Warfarin and food interactions

  Some foods can enhance the anticoagulant effect of warfarin. For example, the combination of garlic, ginger and warfarin can enhance the anticoagulant effect of warfarin. Grapefruit contains coumarins, which can also inhibit the activity of liver-related drug metabolizing enzymes, reduce the metabolism of warfarin and enhance its anticoagulant effect. Mango contains vitamins A, C, B1, B6, etc., which can also enhance the anticoagulant effect of warfarin when combined with it. Fish oil enhances the anticoagulant effect of warfarin by inhibiting platelet aggregation and reducing the levels of coagulation-related thromboxane and vitamin K-dependent coagulation factors.  Some foods can diminish the anticoagulant effect of warfarin. Avocados can induce liver-related drug metabolizing enzyme activity and promote warfarin metabolism, while interfering with intestinal absorption of warfarin, thus weakening the anticoagulant effect of warfarin; soy milk and seaweed weaken the anticoagulant effect of warfarin by altering warfarin metabolism and affecting its absorption. Ginseng and American ginseng, which contain ginsenosides, can also induce liver-related drug metabolizing enzymes and increase warfarin metabolism, thus weakening the anticoagulant effect of warfarin. Patients taking warfarin are sensitive to changes in the vitamin K content of food. Foods rich in vitamin K can make warfarin anticoagulant effect decreased, such as green leafy vegetables, kale, carrots, egg yolk, pig liver, green tea, etc. Especially green leafy vegetables are rich in vitamin K. Among them: spinach, leek, rape is high, amounting to 236-436μg/100g. Cabbage is medium at 89μg/100g. Celery stems, radish, cauliflower, cucumber contain less at 30-40μg/100g (cucumber skin is high). 100g (cucumber skin content is high, should be peeled and eaten).  Tomatoes are the least, only 5μg/100g. Therefore, while taking warfarin, the diet structure needs to be regular so that the drug dose can be easily adjusted.