Herbal Drug Curbicin and Anticoagulation Effect with and without Warfarin: Possibly Related to the Vitamin E Component

Evidence-based drug–herbal interactions

“…Administration of 2 probe medications with saw palmetto at commonly recommended doses to 12 healthy subjects demonstrated that saw palmetto did not effect CYP3A4 activity (Markowitz et al, 2003b). An increase in INR in two male patients taking warfarin was reported (defined as unevaluable) with an herbal product containing saw palmetto, curbicin, and vitamin E (Yue and Jansson, 2001). In one patient, the INR returned to normal upon administration of vitamin K, while the INR stabilized in the other patient once the herbal product was discontinued.…”

Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction

“…Two cases of increased INR were reported after coadministration of curbicin (a preparation containing saw palmetto, pumpkin and vitamin E) [36]; the INR normalized after discontinuation of curbicin. No anticoagulant effect has been found in the literature associated with the two major components of curbicin.…”

Interactions between Herbs and Conventional Drugs: Overview of the Clinical Data

“…Saw palmetto, pumpkin and vitamin E are ingredients of curbicin, a herbal formulation used to relieve symptoms associated with benign prostatic hyperplasia. Two cases of increased INR were reported after co-administration of curbicin and warfarin [135]; the INR normalized after discontinuation of curbicin. No anticoagulant effect has been found in the literature associated with both saw palmetto and pumpkin.…”