Overview of the Interaction between Warfarin and Korean Herbal Medicine

Lee, In; Park, Sang-moo; Park, Seung-chan; Kim, Do-hyung; Cho, Min-kyoung; Han, Chang-woo; Kwon, Jeong-nam; Hong, Jin-woo

The Journal of Internal Korean Medicine > Volume 33(2); 2012 > Article

Original Article

The Journal of Internal Korean Medicine 2012;33(2): 160-171.

와파린과 상호작용하는 한약재에 대한 고찰

이인^1,4, 박상무², 박승찬^3,4, 김도형^3,4, 조민경⁴, 한창우^1,4, 권정남^1,4, 홍진우^1,4

¹부산대학교 한의학전문대학원 한의학과
²원광대학교 한의과대학 한방내과학교실
³부산대학교 한의학전문대학원 한의과학과
⁴부산대학교 한방병원 한방내과

Overview of the Interaction between Warfarin and Korean Herbal Medicine

In Lee^1,4, Sang-moo Park², Seung-chan Park^3,4, Do-hyung Kim^3,4, Min-kyoung Cho⁴, Chang-woo Han^1,4, Jeong-nam Kwon^1,4, Jin-woo Hong^1,4

¹Dept. of Korean Medicine, School of Korean Medicine, Pu-San National University
²Dept. of Internal Medicine, College of Oriental Medicine, Won-Kwang University
³Dept. of Korean Medical Science, School of Korean Medicine, Pu-San National University
⁴Dept. of Internal Medicine, Korean Medicine Hospital of Pu-San National University

Correspondence

Jin-woo Hong ,Tel: 055-360-5962, Email: jwhong@pusan.ac.kr

Published online: June 30, 2012.

ABSTRACT

Background and Objective :
Warfarin is the standard anticoagulation treatment for atrial fibrillation, venous thromboembolism (VTE), and mechanical heart valves. Close monitoring of the International Normalized Ratio (INR) is required due to the drug's very narrow therapeutic window. Many factors can affect INR levels. Drug and food interactions are frequently cited as causes of adverse events with warfarin. We discussed interactions between herbs and warfarin studied in this research.

Methods :
In this review, PubMed was used to search medical journals. Keywords “warfarin AND interaction" were applied.

Results:
55 articles were included. The possibility of correlation between warfarin and single herbal medicines such as Salviae Miltiorrhizae Radix, Angelicae Gigantis Radix, Ginseng Radix Alba, Lycii Fructus, Ginkgo Folium, Menthae Herba, Trigonellae semen was suggested. Furthermore, some herbal compounds interacting with warfarin were reported. The conclusion of studies reporting the effect of herbal medicine on warfarin were controversial due to small size or quality of research.

Conculsions:
We suggest that we should prescribe therapeutic herbal medicines to patients using warfarin more carefully and do INR follow-up regularly.

Key words: warfarin, herbal medicine, interaction