The People's Perspective on Medicine

Can You Safely Take Fish Oil with Blood Thinners?

Many people would like to know if they can safely take fish oil with anticoagulant medicines. Caution is advised, as high-dose fish oil might interact.

Many of us make a clear distinction between the drugs we take and the vitamins or supplements we use. It seems logical enough for our brains, but our bodies don’t recognize categories like that. Anything we ingest may get pressed into service. Conversely, supplements might interact with medications or with each other. One reader asks how to safely take fish oil.

How Can You Safely Take Fish Oil?

Q. In a recent health newsletter, I read that you should avoid fish oil supplements if you take a blood thinner. Is this true? If it is, why hasn’t my cardiologist suggested that I stop taking fish oil?

A. A lot depends upon which anticoagulant you are taking. Years ago there were case reports suggesting that fish oil supplements might “thin” the blood too much if someone were taking warfarin (Coumadin). People who took fish oil in conjunction with warfarin had increased INR values on a blood test that indicates a higher risk for hemorrhage (Buckley et al, Annals of Pharmacotherapy, Jan., 2004; Jalili & Jehpour, Archives of Medical Research, Nov. 2007).

The Value of Fish Oil Supplements:

Many people take fish oil to reduce inflammation linked to conditions such as arthritis, asthma and coronary heart disease (Fetterman & Zdanowicz, American Journal of Health-System Pharmacy, July 1, 2009). Fish oil may have mild anti-clotting activity of its own, although it might not be dangerous (Wang et al, Medicines, Sep. 2015). According to a review in Australian Family Physician, you can safely take fish oil at doses under 3000 mg/day even if you also take aspirin, clopidogrel (Plavix) or even warfarin (Kreijkamp-Kaspers et al, Australian Family Physician, July 2015).

The same review notes that there are no studies of fish oil in combination with newer anticoagulant drugs such as apixaban (Eliquis), dabigatran (Pradaxa), prasugrel (Effient), rivaroxaban (Xarelto) or ticagrelor (Brilinta). As a result, it probably would be prudent not to take fish oil if you are taking any such anticoagulant medications.

Your cardiologist may not be aware you are taking fish oil. Or possibly she or he has not seen any studies showing that there is an interaction with your blood-thinning medication. That might explain why you’ve not been given a clear recommendation. Eating fish should not pose a problem. This dietary approach could be a good way to get valuable omega-3 fatty acids, though not at the high doses supplements can provide.

Rate this article
4.6- 19 ratings
About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
The People’s Pharmacy Quick and Handy Home Remedies

Home remedies can be surprisingly effective for a number of common ailments. They're less expensive with fewer side effects than prescription drugs. Time-tested solutions for minor health problems.

The People’s Pharmacy Quick and Handy Home Remedies
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 8 comments
Add your comment

I have been taking fish oil, calcium and vitamin D with prescribed drugs for heart
pressure, cholesterol and blood thinners. I felt sick all the time, I have cut out the
supplements to see if I will start feeling better.

Can I daily take one teaspoon of omega 3 fatty acid with pradaxa blood thinner?

I think it would be helpful to read the latest on which supplements etc should not be taken by people who are on blood thinners For example is turmeric safe for people on blood thinners. I think many of us, including physicians, are often unaware of the interactions of supplements and some spices, herbs and foods with the medications we are on – especially seniors who may take many medications.

Taking one teaspoon of fish oil daily has made a huge difference in reducing back, knee and hip pain due to arthritis. However, I am also at higher risk of a stroke because of atrial fib and family history. My cardiologist prescribed the lowest dose of Plavix. After taking it two days, the roof of my mouth started bleeding uncontrollably when brushing my teeth. I stopped the Plavix and am now back to taking a baby aspirin every other day. I’m continuing the daily teaspoon of fish oil (4500 mg oil according to ingredient list).

My doctor rather bluntly says I’m wasting my money on supplements as they do nothing for us. I feel that in today’s world I can’t be sure the foods I eat will provide the nutrition I need, so continue taking them.

The drs. had never heard of this but I proved it. I take Warfarin and took fish oil, as most people do now. UTI but no connection, took it, another UTI. I told them I would take the fish oil One More time and … another UTI. My drs. never heard of that before but I no longer take fish oil.

I know that I cannot take even 1 baby aspirin a day if I’m taking fish oil because I could tell simply by doing the glucose finger stick that my blood was thinning. I ignored it, and ended up in the ER with a nosebleed that I could not stop, the nurses where I live could not stop it, the EMTs could not stop it. The only thing that stopped it was a balloon packing the ER doc placed in my nose and it stayed there for almost a week. The doc who removed it told me to NOT ever combine the two.

So baby asp fish oil is ok with blood thinner when I get small cut I can stop bleeding healing fast not so good is taking all that the cause of it

* Be nice, and don't over share. View comment policy^