Drug General Information (ID: DDIHI03WL4)
Drug Name			Garlic		Drug Info		Antithrombin III human		Drug Info
Drug Type		Natural product				Protein/peptide
Therapeutic Class		Herbal Products				Recombinant Antithrombin

Mechanism of Garlic-Antithrombin III human Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Garlic				Antithrombin III human
Mechanism		Risk of bleeding Antiplatelet/anticoagulant effects				Risk of bleeding Anticoagulant
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Garlic and Antithrombin III human

Recommended Action
Management		Patients should consult a healthcare provider before taking any herbal or alternative medicine. In general, consumption of garlic supplements and large amounts of garlic should preferably be avoided during use of coagulation-modifying agents. In patients who have used this herb extensively prior to receiving anticoagulation, antiplatelet or thrombolytic therapy, the potential for an interaction should be considered. Close clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References
1	Burnham BE "Garlic as a possible risk for postoperative bleeding." Plast Reconstr Surg 95 (1995): 213. [PMID: 7809259]
2	Legnani C, Frascaro M, Guazzaloca G, Ludovici S, Cesarano G, Coccheri S "Effects of a dried garlic preparation on fibrinolysis and platelet aggregation in healthy subjects." Arzneimittelforschung 43 (1993): 119-22. [PMID: 8457236]
3	Steiner M, Lin RS "Changes in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extract." J Cardiovasc Pharmacol 31 (1998): 904-8. [PMID: 9641475]