Which supplement may increase bleeding risk when taken with NSAIDs?

Which supplement may increase bleeding risk when taken with NSAIDs?

• A. Ginkgo
• B. Kava
• C. St. John's wort
• D. Valerian

Answer: (A)

Some supplements can affect blood clotting, which matters when you’re already taking medicines that influence platelets. Ginkgo biloba has antiplatelet effects: it can inhibit platelet aggregation and prolong bleeding time. NSAIDs also impair platelet function by blocking a pathway that helps platelets clump together. When these are used together, their effects on platelets add up, increasing the risk of bleeding (for example in the stomach or brain). The other supplements listed don’t have as clear or strong a link to increasing bleeding risk with NSAIDs. Kava is mainly noted for sedative and liver effects, not a direct bleeding risk with NSAIDs. St. John’s wort affects drug metabolism and interactions more broadly, but not specifically a bleeding risk with NSAIDs. Valerian is primarily a sedative with fewer bleeding-related interactions. So, the combination of NSAIDs with ginkgo biloba best explains the increased bleeding risk.

Some supplements can affect blood clotting, which matters when you’re already taking medicines that influence platelets. Ginkgo biloba has antiplatelet effects: it can inhibit platelet aggregation and prolong bleeding time. NSAIDs also impair platelet function by blocking a pathway that helps platelets clump together. When these are used together, their effects on platelets add up, increasing the risk of bleeding (for example in the stomach or brain).

The other supplements listed don’t have as clear or strong a link to increasing bleeding risk with NSAIDs. Kava is mainly noted for sedative and liver effects, not a direct bleeding risk with NSAIDs. St. John’s wort affects drug metabolism and interactions more broadly, but not specifically a bleeding risk with NSAIDs. Valerian is primarily a sedative with fewer bleeding-related interactions.

So, the combination of NSAIDs with ginkgo biloba best explains the increased bleeding risk.