Vitamin K and Warfarin interaction

Vitamin K and Warfarin: the Warfarin prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

Curated guidance for Vitamin K

Major

Vitamin K reduces the anticoagulant effect of warfarin; sudden changes in intake from supplements or diet can throw off INR.

From the Warfarin (Warfarin Sodium) label · effective 2026-06-24

Moderate

Polycythemia vera Vasculitis Diabetes mellitus 5.9 Endogenous Factors Affecting INR The following factors may be responsible for increased INR response: diarrhea, hepatic disorders, poor nutritional state, steatorrhea, or vitamin K deficiency.

Warnings and precautionsnames Vitamin KView label on DailyMed
Moderate

The following factors may be responsible for decreased INR response: increased vitamin K intake or hereditary warfarin resistance.

Warnings and precautionsnames Vitamin KView label on DailyMed
Moderate

Pharmacodynamic mechanisms for drug interactions with warfarin sodium are synergism (impaired hemostasis, reduced clotting factor synthesis), competitive antagonism (vitamin K), and alteration of the physiologic control loop for vitamin K metabolism (hereditary resistance).

Drug interactionsnames Vitamin KView label on DailyMed
Minor

The amount of vitamin K in food may affect therapy with warfarin sodium.

Drug interactionsnames Vitamin KView label on DailyMed
Minor

Advise patients taking warfarin sodium to eat a normal, balanced diet maintaining a consistent amount of vitamin K.

Drug interactionsnames Vitamin KView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.