Can DHA/EPA supplementation be taken while on an anti-coagulant?

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We are not in a position to offer any medical advice in this regard. Individual patients including those on medications should discuss these important questions with their doctor and/or health care provider. A recent report on an elderly patient taking a very dose of omega-3 fatty acids (6000 mg/day) along with heparin (anti-coagulant) + aspirin experienced a subdural hematoma after a fall (Pharmacotherapy, 27:152-160 (2007)). The authors reporting upon this patient advocate judicious caution when using such combinations and the importance of educating such patients as well as health-care providers about the potential bleeding risks associated with such combinations. It can also be pointed out that patients have been on such anti-coagulants as part of their prescribed regimens while enrolled in clinical trials which have suggested beneficial effects of DHA/EPA supplementation of 900 mg/day following a myocardial infarction such as in the GISSI Prevencione trial. The American Heart Association in their dietary guidelines have recommended an intake of 900 mg of DHA/EPA (combined) per day for patients with coronary heart disease; such intakes are similar to those which are commonly consumed in Japan on a daily basis. It remains to be reported whether any potential adverse interactions between omega-3 supplementation and anti-coagulant therapy are encountered in patients consuming the much lower levels of DHA/EPA of 900 mg/day as opposed to the 6000 mg/day intake on the aforementioned case report.