Pomegranate & Warfarin

Publication Date: 
Mon, 06/04/2012
By: Alere Staff

Pomegranate is unique among plants; the only other plant that is closely related is a small tree that grows only on an island in Yemen. It is described in records dating from around 1500 BC in Greek, Hebrew, Buddhist, Islamic, and Christian mythology and writings.

According to the National Institutes of Health, pomegranate is used as an antioxidant, antiviral and antitumor product available as a natural fruit, extract, or dietary supplement. Pomegranate has become a popular choice for consumers looking to improve their health and it is often chosen for a variety of conditions including high cholesterol, triglycerides, osteoarthritis and prostate health.

The manufacturer of Pomegranate juice,POM Wonderful company, shared with PTINR.com the vitamin K content of their product.  An 8 ounce serving contains only 3 micrograms of vitamin K. According to the USDA, there is 14.3 micrograms (mcgs) of vitamin K per ½ cup of raw pomegranate seeds.1

No studies have shown an interaction between pomegranate and warfarin.  However, a case study was reported that showed a patient on warfarin with a stable INR (International Normalized Ratio) upon discontinuing 2-3 servings a week had a decrease in her INR. Using the medical industry standard scale [Drug Interaction Probability Scale] to determine the potential of a drug interaction - pomegranate has been categorized as a “possible” interactive product.2

If you take warfarin, it is recommended you discuss with your doctor before starting or stopping any fruit or vegetable based product or dietary supplement version of the original product, including pomegranate.3 More frequent testing of your INR may be recommended.

Patients who test their INR at home in concert with their doctor or nurse are able to evaluate the effects of food and dietary supplements on INR test results. Home INR monitoring is a covered benefit from Medicare and most private insurance companies.

  1. U.S. Department of Agriculture, Agricultural Research Service. 2004. USDA National Nutrient Database for Standard Reference, Release 17. Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp.

  2. Komperda KE. Potential interaction between pomegranate juice and warfarin. Pharmacotherapy 2009;29: 1002-6.

  3. Bristol-Myers Squibb Company. Medication Guide for Coumadin Tablets and Coumadin for Injection [Package Insert]. Princeton, NJ: Bristol-Myers Squibb Company. 2009.