Serum conc may be increased by antifungal agents, macrolide antibiotics & omeprazole. Increased conc w/ CYP3A4 or CYP2C19 inhibitors. May potentiate platelet aggregation inhibition of aspirin. Increased bleeding w/ anticoagulants, dasatinib, drotrecogin α, NSAIDs or treprostinil. Decreased levels/effects by CYP3A4 inducers & St. John's wort. Potential inhibition of CYP3A4 w/ grapefruit juice. Avoid alfalfa, anise, bilberry, bladderwrack, bromelain, cat's claw, chamomile, coleus, cordyceps, dong quai, evening primrose oil, fenugreek, feverfew, garlic, ginger,
Ginkgo biloba, ginseng (American, Panax, Siberian), grape seed, green tea, guggul, horse chest nut seed, horse radish, licorice, prickly ash, red clover, reishi, sweet clover, turmeric, white willow, S-adenosylmethionine.
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