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Probable interaction between Lycium barbarum (goji) and warfarin
Claudio A Rivera1, Carol L Ferro, Adam J Bursua
1Department of Medicine, University of Southern California, Los Angeles, California, USA.
Pharmacotherapy
|March 7, 2012
Summary
Goji juice, containing Lycium barbarum, can dangerously increase warfarin
Area of Science:
- Pharmacology
- Herbal Medicine Interactions
- Clinical Toxicology
Background:
- Warfarin is a crucial anticoagulant medication.
- Lycium barbarum (goji berry) is a traditional Chinese herb with purported health benefits.
- Goji juice is a popular beverage containing Lycium barbarum.
Observation:
- A 71-year-old woman on warfarin experienced a critical elevation in her international normalized ratio (INR) and bleeding.
- Her symptoms, including epistaxis, bruising, and rectal bleeding, emerged after consuming goji juice for four days.
- Her INR normalized after discontinuing both goji juice and warfarin.
Findings:
- A probable adverse drug interaction was identified between Lycium barbarum and warfarin.
- The Naranjo scale indicated a probable relationship between goji juice consumption and the elevated INR and bleeding.
- This case aligns with two prior reports of similar interactions between warfarin and Lycium barbarum tea.
Implications:
- Patients on warfarin should be cautioned against consuming goji juice and other Lycium barbarum-containing products.
- Healthcare providers must inquire about and document herbal product use in patients prescribed anticoagulants.
- Increased awareness of herbal-drug interactions is crucial for patient safety.
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