Interaction Between Warfarin and Cranberry Juice

@article{Aston2006InteractionBW,
  title={Interaction Between Warfarin and Cranberry Juice},
  author={Jonathan L. Aston and Amy E. Lodolce and Nancy L. Shapiro},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
  year={2006},
  volume={26}
}
Warfarin is extensively used for anticoagulation to a target international normalized ratio of 2.0–3.0 for most indications or 2.5–3.5 for high‐risk indications; however, many drugs and dietary supplements induce fluctuations in the international normalized ratio. Such fluctuations may lead to therapeutic failure or bleeding complications. Cranberry juice is increasingly used for the prevention and adjunctive treatment of urinary tract infections. The United Kingdom's Committee on Safety of… 
The Absence of an Interaction Between Warfarin and Cranberry Juice: A Randomized, Double‐Blind Trial
TLDR
Cranberry juice has no effect on plasma S‐ or R‐warfarin plasma levels, excluding a pharmacokinetic interaction, and a small though statistically significant pharmacodynamic enhancement of INR by CJ at a single time point is unlikely to be clinically important and may be a random change.
Bidirectional Influences of Cranberry on the Pharmacokinetics and Pharmacodynamics of Warfarin with Mechanism Elucidation
TLDR
Cranberry affected the pharmacokinetics of (±) warfarin in a bidirectional manner by activating the BCRP by CJ during absorption and inhibiting the B CRP and CYP2C9 by CMs during elimination, depending on the ingestion time of CJ.
Interaction of Warfarin With Drugs, Natural Substances, and Foods
TLDR
St. John's wort and possibly some ginseng formulations may have the potential to diminish warfarin anticoagulation, apparently by inducing CYP2C9 activity, but otherwise there is no reliable evidence to indicate that any dietary component (other than vitamin K) or any herbal product has an effect on the antICOagulant response to warFarin.
WARFARIN THERAPY, VITAMIN K AND OTHER DIETARY FACTORS
Warfarin (Coumadin and Marevan) is an extensively used anticoagulant drug used for treatment and prophylaxis of thromboembolic events in conditions such as atrial fibrillation, deep vein thrombosis,
The warfarin–cranberry juice interaction revisited: A systematic in vitro–in vivo evaluation
TLDR
A cranberry juice that inhibited warfarin metabolism in HLM had no effect on war Farfarin clearance in healthy participants, and the lack of an in vitro–in vivo concordance likely reflects the fact that the site of warFarin metabolism (liver) is remote from the sites of exposure to the inhibitory components in the cranberry Juice (intestine).
Potential Interaction Between Pomegranate Juice and Warfarin
TLDR
Clinicians should be aware of the interaction and thoroughly interview and closely monitor their patients who are receiving warfarin and investigate a possible relationship between the patient's subtherapeutic INR and the pomegranate juice.
Elevated International Normalized Ratio after concurrent ingestion of cranberry sauce and warfarin.
  • K. Mergenhagen, O. Sherman
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2008
TLDR
Consumption of cranberry sauce led to an increase in INR values in a patient receiving warfarin, which remained stable over the next month.
Warfarin-Cranberry Juice Interaction
TLDR
This case report describes INR elevations in a patient previously stable on warfarin after ingestion of cranberry juice cocktail daily for several days, which distinguishes this case from other published literature.
Effect of high-dose cranberry juice on the pharmacodynamics of warfarin in patients.
TLDR
Cranberry juice (240 ml twice daily for 1 week) did not alter the pharmacodynamics of warfarin in patients and there was no statistical difference between mean prothrombin time at baseline and any day tested during juice administration.
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