{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:36:44Z","timestamp":1787924204567,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,2,28]],"date-time":"2012-02-28T00:00:00Z","timestamp":1330387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:p><jats:italic>Lycium barbarum<\/jats:italic> (also called goji berry), a Chinese herb used as a supplement for health benefits, is traditionally consumed by the Chinese in the form of a tea. Goji juice, a widely available beverage in the United States, also contains this herb. We describe a 71\u2010year\u2010old Ecuadorean\u2010American woman who was taking warfarin and was hospitalized for a markedly elevated, indeterminate international normalized ratio (<jats:styled-content style=\"fixed-case\">INR<\/jats:styled-content>) (prothrombin time &gt; 120 sec) after consumption of goji juice. She had undergone knee surgery approximately 3\u00a0months earlier at which time warfarin therapy was started. She reported no changes in dietary habits or lifestyle other than drinking goji juice for 4\u00a0days before hospitalization. On presentation to the emergency department, she described symptoms of epistaxis, bruising, and rectal bleeding. After discontinuation of the goji juice and warfarin, the patient was treated with phytonadione, and her <jats:styled-content style=\"fixed-case\">INR<\/jats:styled-content> decreased to 2.6 over 2\u00a0days. Application of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 6) between the patient's elevated <jats:styled-content style=\"fixed-case\">INR<\/jats:styled-content> with associated bleeding and her concomitant use of <jats:italic>L. barbarum<\/jats:italic> and warfarin. Two other published reports have described similar interactions between warfarin and a tea containing <jats:italic>L. barbarum<\/jats:italic>. Patients should be educated about avoiding popular herbal drinks, such as goji juice, that contain <jats:italic>L. barbarum<\/jats:italic> while they are taking warfarin. In addition, clinicians should question patients about their use of herbal therapies and document such use in their medical records before prescribing drugs such as warfarin.<\/jats:p>","DOI":"10.1002\/j.1875-9114.2012.01018.x","type":"journal-article","created":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T03:56:15Z","timestamp":1346817375000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Probable Interaction Between <i>Lycium barbarum<\/i> (Goji) and Warfarin"],"prefix":"10.1002","volume":"32","author":[{"given":"Claudio A.","family":"Rivera","sequence":"first","affiliation":[{"name":"Departments of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol L.","family":"Ferro","sequence":"additional","affiliation":[{"name":"Psychiatry University of Southern California Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Bursua","sequence":"additional","affiliation":[{"name":"the Department of Pharmacy Practice College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben S.","family":"Gerber","sequence":"additional","affiliation":[{"name":"the Institute for Health Research and Policy University of Illinois at Chicago Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,2,28]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-4-200108210-00011"},{"key":"e_1_2_5_3_1","first-page":"1","article-title":"Complementary and alternative medicine use among adults and children: United States, 2007","volume":"12","author":"Barnes PM","year":"2008","journal-title":"Natl Health Stat Report"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200565090-00005"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/57.13.1221"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1186218"},{"key":"e_1_2_5_7_1","first-page":"10","article-title":"Herb\/drug interaction?","volume":"13","author":"Lam AY","year":"2002","journal-title":"CJOM"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fct.2008.01.008"},{"key":"e_1_2_5_9_1","unstructured":"FreeLife International.2011. Available fromhttp:\/\/corporate.freelife.com\/international\/usa\/index.cfm\/home. Accessed September 20 2011."},{"key":"e_1_2_5_10_1","first-page":"259","article-title":"Momordica cochinchinensis, Rosa roxburghii, Wolfberry, and Sea Buckthorn: highly nutritional fruits supported by tradition and science","volume":"3","author":"Burke DS","year":"2005","journal-title":"Curr Top Nutraceutical Res"},{"key":"e_1_2_5_11_1","volume-title":"Essentials of Chinese medicine","author":"Liu Z","year":"2009"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foodres.2011.03.027"},{"key":"e_1_2_5_13_1","unstructured":"Natural Medicines Comprehensive Database. Lycium. Available fromhttp:\/\/naturaldatabase.therapeuticresearch.com. Accessed September 20 2011."},{"key":"e_1_2_5_14_1","first-page":"688","article-title":"Modulation of cytochrome P450 1A2 and 3A4 by Morinda citrifolia (noni), Euterpe oleracea (acai), Lycium barbarum (goji) and Garcinia mangostana (mangosteen)","volume":"23","author":"Eck PO","year":"2009","journal-title":"FASEB J"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.1998.00721.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2006.12.281"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2006.12.719"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fj.1875-9114.2012.01018.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/j.1875-9114.2012.01018.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T10:58:17Z","timestamp":1761044297000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/j.1875-9114.2012.01018.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,28]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,3]]}},"alternative-id":["10.1002\/j.1875-9114.2012.01018.x"],"URL":"https:\/\/doi.org\/10.1002\/j.1875-9114.2012.01018.x","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,28]]},"assertion":[{"value":"2012-02-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}