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Drug interactionGuarana has been found to decrease platelet aggregation and thromboxane synthesis, so it may increase the risk of bleeding when taken with aspirin, anticoagulants such as Warfarin (Coumadin®), and platelet inhibitors such as Ticlopidine (Ticlid®), Clopidogrel (Plavix®).Guarana should not be combined with MAO-inhibitors, and may cause headaches.Sources Baghkhani L and Jafari M. "Cardiovascular adverse reactions associated with Guarana: is there a causal effect?" Journal of Herbal Pharmacotherapy. 2.1 (2002):57-61. Bydlowski SP et al. "A novel property of an aqueous guarana extract (Paullinia cupana): inhibition of platelet aggregation in vitro and in vivo." Brazilian Journal of Medical and Biological Research. 21.3 (1988):535-8. Galduroz JC and Carlini EA. "The effects of long-term administration of guarana on the cognition of normal, elderly volunteers." Sao Paulo Medical Journal. 114.1 (1996):1073-8. Lima WP et al. "Lipid metabolism in trained rats: effect of guarana (Paullinia cupana Mart.) supplementation." Clinical Nutrition. 24.6 (2005):1019-28. Haskell CF et al. "A double-blind, placebo-controlled, multi-dose evaluation of the acute behavioural effects of guarana in humans." Journal of Psychopharmacology. 2006 Mar 13. Nyska A et al. "Acute hemorrhagic myocardial necrosis and sudden death of rats exposed to a combination of ephedrine and caffeine." Toxicological Sciences. 83.2 (2005):388-96.
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