updated · Methodology
Mechanism
EPA displaces arachidonic acid in the platelet membrane and shifts synthesis towards thromboxane A3, far less aggregatory than A2. The effect on bleeding time is real but moderate and dose-dependent: it appears mainly above 3 g daily of EPA plus DHA, not with the usual 1 g capsule.
Symptoms
Bruises come slightly more easily and bleeding lasts longer after cuts or a dental extraction. At usual supplement doses most patients notice no change.
Management
There is no need to stop omega-3 routinely. Keep the dose steady, declare it to the prescriber and monitor INR as usual. If the regimen exceeds 3 g daily or antiplatelets are added, review the supplement dose before the anticoagulant's. Before planned surgery, discuss it with the surgical team.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- NIH Office of Dietary Supplements: Vitamin E – Health Professional Fact Sheet (2025)– NIH ODS, Vitamin E, Anticoagulant and antiplatelet medications
- EMA: European Union herbal monograph on Ginkgo biloba L., folium (2015)– EMA/HMPC, final EU herbal monograph, Ginkgo biloba L., folium