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Evidence-Based Complementary and Alternative Medicine
Volume 2015 (2015), Article ID 213927, 7 pages
Research Article

Do Herbal Formulas Influence the International Normalized Ratio of Patients Taking Warfarin? A Retrospective Study

Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, No. 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea

Received 23 December 2014; Accepted 5 February 2015

Academic Editor: Waris Qidwai

Copyright © 2015 Hsu-Yuan Lu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Warfarin is a common anticoagulant agent for cardiovascular diseases, and it is known to interact with several foods and drugs. Several studies report an interaction between warfarin and herbal medicines; however, the influence of herbal medicines on the international normalized ratio (INR) is still controversial. We investigated the influence of herbal formulas on INR of patients taking warfarin. We searched electronic medical records of inpatients for INR results. Then, we compared the changes in INR and any adverse events between the group taking herbal formulas and warfarin (herbal group) and another group taking warfarin only (nonherbal group). Eighty-six patients were included; 45 patients were assigned to the herbal group and 41 patients to the nonherbal group. The herbal group had taken the same dose of warfarin for a longer period. The nonherbal group had a slightly higher mean INR value than the herbal group. The ratio of INR less than 2 and greater than 3, the ratio of INR that increased or decreased by one or more compared to the initial INR, and the ratio of adverse events were not significantly different between the two groups. It is suggested that use of herbal formulas may not influence INR value.