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A Comprehensive Review of Potential Warfarin-Fruit Interactions
Journal of Pharmacy Practice
|August 13, 2014
Summary
Warfarin interactions with fruits like cranberry and grapefruit are suggested by case reports, but scientific evidence is limited. Clinicians should monitor patients for potential international normalized ratio (INR) instability with these fruit products.
Area of Science:
- Pharmacology
- Nutritional Science
- Clinical Medicine
Background:
- Warfarin is a widely prescribed anticoagulant medication.
- Dietary factors, including fruit consumption, can influence warfarin's efficacy and safety.
- Potential interactions between warfarin and various fruit products require thorough investigation.
Purpose of the Study:
- To review and discuss potential interactions between warfarin and fruit products.
- To evaluate the available scientific evidence regarding these interactions.
- To provide guidance for clinicians managing patients on warfarin therapy.
Main Methods:
- A comprehensive literature search was performed using specific keywords related to warfarin and fruit interactions.
- Included studies comprised case reports and controlled clinical trials.
- A total of 23 citations were reviewed.
Main Results:
- Cranberry products were most frequently implicated in suspected warfarin-fruit interactions.
- Pomegranate juice, avocado, grapefruit juice, mango, and papain were also reported to interact with warfarin.
- Controlled clinical trials primarily focused on cranberry concentrate and grapefruit juice.
Conclusions:
- While case reports suggest potential warfarin-fruit interactions, robust scientific evidence is scarce.
- Clinicians should advise moderation in consuming cranberry products and grapefruit juice.
- Dietary history, including intake of mango, pomegranate juice, and avocado, is crucial for assessing international normalized ratio (INR) instability.
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