NMN and Blood Thinners: Is It Safe to Take Together? [2026 Guide]

If you're taking blood thinners like warfarin or apixaban, you've probably learned to be cautious about what you put in your body. Every new supplement, even every leafy green, can potentially affect how your medication works.

So when you hear about NMN and its potential benefits for energy and healthy aging, your first question is likely: Can I safely take NMN with my blood thinner?

This is exactly the right question to ask. Let's look at what we currently know about this combination.

What We Know About NMN and Blood Thinners

Here's the honest truth: there are no clinical studies specifically examining the interaction between NMN (Nicotinamide Mononucleotide) and anticoagulant medications like warfarin or apixaban.

This doesn't mean NMN is dangerous with blood thinners. It means we don't have definitive data either way.

What we do know is that NMN works by boosting NAD+ levels in your cells, which influences metabolism and cellular function. Blood thinners work through entirely different pathways, primarily affecting your body's clotting cascade.

Why Caution Is Recommended

Several factors make healthcare providers cautious about this combination:

Blood thinners have a narrow therapeutic window. Medications like warfarin require careful dosing. Too little, and you risk clots. Too much, and you risk bleeding. Any substance that could shift this balance, even slightly, deserves attention.

NMN may influence vascular function. Some research suggests NMN can affect blood vessel health and blood flow. While this could theoretically be beneficial, it also means there's potential for interaction with medications that affect your cardiovascular system.

Related compounds have shown interactions. Niacin (vitamin B3), which is related to NMN in the NAD+ pathway, has documented interactions with warfarin. One case report showed a patient's INR (a measure of blood clotting) jumped dramatically after increasing their niacin dose.

Which Blood Thinners Are We Talking About?

When we say "blood thinners," we're referring to several types of medications:

Vitamin K antagonists: Warfarin is the most common. It works by blocking vitamin K, which your body needs to make clotting factors.

Direct oral anticoagulants (DOACs): These include apixaban, rivaroxaban, and dabigatran. They work by directly blocking specific clotting factors.

Antiplatelet medications: Aspirin and clopidogrel prevent platelets from clumping together.

Each of these works differently, and the potential for interaction with NMN may vary. Warfarin, which is processed by liver enzymes, may have more potential for interaction than DOACs.

What You Should Do Before Taking NMN

If you're on blood thinners and interested in NMN supplementation, follow these steps:

Talk to your doctor first. This isn't just a suggestion. Your prescribing physician needs to know about any supplements you're considering. They can factor this into your monitoring plan.

Don't stop or reduce your blood thinner. The risks of stopping anticoagulation without medical supervision are serious and immediate. Never adjust your medication based on a desire to try supplements.

Start with the lowest dose. If your doctor approves a trial of NMN, begin with a small amount and monitor for any unusual symptoms.

Watch for warning signs. These include unusual bruising, nosebleeds that won't stop, blood in your urine or stool, or bleeding gums. Report any of these to your doctor immediately.

Request more frequent INR monitoring. If you're on warfarin, ask about checking your INR more often when starting any new supplement.

Who Should Definitely Avoid This Combination?

Some people should be particularly cautious:

If you have a history of bleeding complications, the unknown factor of adding NMN may not be worth the risk.

If you're on multiple medications that affect bleeding, adding another variable makes monitoring more complex.

If you have kidney or liver impairment, your body may process both the blood thinner and NMN differently, making interactions harder to predict.

If you're scheduled for surgery, most doctors recommend stopping supplements well in advance. Discuss timing with your surgical team.

The Bottom Line

We can't tell you that NMN is definitively safe or unsafe with blood thinners because the research simply doesn't exist yet. What we can tell you is that caution is warranted.

Many people safely take various supplements while on anticoagulation, but they do so with their doctor's knowledge and appropriate monitoring. NMN should be no different.

Your health is too important to gamble with. Have an honest conversation with your healthcare provider about your interest in NMN supplements, your reasons for wanting to try them, and what a safe monitoring plan might look like.

If your doctor isn't familiar with NMN, you might share that it's a precursor to NAD+, a coenzyme involved in cellular energy production. You can also point them to the growing body of research on NMN safety in healthy adults, while acknowledging that specific data on drug interactions is limited.

For more information about NMN safety research, read our comprehensive guide: Is NMN Safe?

Want to understand more about how NMN works in your body? Our Complete Guide to NMN covers the science in detail.

This article is for informational purposes only and does not constitute medical advice. Always consult with your healthcare provider before starting any new supplement, especially if you take prescription medications.